Patient Safety: Delivering Cost-Contained, High Quality, Person-Centered, and Safe Healthcare

The World Health Organization defines patient safety as the absence of preventable harm to a patient and the prevention of errors and adverse events caused by the provision of healthcare. Despite stakeholders’ (namely policy makers, providers, insurers, clinicians, and patients) unanimous consideration that patient safety is a basic and vital principle of healthcare delivery, it continues to be a serious concern across health systems worldwide. Across the continuum of healthcare delivery, from primary care, to emergency, to acute, to chronic and long-term care, every process is potentially subjected to adverse events, which may originate from faults/errors in clinical and operational practices, products, procedures, or systems. Thus, patient safety is a priority issue for healthcare organizations.

There is evidence emerging from numerous studies and reports that many patients suffer from unsafe healthcare management on a daily basis with wide-ranging and far reaching consequences, for example iatrogenic infections and injuries, increased length of stay in hospitals, or even death. James T. Reason hypothesized, through the Swiss Cheese Model, that the origin of the majority of accidents, errors, or near misses can be tracked down to four failure domains, namely organizational influences, supervision, preconditions, and specific situations. Specifically in healthcare, preconditions for unsafe practices include overworked and burnt-out clinicians or faulty communication/handover. Insecure and inexperienced supervision may result from lack of attention to skill mix in manpower planning. On the other hand, organizational system failures may result from reduction in costs, in particular during times of financial recessions, on for example, quality control, continuous professional development, and specialized training. Furthermore, organizations that do not invest in leadership, teamwork, and a strong safety and quality culture, are more likely to experience unsound practices of healthcare delivery. Moreover, the risk of committing unsafe patient acts increases with the amalgamation of several often coincidental adverse factors which together contribute to unsafe patient care. For example, within accident and emergency departments, the combination of overcrowding, poor hygiene and sanitation, lack of experienced staff, and shortage of well-functioning basic equipment is more likely to lead to poor diagnoses and patient mismanagement. The risk of compromising patient safety deals also with the adoption of unethical non-responsible behaviors. Thus, the ethical component is crucial to healthcare organizations when it comes to patient safety. Both ethical and economic needs should be considered in healthcare management practices. The role of ethics in healthcare is to increase in transparency between costs, medical quality, and patient risk. Patient safety can therefore be considered from various perspectives and lands itself as an eclectic subject.

In this Research Topic, we seek to reflect on the current debate on patient safety, and the challenges involved in delivering cost-contained, high quality, person-centered, ethically-sound, and safe healthcare. This reflection should be conducted from a scientific, policy, sector, healthcare providers/professionals and/or users’ perspective, and/or including evaluation of integrated initiatives. Manuscripts should be focused on generating knowledge and practice. We also welcome reports of case studies of best practices, patient safety experiences, measures, tools, and strategies based on practical examples in a variety of contexts. Manuscripts will be selected based on their impact on patient safety, delivery of high quality care, person centeredness, cost containment, ethical perspectives, relevance for the healthcare system in which the study has been conducted, and novelty of patient safety approaches.