Hotline indicators
Hotline indicators are serious safety incidents that must be reported in accordance with the organisation's practices and that should result in a serious safety incident investigation.
Hotline indicators in an Excel file (latest update 2 April 2025).
Introductory presentation for introducing the tool to its users: Hotline indicator introductory presentation.
The hotline indicator list is based on the international Never Events list. However, it is not identical with the Never Events list, as the hotline indicator list has been modified to better reflect the needs of both social welfare and healthcare.
Serious safety incidents
Serious safety incidents are events that seriously endanger the safety of a client or patient. They can also affect a large number of clients or patients.
A serious safety incidents may be a harmful incident that causes serious or significant permanent harm, or a near miss that could have affected such harm.
Serious harm is typically defined as one of the following:
- death or risk of death
- beginning or continuing hospital care
- permanent or significant injury
- disability or incapacity (Ministry of Social Affairs and Health, 2023)
In social welfare, serious safety incidents are unlawful events regulated due to their likely or possible consequences including serious danger or harm in the context of social welfare client safety.
Investigation of serious safety incidents
Serious safety incidents should always be reported in accordance with the guidelines of the organisation, and corrective and preventive measures should be immediately started.
In these events, client or patient safety has been seriously endangered. Because of this, they should be investigated systematically and thoroughly so that lessons can be learned from the event, and similar events can be prevented in the future.
For these purposes, organisations must have sufficient resources, expertise and defined procedures for the investigation. The Ministry of Social Affairs and Health has published a guide for the investigation of serious safety events for social welfare and healthcare organisations, which describes one way of performing an investigation.
Background of hotline indicators
The term “Never Event” was officially coined in 2001 by the National Quality Forum (NQF) in the United States. Its goal was to use the list to promote patient safety and prevent serious avoidable medical errors.
Since 2009, the NHS service in the United Kingdom has developed its own Never Event list. It has also been regularly updated – most recently in 2021.
Both the NQH and NHS lists focus solely on the healthcare context and therefore the development of patient safety. The hotline indicators used in Finland also include social welfare.
The Finnish hotline indicators were first published in 2021 as part of the patient and client safety publication Potilas- ja asiakasturvallisuuden tilannekuva ja seurantamenettelyt. Of the 19 indicators identified, 14 were based on the Never Events defined by the NHS.
The hotline indicators were updated for the first time in 2023.
How was the update in 2025 carried out?
The update needs were assessed in autumn 2024 based on a survey conducted with the Finnish Centre for Client and Patient Safety specialist network. The survey also generated some development proposals for updating the structure and the indicators themselves. Additionally, the update work made use of the views of various specialists. After the update work, the indicators were also submitted for comments in early 2025.
Previously, the hotline indicators were divided into specialised healthcare, general healthcare and social welfare indicators. As part of the update, the categorisation was changed so that the division was between healthcare and social welfare, because it better reflects the current Finnish service system.
Additionally, new indicators applicable to both social welfare and healthcare were added, in order to better serve organisations’ development of client and patient safety. Some changes were made to the wording of existing indicators.
Additional information
Ministry of Social Affairs and Health 2023. Vakavien vaaratapahtumien tutkinta – Opas sosiaali- ja terveydenhuollon organisaatioille
In the future, the indicator update needs will be reviewed every two years.
Publication data
The Finnish hotline indicators were first published in 2021 as part of the patient and client safety publication Potilas- ja asiakasturvallisuuden tilannekuva ja seurantamenettelyt.
The first update was made in 2023.
Latest update 2 April 2025