Vermont Patient Safety Forms

The Patient Safety Surveillance and Improvement System (PSSIS) was created for the purpose of improving patient safety, eliminating adverse events in Vermont hospitals, and supporting and facilitating quality improvement efforts by hospitals. The Vermont Department of Health is charged by statute to operate the PSSIS, and contracts with VPQHC to administer the System.

Reporting Forms:

According to State statute (and the PSSIS Rule), each Vermont hospital must:

  1. Establish internal policies and procedures to identify, track and analyze all adverse events and near misses
  2. Report to the Patient Safety Surveillance and Improvement System incidences of any of the National Quality Forum's serious reportable events, and for each event:
  3. Conduct an appropriate causal analysis (and file with the PSSIS)
  4. Develop and implement a corrective action plan (and file with the PSSIS)
  5. Report any incidence of an intentional unsafe acts (defined in the PSSIS Final Rule)
  6. Develop Disclosure policies and procedures delineating when and how to provide and document disclosure
  7. Cooperate with periodic on-site monitoring visits


National Quality Forum’s 2011 Consensus Report on Serious Reportable Events

More Resources:

Preventing Workplace Violence Toolkit
By Bill Marcinkowski December 16, 2025
Act 9 of 2025, An act relating to preventing workplace violence in hospitals, requires hospitals to develop and implement comprehensive security plans to prevent workplace violence. This toolkit is intended to help hospitals comply with Act 9. It contains resources to support hospital security plan development teams in assessing compliance and filling any gaps identified. The toolkit is designed to assist hospitals in improving workplace safety and managing aggressive behaviors. 
Peer Review on green background
By Bill Marcinkowski November 21, 2025
A green background with white text that says medicare beneficiary quality improvement program
August 22, 2025
2025 Core Measure Set guide
Show More

Have Questions?

Contact Us