09/15/2026
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The Patient Safety Structural Measure (PSSM) is a new hospital quality measure, adopted by the Centers for Medicare & Medicaid Services (CMS) in 2025. Starting in 2026, the PSSM requires hospital leaders to annually “attest”—yes or no—to whether each of 25 patient safety best practices specified in the measure is in place at the hospital they lead.
The PSSM is a complement to patient safety outcome or process measures. Rather than focusing on specific clinical outcomes or quality improvement processes, the PSSM evaluates whether the foundational elements of a comprehensive patient safety program are in place.
The PSSM best practices are grouped in 5 domains:
Leadership Commitment to Eliminating Preventable Harm
Strategic Planning and Organizational Policy
Cultural Safety & Learning Health System
Accountability & Transparency
Patient & Family Engagement
Results of hospital Attestation statements will be analyzed by CMS and scored by domain. To receive a point, a hospital must answer “yes” to all the best practices within a domain. The maximum score a hospital can earn is 5. CMS will begin publicly reporting hospital scores, from zero to 5, starting in late 2026.
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Patient Engagement and empowerment is perhaps the most powerful tool to improve patient safety.
