"For healthcare professionals dedicated to advancing patient safety, PSNet serves as an essential tool. The comprehensive collection offers practical guidance and strategic insight that support the development of effective safety protocols and clinical decision-making. The platform encourages system-based thinking and continuous learning by presenting real-world errors and near-misses in a constructive manner. By facilitating reflection and promoting accountability, PSNet contributes significantly to safer healthcare practices and plays a pivotal role in strengthening the overall culture of safety within health care organizations and the medical community.

"By presenting evidence, best practices, and thoughts of experts, PSNet can also help patient safety professionals make the case for the value of patient safety to top leaders and policy makers.

"We know that investing in patient safety improves the health outcomes for patients. Investing in patient safety also reduces the costs that occur when patients are harmed. In so doing, this also improves the efficiency of health systems. A continued investment in PSNet would contribute to the health and wellbeing of all who stand to benefit from improved patient safety. Discontinuing PSNet would be a great loss to the field of patient safety. We need to take steps to ensure it remains a vital and meaningful resource for all of us."

Related reading on the hub:

• The legacy and loss of AHRQ’s Patient Safety Net: A pillar of patient safety

Few initiatives have left as profound a mark on the global patient safety movement as AHRQ's PSNet. For nearly two decades, it was more than just a website—it was a living, breathing community of professionals, researchers and policymakers dedicated to improving the safety of patients worldwide. Its closure is more than a bureaucratic decision; it is the erasure of a collective body of knowledge that shaped and guided countless patient safety initiatives.  

A vision for a safer healthcare system 

PSNet was launched in the early 2000s as part of the broader push to improve patient safety following the landmark 1999 Institute of Medicine report To Err Is Human. Recognising the urgent need for a central hub where healthcare professionals could access the latest research, policy developments and real-world case studies, AHRQ established PSNet as an online resource to bridge the gap between research and practice.  

From its inception, PSNet was driven by a team of leading figures in patient safety, including pioneers such as Dr Kaveh Shojania and Dr Robert Wachter.

Their vision was clear: to create a curated space where the latest evidence, commentary and real-world learning could be disseminated widely, ensuring that healthcare professionals at every level had access to the best possible insights to enhance patient care.  

A hub of knowledge and collaboration over the years

PSNet evolved into the world’s premier patient safety repository. It featured:

• Case studies and real-world analyses of safety incidents, helping clinicians and policymakers understand systemic issues.
• Expert perspectives and interviews with leading safety scientists and practitioners, offering in-depth insights into evolving best practices.
• Curated research and literature reviews, providing a continuously updated digest of the latest evidence on safety interventions.
• Toolkits and guidance, to support frontline healthcare providers in implementing best practices.

It became an essential resource not just in the US, but internationally, serving as a touchstone for policymakers and clinicians striving to reduce preventable harm in healthcare systems worldwide.  

Milestone contributions 

Several landmark contributions defined PSNet’s legacy. These included its ground breaking work on:

• Diagnostic errors, spotlighting how cognitive biases and system failures contribute to missed and delayed diagnoses.
• Medication safety, offering evidence-based strategies to reduce adverse drug events.
• Patient engagement in safety, emphasising the critical role of patients and families in preventing harm.
• Health IT and patient safety, providing critical insights into both the promise and perils of digital transformation in healthcare. 

Articles and reports from PSNet didn’t just inform debate, they shaped policy, guided clinical practice and influenced training programmes worldwide.

A sudden and jarring end despite its immense value

PSNet has been abruptly and systematically dismantled under the Trump administration’s policies. The closure was not just a budgetary decision; it was an ideological move that ignored the overwhelming consensus on the importance of maintaining accessible, evidence-based patient safety resources. 

What is perhaps most shocking is the speed with which the decision has been executed. The removal of content has been swift, with little time for the patient safety community to archive or transition critical materials.

Researchers, clinicians and institutions that have long relied on PSNet have been left scrambling to retrieve invaluable resources before they disappear forever.  

The human cost of the closure 

The loss of PSNet extends far beyond the US. The global patient safety community has long depended on its insights, guidance and leadership.

From hospital administrators to frontline nurses, from policymakers crafting national safety strategies to medical educators training the next generation of clinicians, PSNet was a touchstone—a place where those committed to patient safety could find the best available evidence and real-world learning.  

Now, that light has been extinguished.  

A tribute and a commitment

To those who built PSNet, who curated its content, who shared their expertise and insights over the years: your work mattered. Your contributions saved lives, informed policies and built a global movement dedicated to reducing preventable harm. 

While PSNet itself may be gone, its legacy lives on in the work of those who continue the fight to improve patient safety. The challenge now is to ensure that its loss does not set back the progress of the last two decades.

Those of us who remain in this field must honour its impact by preserving its lessons, continuing its conversations, and finding new ways to collaborate and share knowledge. Patient Safety Learning has captured some of the most important content and tools on the hub so that the global patient safety community can continue to refer to them and use them.   

With sadness, but also with immense gratitude, we bid farewell to PSNet. Its absence will be deeply felt, but its influence will not be forgotten.

Continue to share your knowledge and patient safety resources

the hub is Patient Safety Learning's online platform for patient safety. Designed with input from patient safety professionals, clinicians and patients, we created the hub after identifying shared learning as one of the six evidence-based foundations of safer care. It offers a powerful combination of tools, resources, stories, case studies and good practice to anyone who wants to make care safer for patients. Its communities of interest give people a place to discuss patient safety concerns and how to address them. Membership is free – you can register here and you can then start to share content on the hub.

The National Healthcare Safety Dashboard makes national safety data more transparent, allowing for a comprehensive understanding of healthcare safety by care setting, beginning with hospital care. It opens doors to information and best practices to empower healthcare provider organisations, patient advocates, policymakers, professional associations and others to monitor national safety progress and make informed decisions to improve safety nationwide.

The initial version of the dashboard offers access to hospital safety data and will expand to include other healthcare settings, such as ambulatory clinics and nursing homes. The data sources include:

• AHRQ’s Hospital Patient Safety Indicators from the Healthcare Cost and Utilization Project.
• AHRQ’s Hospital Medicare Adverse Events from the Quality and Safety Review System.
• The Centers for Medicare & Medicaid Services’ Hospital Reporting Program Safety Measures.
• AHRQ’s Surveys on Patient Safety Culture® (SOPS®) Hospital Survey.

• Sepsis is the most common reason for hospitalisations after births, with 2.5 million inpatient stays in 2021. The number of sepsis hospitalisations is growing—with a 40% increase between 2016 and 2021. Covid-19 infections contributed significantly to this dramatic rise. 
• Hospital costs for sepsis patients soared from $31.2 billion in 2016 to $52.1 billion in 2021, accounting for over 14% of all hospital costs. Almost three-quarters of the hospital costs—more than $37.9 billion—were billed to Medicare and Medicaid for sepsis stays.
• Over half of sepsis hospitalisations—1.4 million—were for adults 65 years and older. One in six older patients with sepsis died in the hospital in 2021.
• In 2021, approximately 8,000 pregnant women were hospitalized with sepsis, and 1 in 25 pregnant women hospitalised with sepsis died in the hospital.
• In 2021, there were over 69,000 sepsis hospitalisations for children, and more than 850 children with sepsis died in the hospital. 

• Prioritisation of Patient Safety Practices for Making Healthcare Safer IV
• Potential Harms Resulting From Video-Based Telehealth
• Patient and Family Engagement
• Surgical Report Cards and Outcome Measurements
• Opioid Stewardship
• Reducing Adverse Events Related to Anticoagulants
• Implicit Bias Training
• Deprescribing
• Computerised Clinical Decision Support To Prevent Medication Errors and Adverse Drug Events
• Fatigue and Sleepiness of Clinicians Due to Hours of Service
• Transmission-Based Precautions for Multidrug-Resistant Organisms
• Infection Surveillance for Clostridiodes difficile, Methicillin-Resistant Staphylococcus aureus (MRSA), Carbapenem-Resistant enterobacterales (CRE), and Candida auris
• Failure To Rescue—Rapid Response Systems
• Engaging Family Caregivers
• Sepsis Prediction, Recognition and Intervention

1. Developing and improving your antibiotic stewardship programme, 
2. Creating a culture of safety around antibiotic prescribing in your hospital, and 
3. Learning and disseminating best practices for the diagnosis and treatment of common infectious disease syndromes.

• keeping patients safe
• helping doctors and nurses improve quality
• developing data to track changes in the healthcare system.

It also includes the experiences of five labour and delivery units that successfully implemented the programme.