EOD Incident Log
Imam Abdulrahman Bin Faisal Hospital · Dammam
Keep entries factual. Do not enter patient names or medical record numbers. Describe the event, not the patient.
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Logged by
Incident date & time
Shift
Day
Evening
Night
Location / department
Emergency Department
ICU
Operating Rooms
Inpatient Wards
Outpatient Clinics
Radiology
Laboratory
Pharmacy
Dialysis
Facility / Building
Parking / Grounds
Hospital-wide
Other
Category
Clinical / Patient safety
Security
Facility / Engineering
Utility failure (power, water, HVAC)
IT / Systems
Staffing
Patient / family complaint
Fire & safety
Medication / supply
Other
Severity
Minor
Moderate
Major
Critical
What happened
Immediate action taken
Status
Open
In progress
Escalated
Resolved
Notified / escalated to
(optional)
Log incident