PSO PSES PSWP - Patient Safety · JD, MBA, CPHRM PROJECT MANAGER CENTER FOR PATIENT SAFETY. ... maintained (a flowchart of your processes is helpful) Your committee structure where
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PSO? PSES? PSWP? You Have Questions, We Have Answers
PSOs can aggregate data from many providers to identify risk patterns of care and system failure
Healthcare providers can be comfortable confidentially reporting medical errors, near misses and unsafe conditions with federal protection from disclosure
Providers can work together in a confidential, protected space to share and learn how to prevent mistakes, and,
Participating providers are assured that their safety work will not be used against them.
“patient safety events should be reported through the protected environment of federally designated patient safety organization s (PSOs)”
Potential language in future meaningful use regulations
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National Interest
Institute of Medicine, Health IT and Patient Safety, Building Safer Systems for Better Care, 2012
The CMS Partnership for Patients – Focus on Reducing Harm
The Joint Commission, “Improving Patient and Worker Safety” 2012
National Association for Healthcare Quality (NAHQ) Call to Action, October 2012
Office of the Inspector General (OIG) – Recommendations to CMS
Centers for Medicare & Medicaid Services (CMS), Quality Assurance and Performance Improvement (QAPI) Conditions of Participation (COPs)
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Two Provisions Related to PSOs and Hospitals:
PSO’s to assist high-need hospitals in reducing readmissions (Section 3025)
Beginning January 2015, “A Qualified Health Plan may contract with: (A)A hospital >50 beds only if the hospital utilizes a Patient
Safety Evaluation System; and the hospital implements a mechanism to ensure that each patient receives a comprehensive program for hospital discharges (meeting certain criteria) OR
(B)A health care provider only if the provider implements quality mechanisms required by HHS” (Section 1311(h))
Patient Protection and Affordable Care Act (PPACA)
Implications of PPACA, SEC. 1311
Qualified Health Plans operating through the new Health Insurance Exchanges (HIEs) can only contract with hospitals > 50 beds that have a patient safety evaluation system (PSES)
A hospital that utilizes a PSES works with a PSO
Enormous incentive for hospitals to work with a PSO no later than January 1, 2015
PSOs are prepared to work with additional hospitals to help them comply with this provision
reproduced without consent of the Center for Patient Safety.
Patient Safety Evaluation System (PSES)
A PSES is The means, mechanisms or systems your organization uses to collect, manage, analyze and communicate information for quality and safety improvement and for reporting to the PSO
reproduced without consent of the Center for Patient Safety.
Patient Safety Evaluation System (PSES)
Patient Safety Evaluation System (PSES)
Your PSES may contain
information about events, errors, near-misses, quality improvement data, and other patient safety and quality data and information that is developed, investigated, examined, and analyzed by and for your PSES workgroup
Identify and assess current event reporting systems and information flow for patient safety and quality improvement activities, considering:
Your incident reporting system, including how patient safety events are identified, reported and managed through risk management/ patient safety/quality improvement/customer services/peer review and credentialing processes
How this data is shared, processed, documented and maintained (a flowchart of your processes is helpful)
Your committee structure where patient safety and quality data and information are discussed/shared
reproduced without consent of the Center for Patient Safety.
Getting Started
Ask…
Can my organization benefit from
− Learning from others about causes of medical mistakes and near misses and how to prevent them?
− Obtaining federal legal and confidentiality protections to supplement peer review and attorney-client privileges for quality and safety improvement work?
What type of PSO would best meet my organization’s needs?