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Where the Patient is Our Primary Concern PATIENT INFORMATION DATE: ___ PATIENT NAME: MR. __MRS. __ MS. __MISS __DR. _____HOME ADDRESS: ___ Street City Zip HOME PHONE: (___) ______ CELL PHONE: (___)
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Patient safety is a primary concern in healthcare.
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The purpose of the report is to track and improve patient safety measures in healthcare settings.
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Information such as incidents, near misses, and quality improvement initiatives must be reported.
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