Regular reporting of adverse events was institutionalised in 2010, and a Safe Surgery checklist was introduced in the same year. The programme, run by the Ministry of Health and applying to CCSS as well as private facilities, focuses on accrediting health care providers. Accreditation is at a basic level, however, and essentially comprises verification that the facility complies with minimum requirements around staffing levels, equipment and documentation. More ambitious quality monitoring and improvement programmes have been abandoned.