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1. Related Office of Inspector General (OIG) Reports | PSO
   pso.ahrq.gov/resources/oig-reports
   October 01, 2024 - Related Office of Inspector General (OIG) Reports The HHS OIG has published … AHRQ is disseminating information related to these reports to increase understanding of adverse events … Adverse and Temporary Harm Events in Long-Term-Care Hospitals Designated in Office of Inspector General Report … Adverse and Temporary Harm Events in Rehabilitation Hospitals Designated in Office of Inspector General Report … https://pso.ahrq.gov/resources/oig-reports   Back to Top

2. Patient Safety and Quality Improvement Act of 2005 | PSO
   pso.ahrq.gov/resources/act
   August 01, 2022 - for Artificial Intelligence (AI) in Healthcare Safety Related Office of Inspector General (OIG) Reports … NAM published its report, entitled "Peer Review of a Report on Strategies to Improve Patient Safety," … The Final Report, "Strategies to Improve Patient Safety: Final Report to Congress Required by the Patient … Access the final report " Strategies to Improve Patient Safety: Final Report to Congress Required by … Access and review the draft report, " Strategies to Improve Patient Safety: Draft Report to Congress

3. Choosing a Patient Safety Organization (pdf file)
   pso.ahrq.gov/sites/default/files/wysiwyg/pso-brochure.pdf
   March 01, 2020 - The Patient Safety Act encourages individual providers and healthcare organizations to voluntarily report … resulted in measurable improvements in patient safety Findings from the September 23, 2019 Final Report … Department of Health and Human Services, OEI-01-17-00420.Findings from the September 23, 2019 Final Report … For example, will the PSO help you set up a Patient Safety Evaluation System to report information … Help Grow the NPSD When considering a PSO, ask if the PSO reports data to the NPSD.

4. Strategies to Improve Patient Safety: Draft Report to Congress for Public Comment and Review by the National Academy of Medicine (pdf file)
   pso.ahrq.gov/sites/default/files/wysiwyg/strategies-to-improve-patient-safety_draft-report.pdf
   December 21, 2021 - The dashboard charts detail reports submitted by Common Formats version by year, completeness of reports … submitted by version, percentage of reports by version, percentage of reports by report type, and percentage … Subsequent reports updated the assessment of some topics in a previous report if new evidence was available … In addition to implementing the Patient Safety Act, CQuIPS manages grant funding for patient safety research … September 2019. https://oig.hhs.gov/oei/reports/oei-01-17-00420.pdf 42 https://oig.hhs.gov/oei/reports

5. Patient Safety and Quality Improvement Act of 2005; Public Law 109–41, July 29, 2005 (pdf file)
   pso.ahrq.gov/sites/default/files/Patient%20Safety%20Act%20PDF.pdf
   January 01, 2025 - —Except as provided in subparagraph (B), the term ‘patient safety work product’ means any data, reports … ‘‘(j) REPORTS ON STRATEGIES TO IMPROVE PATIENT SAFETY.— ‘‘(1) DRAFT REPORT. … The Secretary shall make the draft report available for public comment and submit the draft report to … resulting from such analyses shall be made available to the public and included in the annual quality reports … (2) REPORT.

6. Fedregnotice-05242016 (pdf file)
   pso.ahrq.gov/sites/default/files/wysiwyg/fedregnotice-05242016.pdf
   January 04, 2025 - birthing centers, nursing homes, and other facilities are required by various state laws to submit reports … In Kentucky, hospitals are required to ‘‘establish[], maintain[], and utilize[]’’ administrative reports … , including incident investigation reports, ‘‘to guide the operation, measure productivity, and reflect … Written reports 21 of witness ac- counts of what they observed at the time of a patient incident. … The provider originally prepares the written reports for reporting to the PSO so that the richness of

7. U.S. Department of Health and Human Services Guidance Regarding Patient Safety Organizations' Reporting Obligations and the Patient Safety and Quality Improvement Act of 2005 (pdf file)
   pso.ahrq.gov/sites/default/files/wysiwyg/fda-guidance-pso.pdf
   December 01, 2010 - patient safety work product to the FDA or to an entity required to report to the FDA. … However, the statute does permit providers to report patient safety work product to the FDA or to an … entity required to report to the FDA.” … to the FDA, including where such reports contain PSWP collected or developed by the FDA-regulated reporting … FDCA, including FDA inspection, to ensure FDA-regulated reporting entities are making all required reports

8. Patient Safety Organization: Certification for Initial Listing (pdf file)
   pso.ahrq.gov/sites/default/files/wysiwyg/PSO_InitialListing.pdf
   September 30, 2024 - the entity’s workforce or health care providers holding privileges with the entity) are required to report … the entity’s workforce or health care providers holding privileges with the entity) are required to report … excluded from listing adopts such policies or procedures that would require or induce providers to report … aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports … the entity’s workforce or health care providers holding privileges with the entity) are required to report

9. Patient Safety and Quality Improvement Act of 2005; Public Law 109–41, July 29, 2005 (pdf file)
   pso.ahrq.gov/sites/default/files/wysiwyg/Patient-Safety-Act-2005.pdf
   January 01, 2005 - —Except as provided in subparagraph (B), the term ‘patient safety work product’ means any data, reports … ‘‘(j) REPORTS ON STRATEGIES TO IMPROVE PATIENT SAFETY.— ‘‘(1) DRAFT REPORT. … The Secretary shall make the draft report available for public comment and submit the draft report to … resulting from such analyses shall be made available to the public and included in the annual quality reports … (2) REPORT.

10. Notice of Proposed Rulemaking (February 2008) | PSO
    pso.ahrq.gov/resources/rulemaking
    October 01, 2020 - for Artificial Intelligence (AI) in Healthcare Safety Related Office of Inspector General (OIG) Reports … regulations establish a framework by which hospitals, doctors, and other healthcare providers may voluntarily report

11. Reducing Avoidable Hospital Readmissions: The Role of the Patient Safety Organization (PSO) | PSO
    pso.ahrq.gov/resources/readmission
    August 01, 2022 - for Artificial Intelligence (AI) in Healthcare Safety Related Office of Inspector General (OIG) Reports … Report to the Secretary. … the Secretary, eligible hospitals and patient safety organizations working with those hospitals shall report

12. PSO Common Terms and Acronyms | PSO
    pso.ahrq.gov/resources/acronyms
    August 01, 2021 - for Artificial Intelligence (AI) in Healthcare Safety Related Office of Inspector General (OIG) Reports … The AHRQ Director reports directly to the HHS Secretary. … of Safety – A culture of safety encompasses: a blame‐free environment where individuals are able to report … FDA‐Regulated Reporting Entity – This is an entity that is required by law to report information to … SIR – Summary of Initial Report (SIR) Form; it is one of 3 general forms of AHRQ's Common Formats.

13. Benefits of AHRQ Patient Safety Organizations (PSOs): Success Stories From Hospital PSO Members (pdf file)
    pso.ahrq.gov/sites/default/files/wysiwyg/OnDemand%20Webinar%20Slides%20-%20June%2010%202015.pdf
    January 01, 2010 - (NPSD) • Requires reporting of findings annually in AHRQ’s National Health Quality / Disparities Reports … – such as skilled nursing facility or retail pharmacy ► Resources provided – such as comparative reports … PSO meetings with “Safe Tables” ► PSO Participant Meetings ► PSO Alerts and Watches ► PSO Annual Report … • The PSO analyzes data and reports trends and we now report trends related to near miss events … • Report your events so we can “all teach, all learn” • How to prioritize issues?

14. PSO: Certification of Continued Listing (pdf file)
    pso.ahrq.gov/sites/default/files/wysiwyg/PSO_ContinuedListing.pdf
    September 30, 2024 - the entity’s workforce or health care providers holding privileges with the entity) are required to report … the entity’s workforce or health care providers holding privileges with the entity) are required to report … excluded from listing adopts such policies or procedures that would require or induce providers to report … aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports … scope of parent organization: Off Does parent organization have policies that require providers to report

15. Artificial Intelligence (AI) in Healthcare Safety Program: October 2024 Update (pdf file)
    pso.ahrq.gov/sites/default/files/wysiwyg/ai-healthcare-safety-program.pdf
    July 01, 2025 - A 2019 report by the HHS Office of the Inspector General3 found that hospitals who work with PSOs highly … inability to introduce the protected information in a legal proceeding. 3 https://oig.hhs.gov/oei/reports … hospitals-value.html 5 42 CFR Part 3 6 https://pso.ahrq.gov/pso/listed https://oig.hhs.gov/oei/reports … the data nonidentifiable. 9 Following this process, more than 4.8 million patient safety event reports … This is concerning as pathology reports should always be routed regardless of if the patient is inpatient

16. PSO Program - Common Terms and Acronyms (pdf file)
    pso.ahrq.gov/sites/default/files/wysiwyg/pso-program-acronyms.pdf
    October 01, 2022 - The AHRQ Director reports directly to the HHS Secretary. … of Safety – A culture of safety encompasses: a blame‐free environment where individuals are able to report … be used as the starting point for calculating the successive 24‐ month periods in which a PSO must report … FDA‐Regulated Reporting Entity – This is an entity that is required by law to report information to the … SIR – Summary of Initial Report (SIR) Form; it is one of 3 general forms of AHRQ’s Common Formats.

17. Slide 1 (pdf file)
    pso.ahrq.gov/sites/default/files/wysiwyg/guidance-pswp-provider-obligations.pdf
    May 24, 2016 - medical errors by establishing a system in which health care providers can voluntarily collect and report … Note: A provider should only place information in its PSES if it intends to report that information … any external reporting or recordkeeping obligations — whether they require a provider to — ► report … Records (2) HHS interprets "original provider records" to include: (1) Original records (e.g., reports … Where a variety of information could potentially satisfy an external obligation, and where a provider reports

18. Patient Safety and Quality Improvement Rule (Patient Safety Rule) | PSO
    pso.ahrq.gov/resources/rule
    August 01, 2022 - for Artificial Intelligence (AI) in Healthcare Safety Related Office of Inspector General (OIG) Reports

19. AHRQ Slide Template 2019-Widescreen (pdf file)
    pso.ahrq.gov/sites/default/files/wysiwyg/working-with-pso-webinar-value-hospitals.pdf
    January 01, 2020 - valuable ► 80% found the PSO’s feedback and analysis helped prevent future patient safety events OIG Report … • The PSWP definition includes (but is not limited to): ► Information (any data, reports, records, … define roles at each provider to submit and receive PSWP, confidentiality and privilege, and ‘How to report … Quarterly, comparative analysis reports by region in the PSES (APD rates) 21 Patient Safety Alerts … a culture of reporting to one of performance o Reporting is a must o Utilize the data that you must report

20. Working With a PSO: One Approach (pdf file)
    pso.ahrq.gov/sites/default/files/wysiwyg/WorkingWithAPSOOneApproach-20160317.pdf
    January 01, 2016 - information before it is reported to the PSO and then use it for another purpose (4) ■ Prepare and report … Never report to the PSO, as PSWP, originals of ineligible information.