Diane Cousins Agency for Healthcare Research and Quality (AHRQ)

Patient Safety Organizations (PSOs) & Consumer Resources

One of several agencies under the US Department of Health and Human Services, AHRQ focuses on taking evidence-based research to the front lines to improve the quality and safety of health care delivery. Read more below.

One effort managed by AHRQ is the national Patient Safety Organization (PSO) program.   The PSO program is designed as a way to encourage health care providers to report and share information about adverse medical events in an effort to improve the safety of care provided across the nation.

An important aspect of the PSO program is providing federal-based legal and confidentiality protections for participating providers that allow for and encourage open reporting of medical errors.


PSO Case Law: Ungurian v. Beyzman, et al., 2020 PA Super 105:

A recent Pennsylvania case shows how courts narrowly interpret the PSQIA, ignoring the D & A pathway and the clear language of the Final Rule. (Ungurian v. Beyzman, et al., 2020 PA Super 105). The cour

Joint Commission New Sentinel Event Alert 61: Managing the Risks of Direct Oral Anticoagulants:

The Center for Patient Safety wants to share this important harm-prevention advice from The Joint Commission and its Sentinel Event Alert: Managing the Risks of Direct Oral Anticoagulants. The Joint Commis

CPS Safety Watch/Alert – Culture Can Improve the Control of Multi-Drug Resistant Organisms:

Issue: A number of events reported co CPS’ Patient Safety Organization (PSO) demonstrate poor handoff communication about the patients’ infectious disease status Examples include: Patient with

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The Center for Patient Safety believes that collaboration and sharing are the best ways to drive improvement. We strive to provide the right solutions and resources to improve healthcare safety and quality.