Pascal Metrics has pioneered “value-based patient safety,” an essential but often overlooked dimension of the healthcare field’s overall move to “value-based care” or “high-value care.” The Risk Trigger® product suite anchors Pascal’s real-time patient safety management solution which can be applied across the continuum of care by using surveillance, reporting, and other methods population-wide, as well as drawing on real-time data from the EHR/EMR, health IT, medical device, and other data sources.

Value-based patient safety is comprised of three components:

1. Clinical Value – identifying, tracking, reducing, and managing what the peer-reviewed published literature and the regulators both call “all-cause harm,” i.e. the whole range of harm versus focusing only on specific types (e.g. CAUTI, CLABSI, etc.)

  • Pascal uses the definition of “harm” as popularized by the Global Trigger Tool (GTT) developed by the Institute for Healthcare Improvement: “unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment or hospitalization, or that results in death.” 1

2. Financial Value – identifying harm using sound epidemiology and real-time data provides us with a unique “lens” also to identify the financial cost of harm (or, simply, waste) using CFO-grade techniques that build upon but go well beyond the published literature.

  • It is insufficient for operating providers and health systems to invest in patient safety initiatives based on published research alone, which has not succeeded to date; what must be done — and what lies at the heart of Pascal’s field-pioneering cost of harm financial modeling — is directly linking with a “CFO-grade” method clinically confirmed patient-specific harm with financially confirmed outcomes.

3. Regulatory Value – managing and improving patient safety with electronic safety measurement using EHR data, a direction already publicly embraced by the U.S. regulators; and in the United States, protecting findings of harm within a fully audited Patient Safety Organization (PSO) environment.

The results of value-based safety include clients who regularly have:

  • Reduced over 30% of patient harm identified and managed using Risk Trigger® Monitoring, which regularly exceeds 10 times the level identified by the traditional approach, that is voluntary event reporting (or incident reporting)2
  • Realizing over 30% of a financial opportunity calculated to be over US$2 million per year per 10,000 admissions, which considers only excessive length of stay (XLOS) cost related only to 14 top harm categories and only in the inpatient setting; validated as large health systems hundreds of millions of U.S. dollars per year of CFO-grade financial opportunity3

Clients have trusted Pascal for over 10 years to deliver value based on a robust approach that includes the following:

  • Clinical methodology Pascal uses automated clinical “triggers,” long substantiated by peer reviewed published research to be the most efficient indicators of patient harm – all within a robust process of sound epidemiology and comprehensive, integrated management workflow used by safety, quality, and risk health organization team members.Scientific validity – Pascal uses an evidence-based foundation to anchor its pioneering work in automated patient safety and improvement. In addition, Pascal and its Collaborative members use data to pioneer new and improved methods of detection, tracking, and management of harm.Technical modernity – Pascal uses advanced technology infrastructure and was the first enabling healthcare organizations to:
    • deliver a pure (non-hybrid) software-as-a-service offering to leading U.S. health systems in patient safety and quality.
    • build real-time analytics infrastructure based on an event driven architecture ingressing large volumes of health IT data applied to patient safety and quality improvement.
    • apply machine learning and advanced artificial intelligence (AI) techniques to create an all-cause harm predictive model using clinically confirmed EHR-based safety outcomes, the data set of which remains the largest in the world.


1. Griffin FA, Resar RK. IHI Global Trigger Tool for Measuring Adverse Events (Second Edition). IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement; 2009.

2. Pascal Metrics U.S. Community Collaborative Adverse Event Analysis.

3. Pascal Metrics U.S. Community Collaborative Cost of Harm Financial Analysis.