Federally Listed Patient Safety Organization — your case review data stays privileged and out of discovery. How PSO protection works →

We end the administrative burden of quality improvement — so you have time to actually improve care.

HBHS automates clinical case review so your team can stop digging through the EHR and start improving care. Our AI reads the entire record — notes, labs, meds, vitals, every page — and proposes a cited, classified list of opportunities for improvement. Your clinicians approve. It runs inside Healthcare Safeware®, a FedRAMP Authorized platform.

6 minutes per case.

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The Promise

6 min per case review — versus 45–90 minutes done manually

AI-drafted, cited & classified · clinician-approved

Hospital quality teams using structured case review

U.S. Department of Veterans Affairs

Bronson Healthcare

MedStar Health

Valley Health System

Wellstar Health System

Vancouver Coastal Health

UCHealth

How It Works

How the Safety Learning System® Works

From the Loved One Lens to lasting process change — three steps.

Review through the Loved One Lens

Every case gets one question: would you just watch and hold your mother's hand, or would you be in the hallway asking for help? More on the Loved One Lens.

Surface what voluntary reporting misses

Hospitals using the methodology typically surface about 7× more opportunities for improvement than voluntary incident reporting alone — most of them omissions of care. BMJ Open Quality 2025 (103 hospitals, 19,181 reviews).

Close the gap with Healthcare Safeware®

FedRAMP Authorized software turns findings into tracked, permanent process change — inside a federally listed PSO, so the data stays privileged.

~7×

More opportunities for improvement than voluntary incident reporting — most of them omissions of care. BMJ Open Quality 2025: 103 hospitals, 19,181 reviews.

120+

Hospitals in the Safety Learning System® collaborative across four countries (membership count; the BMJ paper studied 103).

PSO

Federally listed Patient Safety Organization — case review data stays privileged and out of discovery.

FedRAMP

Authorized (Moderate) Healthcare Safeware®, built to the security bar federal agencies require.

The Evidence

89% of what needs fixing is invisible to the system built to find it

Peer-reviewed in BMJ Open Quality: 103 hospitals across the US and Canada, 19,181 case reviews, 46,444 opportunities for improvement.

46,444opportunities for improvement identified across 19,181 case reviews

89%of them — 41,439 — were omissions of care, not acts of commission

56%came from just three categories: end of life, documentation, treatment/care

66.3%of all cases reviewed surfaced at least one opportunity (12,714 cases)

Opportunities for improvement by category, most to least frequent

Top three categories (56% of all OFIs) Other omissions of care Traditional patient-safety events

Bar lengths are proportional to Figure 3 of the study. Only the totals and the combined top three are published as exact counts.

Published findings — BMJ Open Quality 2025;14(1):e002988
Hospitals	103, across the United States and Canada, 8 to 2,000+ beds
Period	2016–2023
Case reviews	19,181
Cases with at least one opportunity	12,714 (66.3%)
Total opportunities identified	46,444
Opportunities that were omissions of care	41,439 (89%)
From end of life, documentation and treatment/care alone	25,980 (56%)
Opportunities for gratitude — great care found	6,386

Huddleston JM, Whitford D, Yaszemski AK, Schrieber MP, Pollak E. Broadening the definition of patient-safety events: lessons from a multicentre learning health system collaborative. BMJ Open Quality 2025;14(1):e002988. doi:10.1136/bmjoq-2024-002988 · free full text

"End the administrative burden of quality improvement."

Quality leaders at CHRISTUS Health, IU Health, and the San Antonio VA Independently, in identical language, unprompted.

Real cases. Practical improvements.

A newsletter for frontline healthcare team members and quality improvement professionals, edited by Jeanne M. Huddleston, MD, MS — Mayo Clinic's first hospitalist and Professor of Medicine, Mayo Clinic College of Medicine.

See All Posts

September 7, 2026

Quality, We Have an Algebra Problem

Erase every preventable death in a 20,000-admission hospital and mortality moves from 2.0% to 1.9% — statistical noise. The events that actually move the number are the frequent, quiet omissions.

When Commitment Fails

What over-commitment costs quality improvement professionals — and the capacity check Dr. Huddleston runs before saying yes to leading another project.

No Courage to Make Eye Contact

A nurse overrode the Pyxis to relieve a post-op patient in pain, made the look-alike error the system had drawn up for her, and was told to call herself a bad nurse. Blame worsens it; systems thinking heals it.

Category, stated plainly

What HBHS is — and what it is not

HB Healthcare Safety is a Safety Learning System® collaborative and Healthcare Safeware® software for structured, multidisciplinary case review. It is not a voluntary incident-reporting platform (RLDatix, Verge, Performance Health Partners, Quantros and similar), not an IHI Breakthrough Series harm-reduction bundle for HAIs, falls, or medication safety, and not a live EHR integration. Charts enter by manual or batch CSV upload; there is no direct EHR connection, by design, to limit data leakage. Many hospitals keep their reporting system and add this case-review layer beside it.

How hospitals buy this

Collaborative membership, software, or both — quoted for your organization

There is no public list price. HBHS quotes a Safety Learning System® collaborative membership, Healthcare Safeware®, or both, from bed size, number of facilities, and whether you need FedRAMP-authorized handling of PHI. Work runs inside a federally listed Patient Safety Organization so case-review data stays privileged. Email or call to scope the work; we do not publish per-user or per-hospital dollars on this site.

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Frequently asked questions

The real questions hospital quality and safety leaders ask us directly, answered straight.

What does HB Healthcare Safety actually do?

HB Healthcare Safety (HBHS) is a Social Benefit Corporation founded in 2015 through Mayo Clinic Ventures by Dr. Jeanne M. Huddleston and Lacey A. Hart. HBHS helps hospitals run a peer-reviewed case review methodology, supported by Healthcare Safeware® (part of the Safety Learning System®), to uncover safety failures that traditional event reporting misses.

How is this different from the mortality or peer review process we already run?

Most peer review and M&M programs focus on whether a death was preventable. HBHS's methodology, developed at Mayo Clinic, goes further: it captures findings even when there was no negative impact on the patient, which is why hospitals using it typically surface about 7× more opportunities for improvement than voluntary incident reporting alone. BMJ Open Quality 2025 (103 hospitals, 19,181 reviews).

What is the Loved One Lens?

The Loved One Lens is the question reviewers are trained to ask during every case: would you just watch and hold your mother's hand, or would you be in the hallway asking for help? Reframing each case this way is what HBHS credits for surfacing safety issues a purely clinical review can miss.

Is Healthcare Safeware® secure enough for a hospital IT or compliance review?

Healthcare Safeware® is FedRAMP Authorized at the Moderate level, the security baseline the federal government requires for systems handling sensitive but unclassified data, and it already runs inside VA facilities. See our IT security documentation.

What is a Patient Safety Organization (PSO), and why does it matter for case review?

A PSO, established under the federal Patient Safety and Quality Improvement Act, gives hospitals legal privilege and confidentiality protections when they share case review data for learning purposes. HBHS operates its own federally listed PSO so member hospitals can report and analyze events without that data being discoverable in litigation.

Does this only work for hospital deaths, or can it be used elsewhere?

The methodology started with hospital mortality review but has since been adapted for community hospitals, the VA, mental health providers, and even a state department of corrections for suicide prevention — the underlying case review process applies anywhere one person is responsible for another person's care.

What results have hospitals actually seen?

The independent evidence is BMJ Open Quality 2025: 103 hospitals, 19,181 case reviews, 46,444 opportunities for improvement, 89% of them omissions of care. Hospital-specific results, including mortality change at named sites, are in our case studies — not a single site-wide percentage.

How do we get started or talk to someone at HBHS?

Email johnson@hbhealthcaresafety.org or call (507) 316-1118. HBHS works directly with hospital quality, safety, and risk leaders to scope a collaborative membership or a Healthcare Safeware® implementation.

Still have a question that's not here? Get in touch and we'll get back to you directly.

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See why more than 120 hospitals trust HBHS as their partner in safer, more reliable care.

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Have Questions?

Our team is ready to walk you through the methodology, the software, and how a collaborative membership works.

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Red Wing, MN 55066

Contact

(507) 316-1118

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