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Patient Safety Organizations: Why should we join?

Patient Safety Quality Monthly, October 9, 2008

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In our June issue, we discussed what the Patient Safety Act is and that it called for the establishment of Patient Safety Organizations (PSOs). In this issue, we will discuss the advantages of joining a PSO.

The purpose of the PSO is to provide "new organizations that can work with clinicians and healthcare organizations to identify, analyze, and reduce the risks and hazards associated with patient care."¹

The healthcare industry is rapidly determining how these new entities can fit into the already complex environment of reporting, protection, liability, peer review, disclosure, and Just Culture, to name just a few. Healthcare facilities are challenged with determining how PSOs will best benefit their operations, data and software providers are incorporating PSO features into their existing products, and state and professional organizations are evaluating how best to use PSOs to serve their members.

Although PSOs provide some additional complexity, if they are handled appropriately, they can provide some very valuable benefits.

Benefit of better, easier data management
Healthcare organizations are becoming more and more data driven. Unfortunately the large volume of data often results in large piles of data that are underanalyzed and underused. For example, the large amount of voluntarily reported occurrence/exception data often gets collected, but there seems to rarely be time to effectively analyze or aggregate it. Even worse, the data that are analyzed often don't get you to a clear-cut conclusion. One of the key benefits of PSOs is the ability to provide you with regular, easy-to-use analysis of your occurrence data with a connection to useful, implementable solutions.

Some PSOs will provide data analysts and consultants to work with you to identify, prioritize, and design solutions and needed changes to reduce medical errors.

In addition, organizations rarely have the staff or the time to effectively aggregate and analyze cause analysis data (root cause analyses/apparent cause analyses) or the results of the peer review program. Some PSOs can help you in these areas by getting you to solutions, not just more data.

Benefit of faster improvement using aggregated data
The goal of collecting data about occurrences, causes, and peer review issues is to identify needed change in your organization. If the data does not drive change or verify your present course, it is not very useful. But by the nature of your occurrence/exception data collection systems, you only see your own problems. That means you have to pay the price in your organization to get the learning that drives change. A PSO should provide your organization with information on important risk areas and emerging issues more rapidly. By having access to analyzed, de-identified data from many facilities, you can get better early warnings of important issues—often in time to eliminate the problem in your facility before you have a significant event or loss. Sharing and aggregating data also provides a new set of benchmarks that help you determine where your facility lands within a bigger population. The PSO would provide you with analyzed, aggregated data to help your organization improve faster.

Benefit of solutions-based approach rather than just more data
Good solutions to relevant problems in your organization are tremendously valuable. But more data by itself is one of the last things that an organization wants. No one needs more work to do. Some emerging PSOs´ approach will focus on providing your organization with aggregate data and comparative analysis, and the PSO will work with you to identify solutions and assist with the design and implementation of actions based on the results of the data.

Benefit of additional options for data protection
In addition to the benefits of more rapid improvement in your organizations, the Patient Safety Organization rules provide additional options for protecting and maintaining control of your data. But the implementation of this protection will have effects on other processes in your facility, such as peer review, disclosure, HR, and performance improvement. If your state has weak peer review and protection statutes, this additional benefit may be attractive. The PSO would provide the ability to submit and protect a wide range of data within your facility. In addition, the data submitted to the PSO cannot be released in an identifiable fashion. This allows PSO members to take advantage of the shared data but never weaken their existing protections and, in many cases, increase the level of protection.
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¹Agency for Healthcare Research & Quality (AHRQ) on Patient Safety & Quality Improvement Act of 2005.

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