What is the difference between Patient Safety Work Product (PSWP) and 1157?
—J.J., a Bay Area hospital

Dear J.J.,

According to California Evidence Section Code § 1157, proceedings and records of organized hospital staff committees and peer review bodies are immune from discovery. Additionally, anyone attending those meetings cannot be required to testify as to what transpired at the meeting.

Federal courts do not recognize the California peer-review immunity. Additionally, sharing of information within and between organizations, such as to support a regional patient safety collaborative, is not addressed by § 1157.

Under 42USC299b-22 and 42CFR3.204, Patient Safety Work Product (PSWP) is a federal privilege that secures safety and quality information exchanged either within or across institutional boundaries. This privilege is broad-based, and preempts other state and Federal laws.

The federal privilege, however, is granted solely to Patient Safety Organizations (PSOs) and those health care providers working with PSOs. Additionally, the privilege accrues only to information that the provider collects with the intent of reporting to a PSO as well as deliberations and analyses (e.g., RCAs) regarding that collected information. This, the strongest potential source of protection for health care organizations, is intended to allow providers to securely exchange information with one another without fear of liability or disclosure of confidential information.


“Ask CHPSO” is a regular column in the bimonthly Patient Safety News and is intended to provide answers to common inquiries. If you have a question, please contact us at (916) 552-2600 or All inquirers will remain anonymous.