What are Patient Safety Indicators (PSI)?
Patient Safety Indicators (PSIs) are AHRQ quality measures that use ICD-coded hospital inpatient discharge data to flag potentially preventable complications and adverse events — such as pressure ulcers, postoperative respiratory failure, and accidental puncture or laceration. Hospitals and researchers calculate them with AHRQ-supplied software, and CMS uses the PSI-90 composite in hospital quality reporting programs.
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Full name: AHRQ Patient Safety Indicators
Short explanation
The AHRQ Patient Safety Indicators (PSIs) are a set of quality measures developed by the Agency for Healthcare Research and Quality that use hospital inpatient administrative data to identify potentially preventable complications and adverse events associated with hospital care. PSIs are calculated from ICD-coded discharge data using AHRQ-supplied software. Indicators cover complications of surgery, hospital-acquired conditions, and adverse events during hospitalization — including pressure ulcers, postoperative respiratory failure, accidental puncture or laceration, and transfusion reactions. AHRQ maintains PSI technical specifications; CMS incorporates select PSIs into hospital quality reporting programs including the Hospital Inpatient Quality Reporting (IQR) program and Care Compare.
How it’s used
- CMS Care Compare (hospitals): CMS Care Compare hospital quality data includes PSI-based composite measures such as PSI-90 (Patient Safety and Adverse Events Composite), calculated from Medicare claims data.
- Healthcare Cost Report Information System (HCRIS): HCRIS discharge and cost data can be linked to PSI-adjusted quality measures for hospital-level financial and quality analysis.
- CMS QPP MIPS: select PSI-derived measures inform MIPS quality reporting categories for eligible clinicians in hospital settings.
Frequently asked questions
- What are AHRQ Patient Safety Indicators?
- AHRQ PSIs are quality measures that use hospital discharge data to flag potentially preventable complications and safety events during inpatient care — such as surgical complications, falls, and hospital-acquired conditions.
- How are PSIs calculated?
- AHRQ provides free software (QI software) that hospitals and researchers can apply to ICD-10-CM-coded inpatient discharge data to calculate PSI rates at the patient, hospital, or regional level.
- Which PSIs does CMS use in hospital quality programs?
- CMS uses PSI-90 (Patient Safety and Adverse Events Composite) in hospital quality programs, including the Hospital Value-Based Purchasing program and IQR program, as a composite measure of inpatient safety events.