Prioritizing patient safety
Safe Tables
HCA Healthcare’s Patient Safety Organization (PSO) partners with facility leaders and frontline colleagues to identify, prioritize and address safety risks that affect both patients and our workforce. Our annual enterprise-wide Safe Table campaign provides a confidential forum for colleagues to share concerns and improvement ideas that inform system-level action.
In 2025, more than 46,000 clinical and non-clinical colleagues across nearly all HCA Healthcare facilities participated in Safe Tables, reflecting broad engagement and trust in the process. Since 2023, insights from these discussions have contributed to improvements across key safety indicators, with particular progress in areas related to workplace violence prevention and physical security across the organization.
Feedback highlighted strong engagement with Crisis Prevention Intervention training, the importance of visible and supportive leadership and the effective use of standardized safety tools and protocols such as behavioral risk screening, safe rooms, anonymous reporting mechanisms and enhanced security practices. Together, these actions strengthen our safety culture, reduce operational risk and support consistent delivery of safe, high-quality care across the enterprise.
Culture of Safety
HCA Healthcare uses structured feedback from patients and care teams to identify safety risks, prioritize improvement efforts and drive actions to strengthen care delivery and patient outcomes across our facilities. Our enterprise-wide Culture of Safety survey is a core mechanism for informing safety priorities and reinforcing accountability, incorporating colleague perspectives into operational decision-making.
Results from the 2025 Culture of Safety survey demonstrate continued progress across the organization, reflecting sustained improvement and consistency in how safety expectations are embedded in daily practice, measured and acted upon. Safety culture scores improved in every region, with particularly strong gains in speak-up culture, indicating colleagues feel psychologically safe and supported by leadership to raise safety concerns. The survey revealed strong positive perceptions about the provision of high-quality care across the enterprise.
Patient Safety Structural Measure and National Action Plan
In 2025, the Centers for Medicare & Medicaid Services (CMS) introduced new Patient Safety Structural Measure (PSSM) requirements. The PSSM focuses on foundational safety capabilities, including leadership accountability for eliminating preventable harm, strategic planning and policy alignment, a culture of safety and learning, transparency and patient and family engagement.
In support of these efforts, HCA Healthcare launched a dedicated quality and safety webpage on HCAhealthcare.com and implemented standardized patient safety communication boards across all inpatient units for consistent communication of safety priorities and strategic intent across the enterprise.
As part of this work, each hospital convened multidisciplinary teams — including leaders, physicians and frontline clinicians — to assess the maturity of their safety culture and patient safety programs. These assessments informed targeted actions aligned with National Action Plan recommendations, strengthening local execution while maintaining enterprise standards.
Our work over the past two years to prioritize the implementation of the nationally recognized National Action Plan to Advance Patient Safety has reinforced a consistent, enterprise-wide approach to strengthening safety culture and systems, and we believe it positioned us to be well prepared for the new CMS PSSM requirements.
Patient Family Advisory Councils
HCA Healthcare strengthens patient safety by systematically engaging patients and families as partners in care delivery. Across all hospitals, Patient Family Advisory Councils (PFACs) provide a structured forum for hospital leaders, physicians and nursing leadership to engage directly with patients and families on safety-related experiences and opportunities for improvement.
Insights from these discussions inform local and enterprise-level actions that enhance care delivery, improve responsiveness to patient needs and reduce safety risk. By integrating the patient and family perspective into decision-making, HCA Healthcare reinforces accountability, transparency and trust, key elements of a resilient safety culture and reliable clinical performance.
Infection prevention
HCA Healthcare’s Patient Safety and Infection Prevention teams work in close partnership to reduce preventable harm and strengthen protection for patients, visitors and colleagues. This collaboration focuses on aligning systems, data and accountability to improve visibility into infection-related risk across the enterprise.
In 2024, Infection Prevention began leveraging a standardized patient safety reporting platform to capture healthcare-associated infection (HAI) events using the same enterprise framework applied to other patient harm events, such as falls. This integration improves consistency, comparability and oversight of safety data.
In 2025, HCA Healthcare continued to advance its enterprise dashboards by further aligning data standards and business requirements, enabling more real-time, granular and actionable insights for colleagues at facilities, divisions, operating groups and corporate. These enhancements strengthen our ability to identify trends, prioritize interventions and proactively manage infection-related risk — supporting safer care across the organization.
Applying high-reliability industry
practices to healthcare safety
We continue to strengthen our safety operating model by learning from leading industries in managing safety in complex, high-risk environments. In 2025, HCA Healthcare engaged directly with industry leaders and frontline teams in aviation, advanced manufacturing and military operations — spending time in operational environments where reliability, standardization and disciplined execution are essential to preventing safety failures — to inform how these principles can be applied to healthcare.
Through site visits and direct engagement with organizations such as General Electric’s Computed Tomography manufacturing operations, DuPont Chemical and the U.S. Army’s 160th Special Operations Aviation Regiment, our leaders examined how these organizations design systems that anticipate risk, reinforce accountability and enable teams to identify and respond to risk before harm occurs in real time.
By adapting proven high-reliability principles into the healthcare environment, HCA Healthcare strives to advance a more resilient safety system, one designed to support consistent performance, reduce preventable harm and set a higher bar for safety across the industry.
Regulatory
HCA Healthcare’s Regulatory and Accreditation Services (RAS) team plays a critical role in maintaining a constant state of readiness across our hospital and ambulatory care network. RAS supports our mission by partnering with facilities to ensure consistent compliance with the standards and requirements of The Joint Commission (TJC), the Accreditation Association for Ambulatory Health Care (AAAHC), the CMS Conditions of Participation and applicable licensure and regulatory requirements.
Rather than a survey-driven or episodic approach, RAS focuses on continuous readiness by providing leader-specific education, knowledge validation, practical application of knowledge, expert consultation and proactive guidance that helps facilities identify gaps, mitigate risk and embed regulatory expectations into daily operations. This approach is designed to reinforce accountability, reduce variability, support reliable, high-quality and regulatory-compliant care delivery across diverse care settings.
Through ongoing collaboration with facility leaders and clinical teams, RAS helps translate evolving regulatory and accreditation standards into actionable operational practices. By strengthening governance, standardizing readiness processes and promoting sustained compliance, RAS contributes to risk mitigation, regulatory stability and the uninterrupted delivery of safe, high-quality care across the enterprise.