Patient Safety and Adverse Events Composite Measure

Identifying Attributes

Care Settings
Hospital Care
Country
United States of America
Publishing Organisation
Centers for Medicare & Medicaid Services (CMS): Hospital-Acquired Condition (HAC) Reduction Program, Centers for Medicare & Medicaid Services (CMS): Hospital Value-Based Purchasing (VBP) Program, Agency for Healthcare Research and Quality (AHRQ): Patient Safety Indicators, Centers for Medicare & Medicaid Services (CMS): Hospital Inpatient Quality Reporting Program, Veterans Health Administration (VHA)
Type of Quality Indicator
Outcome
IOM Quality Dimension
Safety
Domain
Complications and Adverse Events

Defining Attributes

Definition

The Patient Safety Indicator (PSI) 90 composite measure captures hospital performance related to the occurrence of 10 preventable adverse events among hospitalised patients.

Numerator

This is a weighted composite measure of Patient Safety Indicators, each of which evaluate pressure ulcer rate, iatrogenic pneumothorax rate, in-hospital fall with hip fracture rate, perioperative haemorrhage and haematoma rate, postoperative respiratory failure rate, perioperative pulmonary embolism and deep vein thrombosis rate, postoperative sepsis rate, postoperative wound dehiscence rate, and unrecognized abdominopelvic accidental puncture/laceration rate.

Denominator

Detailed calculations for this composite measure are reported in the technical specifications.

Exclusions

See technical specifications for each PSI's exclusion criteria.

Use of Risk Adjustment
Yes
Risk Adjustments

See each PSI for risk-adjustment models.

Stratifications

By hospital and state.

Collection and Reporting Attributes

Type of Data Collection
Administrative data
Data Collection Methods

Medicare fee-for-service (FFS) discharges and Medicare beneficiary enrolment data

Frequency of Data Collection
Annually
Frequency of Data Collection in Days
365
Reporting Methods

HAC Reduction Program data is displayed at data.cms.gov

Reporting Frequency
Annually
Reporting Frequency in Days
365
Indicator Has Recommended Targets
No

Source and Reference Attributes

Technical Specifications
Link to Measurement Tools
Quality Indicator Confirmed to be Part of a Program Used to Monitor Quality and Safety of Care Among Older People at a Population-Level between 2012-2022
Yes
Assessed by the Australian Consortium for Aged Care Collaborators as Generally Containing Good Properties (Importance and Scientific Acceptability)
Yes
Australian Consortium for Aged Care Endorsed
No
Can the Quality Indicator be Readily Implemented at a Population Level in Australia Given its Current Data Landscape?
Yes. Data exists, with high coverage.
Identified by PHARMA-Care Project
No
Upload Date
31 March 2026