User:SafePatients

Pennsylvania Patient Safety Authority The Patient Safety Authority was established under Act 13 of 2002, the Medical Care Availability and Reduction of Error ("Mcare") Act, as an independent state agency. It operates under an eleven member Board of Directors, six appointed by the Governor and four appointed by the Senate and House leadership. The eleventh member is a physician appointed by the Governor as Board Chair. The Authority is charged with taking steps to reduce and eliminate medical errors by identifying problems and recommending solutions that promote patient safety in hospitals, ambulatory surgical facilities, birthing centers, and certain abortion facilities. Under Act 13, these facilities must report what the Act defines as "serious events" and "incidents" to the Authority. In turn, the Authority will analyze and evaluate those reports and make recommendations for changes in health care practices and procedures which may be instituted to reduce the number and severity of serious events and incidents in Pennsylvania's healthcare institutions. The Authority's role is non-regulatory and non-punitive and is distinguished from the role of other state agencies involved in regulating and/or licensing health care facilities or individual providers. Consistent with Act 13, the Authority developed the Pennsylvania Patient Safety Reporting System (PA-PSRS, pronounced "PAY-sirs"), a confidential web-based system that both receives and analyzes reports of what the Act calls Serious Events (actual occurrences) and Incidents ("near-misses"). The Authority operates with a dedicated funding stream, called the Patient Safety Trust Fund, which is independent of the General Fund. Moneys in the Trust Fund come from an annual surcharge on licensing fees charged to those medical facilities that are required to report to the Authority. The total annual assessment for those surcharges cannot exceed $5 million, plus the current Consumer Price Index for subsequent years after the first year.

The primary way the Patient Safety Authority communicates with healthcare facilities about the significant trends identified in PA-PSRS reports is through the Patient Safety Advisory, a quarterly research publication with periodic supplements. The Advisory is widely distributed via email and is also available online at the Authority’s web site (www.psa.state.pa.us). Since the first Advisory was issued in March 2004, the Authority has published over 200 articles on a variety of clinical issues. Educational toolkits are an additional resource for the facilities to use for patient safety improvements. Some of the topics for toolkits include: Preventing Wrong-Site Surgery, Verbal Orders; Express Breast Milk; Contrast-Induced Nephropathy; Hospital Bed Safety; Skin Tears; and Color-Coded Wristbands.