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What Are Patient Safety Indicators?

August 1, 2023

Quality health care is often described as “doing the right thing, at the right time, in the right way.” However, sometimes patients will experience complications, ranging from common post-surgery problems to those resulting from medical errors. Medical workers and administrators armed with a health administration education use patient safety indicators to measure the rate of recurring medical errors so they can create action plans to prevent these errors from happening in the future. 

What Is Patient Safety? 

Patient safety refers to the efforts of healthcare providers to reduce or prevent harm to patients during treatment. Harm may result from patient medication mix-ups, for example, or errors by members of a surgery team, unsafe surgical care procedures, or unsanitized surfaces that spread infections. Patient safety addresses the need for strategies to keep medical error rates and infection rates as low as possible.

By keeping medical error rates low and ensuring patient safety, hospitals and other healthcare providers instill trust in the healthcare system as a whole. This in turn makes people feel more comfortable seeing doctors when they need to.

Patient Safety Information Systems 

To be able to make meaningful decisions about patients, safety data needs to be collected. That is where patient safety information systems come in. They are systems that help provide an understanding of how serious specific safety issues are in hospitals, in regions, and nationwide. They also provide baseline and trend data to help hospital leaders make informed decisions.

What Are Patient Safety Indicators? 

The federal Agency for Healthcare Research and Quality (AHRQ) is in charge of improving the safety and quality of health care. They research aspects of the nation’s healthcare delivery system and look for ways to improve the quality of care and outcomes. They have improved healthcare access in rural and underserved communities, created tools to rework hospital discharge processes, and helped train healthcare professionals to put research results into action.

To help collect data on patient safety, the AHRQ developed a list of patient safety indicators (PSIs). The 26 PSIs provide ways to measure specific safety-related incidents that occur in hospitals following procedures like operations or childbirth. They help hospitals identify problem areas that can then be addressed.

With free software provided by AHRQ, hospitals, and clinics can analyze their discharge data using the PSIs to identify and improve problem areas. Some of the most common indicators used are patient deaths, infection rates, accidental laceration rates, and other medical errors.

PSIs give hospital management the data to know where they are doing well and where they could improve. This enables them to make decisions about policy changes for their facilities based on real data. 

History of Patient Safety Indicators

In 1999, the Institute of Medicine reported that as many as 98,000 patients died from preventable medical errors in U.S. hospitals each year. After the report was published, it did not take long for Congress to pass a law requiring the AHRQ to monitor and release reports on the quality of patient care across the United States.

As a result, the AHRQ developed the PSIs, with the first iteration being released in 2003. In the 20 years since then, hospitals have gained insight into the root causes of hospital errors, with one focus being on systemic problems that result in errors rather than individual mistakes. When a hospital has poor systems in place, it can lead to miscommunication and loss of information. Once hospital administrators were equipped with this knowledge, many were able to implement system wide solutions.

Over the years, facilities have used PSIs to meet state-mandated requirements for reporting. Others have used the PSIs to set up websites with the data they have collected to create more transparency for their communities. 

Types of Patient Safety Indicators 

Following are some patient safety indicator examples.

PSI 02 — Death Rate in Low-Mortality Diagnostic Related Groups. This PSI measures in-hospital deaths per 1,000 discharges when patients were diagnosed with a condition with a low mortality rate (less than 0.5 percent) and later died.

PSI 03 — Pressure Ulcer Rate. This PSI measures the rate of stage 2 and stage 4 pressure ulcers — or bed sores — per 1,000 discharges among surgical or medical patients 18 years or older. 

PSI 04 — Death Rate Among Surgical Inpatients With Serious Treatable Complications. This PSI measures the rate of deaths per 1,000 surgical discharges when patients were diagnosed with a serious but treatable condition. Some conditions include deep vein thrombosis, pneumonia, and sepsis.

PSI 08 — In-Hospital Fall With Hip Fracture Rate. This PSI measures the rate of hip fractures as a result of a fall per 1,000 discharges. This measurement excludes patients who have been diagnosed with a condition that makes them more susceptible to falling, like seizure disorder, stroke, and cardiac arrest. It also excludes patients with metastatic cancer or other conditions associated with fragile bones.

PSI 17 — Birth Trauma Rate — Injury to Neonate. This PSI measures the rate of trauma injuries per 1,000 newborns. It includes injuries to the spine, face, and femur among many others. It excludes preterm newborns who weigh less than 2,000 grams.

Influence Patient Safety by Becoming a Healthcare Leader 

Patient safety is more important than ever. By using patient safety indicators, hospitals, and healthcare leaders can uncover the data that will allow them to determine where improvements can be made to increase the quality of care for their patients. 

Those looking to take their careers in health care to the next level and become leaders in the field should consider the benefits of pursuing Tulane University’s Online Master of Health Administration degree. Students in the program can gain the education and training they need to make a positive impact through ethical leadership in the healthcare field. 

Learn more about how to become a leader in health care. 

Recommended Readings

The Role of Leadership in Public Health Advocacy

Ethics in Health Care: Improving Patient Outcomes

How to Improve Health Care in Rural Areas


Agency for Healthcare Research and Quality, Case Studies

Agency for Healthcare Research and Quality, A Profile

Association of American Medical Colleges, “20 Years of Patient Safety”

 IGI Global, What Is Patient Safety Information System (PSIS)

The National Academies Press, To Err Is Human: Building a Safer Health System

World Health Organization, Patient Safety