The Patient Safety Authority (the Authority) is an independent state agency established under Act 13 of 2002, the Medical Care Availability and Reduction of Error (“Mcare”) Act. Under Act 13, all hospitals, birthing centers, ambulatory surgical facilities and certain abortion facilities must report what the Act defines as “Serious Events” (actual adverse events) and “Incidents” (so-called “near-misses”). The Authority analyzes and evaluates those reports so it can learn from the data reported in order to advise facilities and make recommendations for changes in healthcare practices and procedures which may be instituted to reduce the number and severity of Serious Events and Incidents. Statewide mandatory reporting went into effect in June 2004, making Pennsylvania the first state in the nation to require the reporting of both actual adverse events and near-misses. To date, Pennsylvania healthcare facilities have submitted over 500,000 reports of Serious Events and Incidents through PA-PSRS, with recent average monthly reports over 17,000.