The Centers for Medicare & Medicaid Services (CMS) has introduced a significant new requirement for hospitals as part of the FY2025 final rule. Hospitals participating in the Hospital Inpatient Quality Reporting (IQR) program are now required to report on the Patient Safety Structural Measure (PSSM), a structured way to assess a hospital’s commitment to patient safety.
This new measure ensures that patient safety is prioritized by emphasizing evidence-based programs aimed at reducing preventable harm.
What is the Patient Safety Structural Measure (PSSM)?
With this rule CMS has chosen a combination of 25 industry best practices, ranging from somewhat common to highly difficult, and upgraded them all to be new standards in patient safety.
They are five each in five domains, each representing a vital aspect of patient safety, with hospitals required to annually attest to their total adherence to evidence-based best practices in each to earn a point each towards a total score to be graded at the end of 2025, and published in 2026. There is no partial credit given for incomplete measures.
The Five Domains of PSSM
- Leadership Commitment to Eliminating Preventable Harm
- Hospital leadership, including senior governing boards, must be accountable for patient safety outcomes. Safety should be integral to strategic, financial, and operational decisions, and leaders must foster a culture that places patient safety at the forefront.
- Strategic Planning and Organizational Policy
- Hospitals must develop strategic plans that highlight patient safety as a core value, set specific safety goals (like “zero preventable harm”), and employ written policies that cultivate a just culture.
- Culture of Safety & Learning Health System
- A hospital must foster a proactive culture of safety that encourages learning and improvement across the entire organization. This requires integrating evidence-based practices, conducting regular safety surveys, and analyzing serious safety events to develop actionable improvements.
- Accountability and Transparency
- Hospitals must promote transparency around patient safety, encouraging the reporting of safety events and ensuring that this information is shared without fear of retribution. Hospitals should have clear communication strategies and systems in place to handle harmful events effectively.
- Patient and Family Engagement
- Engaging patients, families, and caregivers in safety processes is crucial for delivering safer care. Hospitals are encouraged to involve them in safety-related activities and ensure open communication channels are in place for reviewing and addressing safety concerns.
How Does PSSM Work?
Hospitals will report their adherence to the PSSM through the National Healthcare Safety Network (NHSN) platform. Detailed guidelines and additional resources are being developed and will be made available to assist hospitals in evaluating their safety activities across the five domains.
Conclusion
The CMS Patient Safety Structural Measure represents a significant step forward in ensuring that hospitals prioritize patient safety at every level.
PSSM provides hospitals with a guide to improve their safety by concentrating on leadership, strategy, culture, and involvement. The result is an improved capability to provide quality care that protects patients and benefits healthcare providers.
Hospitals can use resources like SafeQual and the PSSM framework together to engineer a safer and swifter healthcare environment. An environment that truly gives weightage to the health of the patients and stops harm as soon as it comes into sight.
