The patient safety and quality improvement act of 2005: Developing an error reporting system to improve patient safety

The Patient Safety and Quality Improvement (PSQI) Act enacted in July 2005 constitutes the basis for significant opportunity to improve patient safety in the health care system by creating a voluntary error reporting system. The PSQI Act creates an unprecedented opening to prospectively prevent injury through analysis of mistakes and close calls that have been voluntarily reported by providers and ensures legal protection for providers who report information about errors and injury to a Patient Safety Organization. This paper provides an overview of the main features of the PSQI legislation, describes essential components of a national patient safety reporting system, discusses what events to report, and identifies what lessons can be learned from aviation safety reporting systems.