Patient Safety Authority

12/23/2025

We know how busy you are, so in case you missed them, we want to elevate these recent data and research articles, quality improvement studies, and important safety updates from Patient Safety. Please take a moment to read and share them within your social circles.

In case you missed them, we want to highlight these recent data and research articles, quality improvement studies, and important safety updates from the journal.

12/19/2025

Some healthcare facilities have limited experience conducting patient safety surveys or translating the results into actionable improvements. Targeted and effective interventions are difficult to establish without a thorough understanding of how the survey informs patient safety.

In this recorded webinar, Matthew McCambridge, MD, MS; Oren Guttman, MD, MBA; Ruchi O'Reilly, MSN, RN; and Gwenis Browning, DNP, RN, described how to identify the culture of safety survey’s roles and limitations, explore practical applications, and relate the survey’s future direction to leveraging safety.

Watch now and subscribe to PSA's YouTube channel to be notified of new videos:

Some healthcare facilities have limited experience conducting patient safety surveys or translating the results into actionable improvements. Targeted and ef...

12/16/2025

This Thursday, join Isabel DeOliveira, compliance assistance specialist and coordinator at the Philadelphia Regional Office of the Occupational Safety and Health Administration (OSHA), for a must-attend webinar tailored for ambulatory care professionals: “Safeguarding Your Workplace: Navigating Key OSHA Laws for Healthcare.”

In this practical and informative session, participants will review OSHA regulations in ambulatory care centers, including the top citations affecting healthcare settings; understand employer responsibilities and worker rights under OSHA standards; and explore OSHA compliance resources to strengthen workplace safety programs.

This webinar is intended for healthcare administrators, patient safety officers, human resources professionals, and clinical leaders who are committed to maintaining a safe and compliant workplace.

Don’t wait—gain practical strategies straight from an OSHA expert and take your workplace safety to the next level!

1.50 continuing education hours will be awarded for completion of this course. Continuing education credits apply to Pennsylvania registered nurses only.

There's still time to register: 8a741a62-4e65-41e0-98f0-d01df8ba775a@418e2841-0128-4dd5-9b6c-47fc5a9a1bde" rel="ugc" target="_blank">https://events.gcc.teams.microsoft.com/event/8a741a62-4e65-41e0-98f0-d01df8ba775a@418e2841-0128-4dd5-9b6c-47fc5a9a1bde

12/10/2025

PSA Director of Data Science & Research Becky Jones recently spoke with Betsy Lehman Center for Patient Safety's PATIENT SAFETY BEAT about the value of collecting data about events, incidents, and near misses, as well as how AI is being used to analyze this data and the potential impact of this emerging technology on patient safety and event reporting.

"For example, we recently conducted research on falls that occur on the day of discharge," Jones says. "Having reports of both incidents and serious events allowed us to uncover a threat that had not been identified in any previous research."

Read, watch, and share the interview at

The Betsy Lehman Center is a state agency that uses communications and research working toward safer health care in Massachusetts.

11/25/2025

𝗪𝗲'𝗿𝗲 𝗴𝗶𝘃𝗶𝗻𝗴 𝘆𝗼𝘂 𝗼𝗻𝗲 𝗺𝗼𝗿𝗲 𝘄𝗲𝗲𝗸 𝘁𝗼 𝘀𝘂𝗯𝗺𝗶𝘁 𝘆𝗼𝘂𝗿 𝗲𝗻𝘁𝗿𝘆 𝗳𝗼𝗿 𝘁𝗵𝗲 𝗜 𝗔𝗠 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗦𝗮𝗳𝗲𝘁𝘆 𝟮𝟬𝟮𝟲 𝗰𝗼𝗻𝘁𝗲𝘀𝘁!

The nomination period now ends at 11:59 p.m. EST on Sunday, November 30, 2025.

Don't delay! This is 𝘳𝘦𝘢𝘭𝘭𝘺 your last chance to recognize an individual or a team for their extraordinary accomplishments by nominating them for an IAPS award in Ambulatory Care, Commitment to Safety, Healthcare Disparity, Improving Diagnosis, Individual Impact, Medication Safety, Patient Communication, Safety Story, or Transparency and Safety.

𝗡𝗼𝘁𝗲: 𝗜𝗳 𝘆𝗼𝘂'𝘃𝗲 𝗮𝗹𝗿𝗲𝗮𝗱𝘆 𝘀𝘁𝗮𝗿𝘁𝗲𝗱 𝗮 𝗻𝗼𝗺𝗶𝗻𝗮𝘁𝗶𝗼𝗻 𝗲𝗻𝘁𝗿𝘆, 𝗽𝗹𝗲𝗮𝘀𝗲 𝗹𝗼𝗴 𝗯𝗮𝗰𝗸 𝗶𝗻𝘁𝗼 𝘁𝗵𝗲 𝘀𝘂𝗯𝗺𝗶𝘀𝘀𝗶𝗼𝗻 𝗽𝗼𝗿𝘁𝗮𝗹, 𝗰𝗼𝗺𝗽𝗹𝗲𝘁𝗲 𝘆𝗼𝘂𝗿 𝗲𝗻𝘁𝗿𝘆, 𝗮𝗻𝗱 𝗽𝗿𝗲𝘀𝘀 𝗦𝘂𝗯𝗺𝗶𝘁: https://webportalapp.com/sp/login/iaps-2026-submissions

Thank you! We look forward to reading, sharing, and celebrating the inspiring stories of your patient safety champions.

11/20/2025

TOMORROW is the deadline for submitting nominations for the 𝟮𝟬𝟮𝟲 𝗜 𝗔𝗠 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗦𝗮𝗳𝗲𝘁𝘆 𝗔𝗰𝗵𝗶𝗲𝘃𝗲𝗺𝗲𝗻𝘁 𝗔𝘄𝗮𝗿𝗱𝘀. Thinking of nominating someone for the 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗖𝗼𝗺𝗺𝘂𝗻𝗶𝗰𝗮𝘁𝗶𝗼𝗻 𝗔𝘄𝗮𝗿𝗱? Read about last year’s winner below, and get your entry for this year's contest in by Friday, November 21, at https://patientsafety.pa.gov/NewsAndInformation/Brochures/Pages/2026-i-am-patient-safety.aspx.

Lisa Kolodziejski, orthopedic nurse navigator at UPMC St. Margaret, expanded not only access to presurgical classes for total joint replacement patients by offering them online and in evenings, but also the content of the classes. She incorporated a dietician, physical therapist, and occupational therapist in lessons to instruct patients on best practices before and after surgery for better healing and recovery. She also visits overnight patients after surgery to encourage them towards discharge and reinforce education, which continues through phone calls following discharge. Through these advances and additional efforts with the geriatric fracture program and community outreach, she has been helping reduce harm and improve outcomes.

11/19/2025

𝗧𝗵𝗲 𝗜 𝗔𝗠 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗦𝗮𝗳𝗲𝘁𝘆 𝗻𝗼𝗺𝗶𝗻𝗮𝘁𝗶𝗼𝗻 𝗽𝗲𝗿𝗶𝗼𝗱 𝗲𝗻𝗱𝘀 𝘁𝗵𝗶𝘀 𝗙𝗿𝗶𝗱𝗮𝘆! If you've already started your nomination, please log back into the submission portal and finish it. You must hit Submit on your entry by 11:59 p.m. EST on November 21. https://webportalapp.com/sp/login/iaps-2026-submissions

11/19/2025

The CDC’s theme for U.S. Antibiotic Awareness Week ( ), November 18–24, is “Fighting Antimicrobial Resistance Takes All of Us.” The daily theme for November 19, 2025, is human health and antimicrobial resistance.

It’s vital for healthcare providers and patients alike to understand how and when to use antibiotic and antifungal drugs to treat and prevent illnesses. They are effective tools for managing infections, but any use can cause side effects and contribute to antimicrobial resistance (when bacteria and fungi develop the ability to survive drugs designed to kill them). We can slow this resistance through stewardship—using antibiotics and antifungals appropriately, only to treat the germs that respond to them—as well as by staying well and preventing infection in the first place, with actions such as handwashing, vaccination, being engaged in your health, and staying informed about risks of illness.

Read and share these articles from PATIENT SAFETY highlighting information and antibiotic stewardship strategies for hospitals, long-term care facilities, and patients:

U.S. Antibiotic Awareness Week is observed from Nov. 18 to 24, highlighting the importance of antimicrobial stewardship in preventing antimicrobial resistance to protect people and our world.

11/19/2025

Time’s running out! The 𝟮𝟬𝟮𝟲 𝗜 𝗔𝗠 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗦𝗮𝗳𝗲𝘁𝘆 𝗔𝗰𝗵𝗶𝗲𝘃𝗲𝗺𝗲𝗻𝘁 𝗔𝘄𝗮𝗿𝗱𝘀 nomination period ends in TWO DAYS. Thinking of nominating someone for the 𝗠𝗲𝗱𝗶𝗰𝗮𝘁𝗶𝗼𝗻 𝗦𝗮𝗳𝗲𝘁𝘆 𝗔𝘄𝗮𝗿𝗱? Read about last year’s winner below, and get your entry for this year's contest in by Friday, November 21, at https://patientsafety.pa.gov/NewsAndInformation/Brochures/Pages/2026-i-am-patient-safety.aspx.

Christine Zdaniewski, a clinical pharmacy specialist at UPMC Hamot, reported 16 medication-related events in 2024, with 10 being good catches or pharmacy interventions that had significant patient impact. In her work she demonstrates commitment to collaboration, communication, and education; for example, after reporting a medication event involving low-dose ketamine administration for pain, she partnered with the ordering physician and his team to develop educational materials for pharmacy and nursing.

11/18/2025

You only have a few more days to submit your entries for the 𝟮𝟬𝟮𝟲 𝗜 𝗔𝗠 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗦𝗮𝗳𝗲𝘁𝘆 𝗔𝗰𝗵𝗶𝗲𝘃𝗲𝗺𝗲𝗻𝘁 𝗔𝘄𝗮𝗿𝗱𝘀 contest! Thinking of nominating someone for the 𝗜𝗻𝗱𝗶𝘃𝗶𝗱𝘂𝗮𝗹 𝗜𝗺𝗽𝗮𝗰𝘁 𝗔𝘄𝗮𝗿𝗱? Read about last year’s winner below, and get your entry for this year's contest in by Friday, November 21, at https://patientsafety.pa.gov/NewsAndInformation/Brochures/Pages/2026-i-am-patient-safety.aspx.

Andrea Colfer has been a driving force for innovation at Children’s Hospital of Philadelphia, from proposing an enterprisewide refresh of major event analysis to creating a book club to spark conversation around patient safety. In her role and beyond, she always advocates for including the voice of the patient or family as the team considers any harm and gives every event review careful thought and attention.

11/17/2025

The nomination period for the 𝟮𝟬𝟮𝟲 𝗜 𝗔𝗠 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗦𝗮𝗳𝗲𝘁𝘆 𝗔𝗰𝗵𝗶𝗲𝘃𝗲𝗺𝗲𝗻𝘁 𝗔𝘄𝗮𝗿𝗱𝘀 contest closes this Friday! Thinking of nominating someone for the 𝗜𝗺𝗽𝗿𝗼𝘃𝗶𝗻𝗴 𝗗𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀 𝗔𝘄𝗮𝗿𝗱? Read about last year’s winner below, and submit your entry for this year's contest by November 21 at https://patientsafety.pa.gov/NewsAndInformation/Brochures/Pages/2026-i-am-patient-safety.aspx.

The Penn Medicine Enterprise High Sensitivity Troponin Implementation Team developed chest pain algorithms to reduce the risks associated with the use of high-sensitivity cardiac troponin assays (hs-cTn), such as diagnostic errors, inappropriate admissions, and rise in cardiology consultations and unnecessary imaging. Implemented across five participating hospitals, the initiative generated over $3.9 million in savings within 10 months by reducing length of stay, enhancing patient throughput, and increasing ED capacity.

11/16/2025

The nomination period for the 𝟮𝟬𝟮𝟲 𝗜 𝗔𝗠 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗦𝗮𝗳𝗲𝘁𝘆 𝗔𝗰𝗵𝗶𝗲𝘃𝗲𝗺𝗲𝗻𝘁 𝗔𝘄𝗮𝗿𝗱𝘀 contest closes in one week! Thinking of nominating someone for the 𝗧𝗿𝗮𝗻𝘀𝗽𝗮𝗿𝗲𝗻𝗰𝘆 𝗮𝗻𝗱 𝗦𝗮𝗳𝗲𝘁𝘆 𝗶𝗻 𝗛𝗲𝗮𝗹𝘁𝗵𝗰𝗮𝗿𝗲 𝗔𝘄𝗮𝗿𝗱? Read about last year’s winner below, and submit your entry for this year's contest by Friday, November 21, at https://patientsafety.pa.gov/NewsAndInformation/Brochures/Pages/2026-i-am-patient-safety.aspx.

The nurses at the Crozer Endoscopy Center at Brinton Lake implemented an action plan to complete risk event reports for multiple events that were not captured previously due to lack of knowledge or other reasons, as well as to encourage event reporting. After providing education and posting a list of possible events at every nurse's station, the number of event types being reported increased, as did the numbers of event reports and nurses reporting. The nurses now feel safe in being transparent in event reporting.