Patient Safety Indicators

What Are Patient Safety Indicators?

Patient Safety Indicators (PSIs) are a set of measures developed by the Agency for Healthcare Research and Quality (AHRQ) to identify potentially preventable adverse events using administrative claims data. PSIs help hospitals monitor and improve patient safety performance.

AHRQ PSIs

Examples of AHRQ PSIs include postoperative pulmonary embolism or deep vein thrombosis, accidental puncture or laceration, and pressure ulcer rates. Because PSIs rely on coded data, accurate and complete documentation and coding are essential for valid measurement.

Never Events

Never events are serious, largely preventable, and often shocking medical errors, such as surgery performed on the wrong body part or a retained surgical item. The National Quality Forum maintains a list of never events, and many payers, including Medicare, will not reimburse for care associated with them.

Hospital-Acquired Conditions

Hospital-Acquired Conditions (HACs) are conditions that develop during a hospital stay that were not present on admission, such as certain infections or falls resulting in injury. Under the CMS HAC-Present on Admission program, hospitals do not receive additional payment for treating a HAC that could reasonably have been prevented.

Safety Culture Assessment

Tools such as the AHRQ Hospital Survey on Patient Safety Culture assess staff perceptions of safety practices, teamwork, and communication, helping organizations identify cultural barriers to reporting and improvement.

Reporting Systems

Robust internal incident reporting systems, combined with a non-punitive just culture, encourage staff to report near misses and errors, providing the data needed to drive meaningful safety improvements.

Exam Tip

Know that Present on Admission (POA) indicator coding directly affects HAC payment determinations.

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