Patient safety, relating to prevention of harm during healthcare activities, remains a pressing issue with substantial health and economic costs in countries in Europe. It is estimated that up to 13% of health spending goes towards treatment of patients harmed during care, the majority of which could be avoided if appropriate safety protocols and clinical guidelines were adhered to (Slawomirski, Auraaen and Klazinga, 2017[1]). Promoting patient safety culture in healthcare workplaces and capturing the patient voice on patient safety is vital for driving sustainable progress in providing safe care and to meet the goals of WHO’s Global Patient Safety Action Plan 2021‑30.
Measures of patient safety culture from the perspective of health workers capture aspects of the work environment that facilitate the provision of safe and high-quality care. These measures, along with patient-reported experiences of safety, traditional patient safety indicators and health outcome indicators, provide insights on the safety of health systems from various perspectives. A positive patient safety culture for health workers means there is agreement on the importance of patient safety, transparency and trust, shared responsibility, and confidence in organisational and national safety initiatives. It is associated with better patient outcomes and experiences, as well as improved productivity and staff satisfaction.
Figure 6.1 illustrates the domain of the Hospital Survey on Patient Safety Culture relating to the reporting of patient safety events, including mistakes that are caught and corrected before reaching the patient and mistakes that could have harmed the patient but did not. The percentage of health workers who had positive overall perceptions of the reporting of patient safety events ranges from 63% in Türkiye to less than 40% in Poland and Belgium. Staffing and work pace, as it relates to patient safety, means that staff think the procedures and systems at their workplace are good at preventing errors and that there is a lack of patient safety problems. Figure 6.2 shows differences in positive response on this domain by staffing levels. In Türkiye and Portugal, the difference between managers perceptions of safe staffing and work pace and that of physicians differs by at least 14 percentage points, and at least 13 percentage points for nurses.
Patient perspectives are also critical to make health systems safer and people‑centred. To strengthen health systems based on people’s voices, a number of EU countries have started utilising patient-reported safety indicators systematically to monitor patient harms and improve processes for preventing and reducing harms. Poland uses patient-reported safety measures as part of its provider accreditation mechanism. According to the Commonwealth Fund 2020 survey, the proportion of patients reporting experiences of medical mistakes in the past two years varied between 6% in France and 10% in Germany and Norway in 2020. Among hospitalised patients, the proportion was less than 4% in Italy and Latvia and 8% in Poland, according to national surveys (Figure 6.3). The proportion was much higher in Belgium, which collected these data for the first time through a pilot survey. The response rate was very low at about 5%, so it is possible that the survey was filled more often by patients who had experiences of unsafe care than others. Among different types of patient safety incidents, medication-related errors are most frequently reported across countries.
