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:

By Bill Marcinkowski May 28, 2026
Annually, 90 Sexual Assault Nurse Examiners provide approximately 400 exams in 16 hospitals across Vermont. National data reveals that 1 in 2 women and 1 in 3 men experience contact sexual violence, and in Vermont, 156,000 women and 103,000 men have experienced contact sexual violence in their lifetimes. Rural sexual assault survivors face isolation, lack of anonymity, and limited community resources, and are less likely to report assault or seek support services. Part of the HRSA Rural Northern Border Region Outreach Program, the SANE Care Collaborative & Innovation Network (2024-2027) is a 3-year initiative focused on expanding capacity for SANE services, enhancing quality of care within SANE programs, and increasing collaboration and innovation among rural hospitals in Vermont. Resources and reports related to the SANE Care Collaborative & Innovation Network can be found below.
Telehealth and Suicide Safer Care with Dr. Frederic Reamer
By Bill Marcinkowski February 19, 2026
Telehealth Resource Guide: Tools and Guidance for Managing Suicide Risk in Telehealth Settings This resource guide is designed to support mental health clinicians providing telehealth services focused on suicide prevention and treatment. It offers evidence-based guidelines, practical tools, and best practices for delivering high-quality, safe, and effective care in a virtual environment.* When viewed digitally, the guide is interactive and includes clickable links for quick access to referenced materials.
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. 
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