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Dear Editor-in-Chief
Establishing patient safety reporting systems is an important step for improving patient safety. Using such systems, healthcare organizations can collect, analyze, and share information about patient safe- ty (1, 2). A variety of incidents including adverse events, near misses, and medical errors may be considered reportable (2); however, there are some controversies about near misses. Additional- ly, this concept has been defined differently.
WHO defines a near miss as "an error that has the potential to cause an adverse event (patient harm) but fails to do so because of chance or because it is intercepted" (2). According to the Institute of Medicine, a near miss is "an act of commission or omission that could have harmed the patient but did not cause harm as a result of chance, preven- tion, or mitigation" (1). "An error caught before reaching the patient" is another definition (3). I have reviewed more than 20 definitions; there is a general consensus that this concept should be used for indicating a type of incident that has the potential to result in harm but finally fails to cause harm. However, there are some serious controver- sies in details. Some definitions had an emphasis that a near miss is an incident that did not reach the patient at all because it was intercepted before reaching the patient; however, others emphasized that a near miss may reach to the patient but does not cause harm. Therefore, some researchers have focused on the interception of an error and others...