Volume 39, No. 2 • June 2024   Issue PDF

Why Should I Obtain the Certified Professional in Patient Safety (CPPS) Credential?

Jonathan B. Cohen, MD, MS, FASA, CPPS; Patricia A. McGaffigan, MS, RN, CPPS

Although significant progress has been made in patient safety since the publication of the Institute of Medicine’s Report To Err is Human 25 years ago, there is evidence that progress is slowing down. In order to continue to improve, we will need more individuals with demonstrated knowledge and competencies in the field of patient safety, who embrace constancy of purpose in improving safety. The Certified Professional in Patient Safety (CPPS) credential was developed to establish core standards for the field of patient safety, set an expected proficiency level of those who practice it, and provides those interested in patient safety a way to demonstrate their knowledge and skill. Through its evidence-based identification of relevant safety domains, testing of candidate knowledge, and recertification requirements for continuing education or demonstrated experience in safety, the CPPS credential supports the development of professionals dedicated to improving patient safety.

Anesthesia professionals have a long history of paving the way in patient safety. The Anesthesia Patient Safety Foundation was launched in 1985, four years before the publication of To Err is Human, and twelve years before the founding of the National Patient Safety Foundation.1-3 Significant progress has been made in patient safety over the past several decades, but there is growing evidence that continued progress in harm reduction has stalled.4-7 Further, despite the advancements that have made the delivery of anesthesia safer today than it has ever been, knowledge of the science underlying patient safety is not instinctual and not always straightforward. Popular misconceptions that place greater emphasis on the need for human vigilance over the design of safe systems and cultures which support human performance have resulted in the persistence of adverse events (Table 1).

Table 1: Some Common Misconceptions About Patient Safety.

Table 1: Some Common Misconceptions About Patient Safety.

In order to overcome the misconceptions and inertia with progress in eliminating preventable harm, health care requires clinicians, leaders, and faculty who embrace a fundamental commitment to constancy of purpose for safety and demonstrate the requisite knowledge and competencies to lead and ensure this progress. Anesthesia professionals are optimally suited to leverage their profession’s focus on patient safety to become health care leaders that shepherd the evolution of the field and organize safe systems of care. One such path for validating knowledge and competencies and advancing progress in safety is through formal certification in patient safety.


CPPS Credential Recognizes Skills and Knowledge in Patient Safety

In 2011, the National Patient Safety Foundation (which merged with the Institute for Healthcare Improvement in 2017), formed the Certification Board for Professionals in Patient Safety (CBPPS) to develop and oversee a program to credential individuals with knowledge and competencies in patient safety.21 To date, more than 6300 professionals from all 50 US states and 32 countries have earned the Certified Professional in Patient Safety (CPPS) credential.22 This professional certification program serves several purposes.22 It establishes core standards for the field of patient safety, sets an expected proficiency level of those who practice it, and provides those interested in patient safety a way to demonstrate their knowledge and skill. It also serves to provide a means for employers and organizational leadership to validate a professional’s competencies in patient safety. In 2023, the CPPS examination became the first and only certification examination dedicated to patient safety to be accredited by the National Commission for Certifying Agencies (NCCA).

To be eligible to sit for the CPPS certification examination, a professional must have at least a Baccalaureate degree and three years of experience in a health care setting or with a provider of services to the health care industry, or an associate degree or equivalent plus five years of experience. Those who are in training, or have recently completed training, may satisfy this requirement with time spent in clinical rotations and residency programs. The content of the domains covered by the examination was originally developed in 2011 after an initial job analysis of patient safety professionals was conducted. The purpose of the job analysis, which is repeated over time, is to identify the practice, knowledge, and tasks associated with professional certification in patient safety and to inform a relevant, valid certification examination that is supported by evidence. While the first CPPS job analysis was informed primarily by survey respondents from within the United States, subsequent job analysis surveys have widely incorporated feedback on practice from diverse respondents from around the world. The current CPPS examination includes the five domains of culture, leadership, patient safety risks and solutions, measuring and improving performance, and systems thinking and design/human factors.
Additional information about the CPPS certification examination and recertification requirements is available in the CPPS Candidate Handbook at https://forms.ihi.org/hubfs/CPPS/CPPS%20Candidate%20Handbook%20April%202023.pdf.23

The CPPS certification examination, practice examination, and recertification programs are overseen by the CBPPS. The CPPS review course, offered by IHI, is separately developed, offered, and taught by subject matter experts, who are unaffiliated with the CPPS examination to create a firewall and ensure integrity between the preparation and examination activity. The CPPS review course is offered in multiple formats, including live in-person and virtual sessions, and a self-paced, online format. Additional information about the IHI CPPS review course is available at https://www.ihi.org/education/cpps/review-courses.24

Much like the practice of anesthesiology, patient safety is a science, and knowledge of best practices continues to evolve. Lifelong learning in patient safety is essential. Maintenance of the CPPS credential indicates that those who have the certification remain current in this knowledge. Recertification follows a three-year cycle, and there are two approved pathways that can be taken: 1) earning 45 continuing education or experiential hours in content areas that align with the domains that comprise the current CPPS certification exam or 2) retaking and passing the CPPS certification exam within a year prior to the expiration date. Anesthesia professionals have access to a significant amount of continuing education material offered by professional societies both online and at conferences and meetings that meet the criteria for the first recertification pathway.


In the early years of CPPS certification, exam candidates were primarily US-based, and more highly experienced and tenured patient safety, quality, and risk officers or leaders. Since the first exam was offered in 2012, diverse candidates from a variety of roles, specialties, and geographies have earned the CPPS credential. This includes health care executives, clinical department leaders, and direct patient care providers and clinicians across the continuum of care, as well as colleagues from medical technology companies, accreditation organizations, quality and safety associations and agencies, consultants, and patient and family advocates. Examples of specialties include anesthesiologists, CRNAs, surgical, perioperative, critical care, and pain management staff.


The CPPS review course and exam are increasingly incorporated into graduate medical, nursing, and safety and quality education. Inspired in part by the Lucian Leape Institute’s report Unmet Needs: Teaching Physicians to Provide Safe Patient Care, the leaders of the University of North Texas Health Science Center’s Texas College of Osteopathic Medicine restructured their curriculum to prepare graduates with demonstrated knowledge and competencies in safety.25 In the three-year period since integrating the CPPS review course into their third-year curriculum, 27 academic leaders and faculty and nearly 850 students have earned the CPPS credential, entering residency more prepared to practice safely and serve as advocates for patient safety. More graduate programs in health care are integrating the CPPS review course into their curriculum offerings.


Lifelong Learning in Patient Safety is Essential

Certification IconIndividuals pursue certification in patient safety for a range of reasons, including personal and professional recognition of their knowledge and competencies. In recent years, the CPPS credential has become a requirement upon hire or within the first year of employment, especially for safety, quality, and risk positions to distinguish their capabilities from other candidates. Seventy-nine percent of those who have earned the CPPS credential report that it has helped them improve patient care at their organization, and 81% report that they have led organization, or system-wide initiatives, leading to critical improvements, since earning the CPPS credential.22

Specific examples include leading opioid and other medication safety initiatives, developing sedation and monitoring guidelines, collaborating with risk management and quality/safety departments to educate on just culture, safety reporting and risk reduction strategies, and reengineering undergraduate medical school and other safety education programs.

Although quality improvement and patient safety have been combined over the years, it is increasingly recognized that the skills necessary to become a leader in patient safety are distinct from those necessary in quality improvement.26,27 The rapidly evolving health care landscape offers expanded opportunity for anesthesia professionals to contribute their safety expertise across new and diverse roles and settings of care. The CPPS credential is distinct in that is the only certification that recognizes professionals’ skills and knowledge specifically in the field of patient safety. In 2007, Paul Batalden and Frank Davidoff challenged us in health care to not only do our work every day, but to improve upon it.28 The CPPS credential, through its evidence-based identification of relevant safety domains, testing of candidate knowledge, and requirement for continuing education or demonstrated experience in safety, provides both the map and the destination for developing professionals dedicated to improving patient safety.

As a result of the collaborative efforts of the APSF, ASA, IHI, and CBPPS, a CPPS review course will be offered at the 2024 ASA Annual Meeting in Philadelphia, PA, in October, and a discount is available to anesthesia professionals who elect to take the CPPS examination.


Jonathan B. Cohen, MD, MS, FASA, CPPS, is vice chair of quality and safety and an associate member in the Department of Anesthesiology at Moffitt Cancer Center, Tampa, FL.

Patricia A. McGaffigan, MS, RN, CPPS, is vice president of safety at the Institute for Healthcare Improvement (IHI), and president of the Certification Board for Professionals in Patient Safety, Boston, MA.

Jonathan Cohen is a faculty member for the CPPS Review Course. Patricia McGaffigan is a board member of the I-PASS Institute.


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