Working with a PSO: Benefits and Privileges

One of the common challenges to achieving this goal is the concern that patient safety information that you or your organization create as part of the care improvement process could also be used against you. The architects of the Patient Safety and Quality Improvement Act of 2005 (PSQIA) understood this challenge and created the PSO as part of that Act.

Lisa Mead, RN, MS, CPHQ
Executive Director, Strategic Radiology
November 8, 2022

By Lisa A. Mead RN, MS, CPHQ

As quality focused health-care professionals, we share a commitment to making health-care safer and better for our patients Working with a federally listed Patient Safety Organization (PSO) can support your quality and safety efforts while providing a unique level of protection and confidentiality for your quality-improvement data.

The Patient Safety Quality Improvement Act of 2005 (PSQIA) encourages individual providers and health-care organizations to voluntarily report quality and patient safety information to PSOs confidentially and without fear of legal discovery. PSOs can help health-care professionals learn from quality and patient safety concerns to prevent similar problems from happening in the future.  

In 2013, Strategic Radiology (SR) formed and listed a Patient Safety Organization through the Agency for Healthcare Research and Quality (AHRQ), part of the U.S, Department of Health and Human Services (HHS). AHRQ administers the PSO certification and listing process but is not involved in the PSOs’ work with providers. Each PSO and its members develop the scope of the work they will do together under the Patient Safety Act. Participating with a federally listed PSO offers significant benefits to healthcare providers. When implemented correctly, providers can utilize PSOs to further support a culture of safety and focus on processes to create sustainable change.

What Are the Benefits?

Working with the SR-PSO is voluntary,  however working collaboratively with members within the SR-PSO offers many advantages that enhance your patient safety and quality improvement activities:

  • Federal confidentiality and privilege protections apply to certain information (defined as “patient safety work product”) developed when a provider works with a PSO. With certain exceptions, patient safety work product is confidential and not subject to Federal, State, or local subpoena or discovery; may not be admitted as evidence in criminal, civil, administrative, or disciplinary proceedings, and is not subject to the Federal Freedom of Information Act or similar State and local laws.
  • PSOs utilize experts who can analyze and aggregate patient safety work product to help develop insights into the underlying causes of patient safety events.
  • PSOs can help you develop successful approaches to improving quality and reducing adverse outcomes. Feedback and recommendations provided by the PSO to the provider also are protected as patient safety work product.
  • PSOs can aggregate and analyze data from each provider and from multiple providers working with that PSO. This aggregation enables the PSO to detect patterns and trends not visible from smaller numbers of organizations.

Choosing a PSO

Healthcare providers (individual clinicians, practices, and organizations) can work with any PSO, or with more than one PSO.  Many organizations may call themselves “patient safety organizations,” but if the PSO is not listed by AHRQ, Federal confidentiality and privilege protections of the Patient Safety Act will not apply.

Some PSOs specialize in a specific area. The SR-PSO focuses solely on radiology care and services.The best way to learn about a PSO is to get in contact with a PSO. Strategic Radiology PSO (SRPSO) members are encouraged to participate in patient safety activities through working in a collaborative learning environment. In turn, SRPSO members are afforded a federal preemption from legal discovery for certain types of information collected and analysis performed. SRPSO members have the opportunity through multiple types of activities to analyze aspects of care delivery that may not otherwise be identified.

A Cultural Committment

Working with a PSO requires a commitment to the quality and safety of patient care.  SR practices typically embrace quality as a culture, with an emphasis on safety, learning, and justice.

While we are in health care to service and improve the care provided to our patients, it is not an easy process or even possible to create an error-free system. The PSQIA has enabled providers to initiate patient safety activities by working with a PSO. This is an opportunity for providers to evoke a confidential and privacy privilege that focuses solely on the safety and quality of the care rendered in their respective organizations.  

PSO participation encourages providers to analyze aspects of care delivery that may not have otherwise been identified or considered. This is an opportunity for providers to evoke a confidential and privacy privilege that focuses solely on the safety and quality of the care rendered in their respective organizations.

SR members can access the SR Quality Manual in the PSO Section of the Member Portal for more details on PSO participation guidelines, metrics, and helpful templates. For current contact information for Federally listed PSOs, visit

Lisa A. Mead RN, MS, CPHQ, is executive director of the SR-PSO and a consultant in the field of radiology quality improvement. She can be contacted at

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