THE number of "clinical incidents" reported by hospital and other NHS trust staff in Gwent almost doubled in two years.
Clinical incidents can be mistakes, misjudgements or accidents by staff, or problems caused by poor organisation or planning.
They can range from major incidents during surgery, to problems with drugs dosages or in moving or lifting patients.
But experts say they do not believe the rise means Gwent Healthcare Trust is now an unsafe organisation.
They instead attribute the increase largely to changes in approach regarding blame and retribution.
More than 13,000 incidents were reported by Gwent Healthcare Trust staff during 2004/05, compared to fewer than 7,000 in 2002/03, and more than 9,000 the following year, according an annual internal risk review.
Forty-five of the 2004/05 incidents were classed as serious, compared with 28 the previous year, though the proportion of serious incidents - three per cent - remained the same.
Much of the increase has been put down to an increasing willingness among staff to report incidents and confidence they can do this without fear of retribution.
"Therefore (the rise) is not necessarily indicative of an unsafe organisation but one that wishes to improve quality of care by learning from its incidents," states the review report, by Kathryn Bourne, the trust's senior risk manager.
New approaches are being adopted across the UK to encourage more reporting.
She said that as lessons were learned and measures drawn up to prevent a repeat, reported figures should level out.
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