Health and disability service providers are accountable for ensuring the systems they implement recognise the various degrees and types of harm (physical, psychological, cultural or spiritual) and meet national expectations for reporting, healing, learning and improving.
Recognising and reporting harm
Submit an event
Report a harm (adverse) event to Health Quality & Safety Commission Te Tāhū Hauora
Event of harm review tool
Use this review tool to support the development of learning reports following events of harm.
Access the event of harm review tool
Severity Assessment Code (SAC) rating and process tool
Visual guides for recognising, reviewing and reporting harm using Severity Assessment Code (SAC) criteria.
SAC example guides
Sector specific example guides for rating and reviewing consumer harm that occurs within an organisation. The guides are co-designed with the sector and are not exhaustive lists.
Always Report and Review list
A list of events that hospital specialist services should report and review, regardless of whether the consumer experienced harm.
Read the always report and review list
Overview of mental health and addiction adverse event review methods
An overview to help clinicians understand various methodologies for reviewing an event.
Learning and improvement resources
Healing, learning and improving from harm: National adverse events policy 2023 User Guide
This guide summarises the principles and processes of the 2023 policy and includes frequently asked questions.
Read the user guide Healing, learning and improving from harm: National adverse events policy 2023
Guide to doing a learning review
This guide helps health and disability providers to review harm by applying the learning review method.
Read the learning review guide here
Learning review template
Use this optional template to complete a review using the learning review method.
View the learning review template
Falls and pressure injuries templates
Optional templates to assist with reviews of pressure injuries or falls.
View the pressure injury review template
View the falls review template
Terms of reference template
Use this optional template to prepare terms of reference for a review.
View the learning from harms terms of reference template
Implementation assessment tool
This assessment tool is a maturity assessment checklist to support health and disability providers to evaluate operational processes and a completed review of harm to see where the gaps are in meeting the criteria within the policy.
Analysis and implementation tools
Systems Engineering Initiative for Patient Safety(SEIPS) Human Factors tool
SEIPS is a sociotechnical human factors model that assists people to illustrate the following components:
- the work system, processes and outcomes
- key characteristics or factors of each
- how the components affect one another
SEIPS can be used as a systems analysis and problem-solving tool.
Adverse events national quarterly dashboard
Our quarterly dashboard is an interactive tool for exploring a national summary of adverse events data.
Compliance and legal obligations
WorkSafe’s approach to the health care and social assistance sector
Worksafe's regulatory and expectations of PCBUs (persons conducting a business or undertaking) in the health care and social assistance sector.
Privacy legislation and assessments
Information on the Privacy Act 2020 and the privacy principles.
Published: 20 Jun 2023
Modified: 26 Jan 2026
