HN Summary

• Unintended harm remains a serious challenge, affecting 1 in 17 hospitalizations—about 153,000 stays each year—highlighting the need for continued system-wide safety improvements.

•  Better reporting is key to safer care, as hospitals with strong safety cultures document more incidents—not because they are less safe, but because transparency drives learning and prevention.

•  National collaboration is strengthening patient safety, with CIHI and Healthcare Excellence Canada providing data, tools, and evidence-based resources to reduce harm and support a culture of continuous improvement.

For the fifth consecutive year, the rate of unintended harm experienced by patients in Canadian hospitals has remained stable at 6%. According to data from the Canadian Institute for Health Information (CIHI), in 2024–2025, patients experienced at least one instance of harm in 1 out of every 17 hospitalizations. This figure represents about 153,000 hospital stays out of a total 2.6 million. And in a quarter of those cases, multiple harmful events occurred.

While rates of unintended harm haven’t worsened, this number highlights the ongoing need for system-wide efforts to make hospitals safer for patients.

Why reporting matters

Measuring patient harm in hospitals isn’t about fault-finding. It’s about strengthening a culture of safety and transparency in Canada’s hospitals. Paradoxically, hospitals with stronger reporting systems may record more harmful incidents — not because they are less safe, but because they are better equipped and more willing to document harm when it happens. This transparency is essential for understanding risks, preventing future incidents, and learning how to reduce the likelihood that harmful events will recur in the future. 

“Measuring patient safety is not an easy endeavour,” says Yana Gurevich, Manager of Health Indicators and Client Support at CIHI. “Mature data systems are needed to capture patient harms. That, and a very strong patient safety culture to report incidents of harm without facing repercussions, so that others can learn from the experience. Canada’s information reporting system is among the best.”

Despite these strengths, under-reporting of hospital harms remains a challenge. “Hospitals are complex places with lots of activity going on,” Gurevich explains. “We need reporting and an elimination of the fear of blame and shame, so that we can continuously be learning and preventing future harms.”

A strong reporting culture not only identifies circumstances where harm is more likely to occur, but also creates opportunities for staff to learn and to implement new practices to improve patient safety.

What does “unintended harm” mean?

CIHI’s Hospital Harm indicator tracks 31 different potentially preventable harms to patients. Of these, a small group of conditions makes up the majority of cases. Two-thirds of harmful events recorded in our most recent analysis are:

• Electrolyte and fluid imbalance

• Urinary tract infections

• Delirium

• Pneumonia

• Aspiration pneumonitis (lung inflammation as a result of inhaling a substance)

•Post-procedural infections

While some harmful events may seem minor, their impact is significant. Patients who experience a harmful event stay in hospital, on average, 5 times longer than those who do not — 28 days compared with 6.

In addition to the impact on patients and their families, unintended harms are costly for Canada’s health care systems. Hospitalizations where a patient experienced unintended harm cost 4 times more — an average of $44,641 per hospital stay, compared with $9,729 for patients who did not experience harm.

A national effort to make hospitals safe

Improving patient safety requires more than measurement alone — it requires a collaborative effort to educate those involved in patient care and to foster a culture of transparency. The Hospital Harm Project is a collaboration between CIHI and Healthcare Excellence Canada (HEC). It links measurement of unintended harms with improvement tools that give hospital executives, clinicians and policy-makers the data and resources they need to prevent patient harm.

HEC’s Hospital Harm Improvement Resource complements the Hospital Harm indicator developed by CIHI. It links measurement and improvement by providing a curated list of evidence-informed practices that will support patient safety improvement efforts. Their suite of resources includes information about the most common types of unintended harm experienced by patients, frameworks and toolkits to support learning from harmful incidents, and general patient safety guides.

Culture, collaboration and continuous learning 

Safer care doesn’t happen by chance. It requires collective responsibility, courageous conversations and systems that make space for every voice. “Whether you deliver care, support a loved one or are navigating the system yourself, your actions matter,” says Denise McCuaig, Executive Director, Healthcare Transformation and Capacity Building, HEC. “By making space for all voices, we can make health care safer for everyone.” 

As Canadian hospitals continue to navigate an aging population, workforce pressures and shifting patient needs, comprehensive data on unintended harm is essential. With stronger reporting systems, shared data, and the right tools, Canadian hospitals can continue moving toward a future where unintended harm becomes far less common — and where every patient receives the safest care possible.