[Date]
Dear [name of patient or representative]
As promised, I am writing to follow up on earlier correspondence regarding your admission at [facility name] on [date], during which time [briefly reference the event, e.g. you sustained a fall with a fracture of the left hip, we implanted the wrong lens in your right eye]. We sincerely regret that this unfortunate event occurred while you were a patient in our [hospital or surgery center].
As we mentioned earlier, this event meets the criteria of a Serious Reportable Event as defined by the Massachusetts Department of Public Health (DPH). In an effort to assist health care providers improve internal practices and patient care, [facility name], as part of a statewide initiative and in accordance with state law, has been closely tracking such events and reporting them to the DPH. Your health insurance company has also been notified. [Note: This line is not used for Medicare patients.]
As part of our commitment to providing our patients with the highest quality care, and in keeping with our organization’s policies and state law, we have conducted an in-depth internal review to determine the nature of the event, review potential changes to our [specify, e.g. surgical, hospital, emergency department] practices, and determine whether this event was preventable.
[Include a brief synopsis of the root cause analysis, preventability determination, and corrective action, if any, taken by the facility.] Enclosed with this letter is a copy of the full report that we filed with DPH.
Our team at [facility name] takes all adverse medical events such as the one you experienced very seriously. We regularly conduct quality reviews to ensure that our services and clinical practices continue to meet the needs and exceed the expectations of our patients and the communities we serve.
Once again, please know that we are very sorry that this event occurred in our [hospital or ambulatory surgery center]. We remain committed to providing you with timely and high quality care. If you have any questions, please contact [appropriate contact, e.g., health care quality team, patient representative, individual] at [direct phone number].
Sincerely,
[Name, Title]