PSI-90: Patient Safety and Adverse Events Composite
PSI-90 is the AHRQ composite of 10 patient safety indicators used by CMS in the Hospital-Acquired Condition Reduction Program. Bottom-quartile hospitals lose 1% of all Medicare DRG payments — typically $200K-$2M+ depending on hospital size.
The 10 PSIs in PSI-90
PSI-90 weights and combines: PSI 03 (Pressure Ulcer), PSI 06 (Iatrogenic Pneumothorax), PSI 08 (In-Hospital Fall with Hip Fracture), PSI 09 (Perioperative Hemorrhage or Hematoma), PSI 10 (Postoperative Acute Kidney Injury), PSI 11 (Postoperative Respiratory Failure), PSI 12 (Perioperative Pulmonary Embolism / DVT), PSI 13 (Postoperative Sepsis), PSI 14 (Postoperative Wound Dehiscence), and PSI 15 (Abdominopelvic Accidental Puncture or Laceration).
HAC Reduction Program economics
The CMS HAC Reduction Program ranks hospitals on PSI-90 plus six healthcare-associated infection measures (CLABSI, CAUTI, SSI for colon and abdominal hysterectomy, MRSA, C. diff). The bottom-quartile-performing hospitals lose 1% of all Medicare DRG payments for the federal fiscal year. For a hospital with $40M in annual Medicare DRG payments, that's $400K — significant enough that PSI-90 monitoring drives quality investment decisions.
Where Vizier fits
Vizier computes each individual PSI continuously from your inpatient encounter data and surfaces the rolling PSI-90 composite. The view shows which specific PSIs are dragging the composite, lets safety teams drill to patient-level cohorts, and supports the chart-review workflow that distinguishes truly preventable events from measurement artifacts.