A Comprehensive Approach to Reducing Patient Safety Indicators (PSI-90)

Area of Science:

• Healthcare Quality Improvement
• Patient Safety Research
• Hospital Administration

Background:

• The Patient Safety Indicator 90 (PSI-90) measures hospital care quality, impacting financial performance through the Hospital-Acquired Condition Reduction Program (HACRP).
• HACRP incentivizes hospitals to improve quality by linking performance on measures like PSI-90 to financial penalties for underperforming facilities.

Purpose of the Study:

• To systematically evaluate Patient Safety Indicator (PSI) events within a hospital setting.
• To develop and implement effective workflows for accurate clinical documentation.
• To enhance interdisciplinary collaboration to ultimately reduce the incidence of PSI events.

Main Methods:

• Appointed dedicated roles: a PSI nurse reviewer and a quality physician advisor.
• Ensured strong engagement and support from executive leadership.
• Integrated computer-assisted coding technology to streamline documentation processes.
• Fostered teamwork among Clinical Documentation Improvement (CDI), coding, and Health Information Management (HIM) departments.

Main Results:

• Achieved a significant 45% reduction in overall PSI events.
• Estimated cost avoidance of $1.4 million attributed to the reduction in PSI events.
• Successfully exempted the hospital from potential HACRP penalties due to improved performance.

Conclusions:

• Demonstrated the critical role of interdepartmental collaboration, robust leadership backing, and data-driven strategies in reducing PSI events.
• Highlighted the positive impact of a dedicated surgical quality officer in enhancing patient safety outcomes.
• Emphasized the alignment of these quality improvement initiatives with established recommendations from organizations like the American College of Surgeons (ACS).