Patient safety

Global priority areas for Patient Safety research

Bridging the knowledge gap for important patient safety issues

Patient safety is a global issue affecting countries at all levels of development. To date, there is not enough scientific evidence to understand why adverse events occur, how and to what extent patients are harmed, and moreover, how these issues could be reduced and the related patient harm minimized. There is an obvious need for priority-setting, particularly in transitional and developing countries. Research needs are vast, but resources are scarce.

An international expert working group set up by WHO Patient Safety, led by Dr David Bates, produced a list of global research priorities that indicate the broad areas where substantial knowledge gaps exist and where further knowledge would significantly contribute to improving patient safety and reducing harm. Using a modified Delphi technique, the group built consensus based on a systematic review of scientific literature. The final lists of priorities were based on the severity and frequency of the patient safety issue, the magnitude of harm and its distribution, and the impact the issue has on the efficiency of the health system as a whole.

Combined top research priority areas

Fifty topics were identified and selected for prioritization. These were ranked separately for developing, transitional and developed countries.

In developing and transitional countries, the top priority area was judged to be the development and testing of locally effective and affordable solutions, followed by cost-effectiveness of risk-reducing strategies. The leading priorities in developed countries were lack of communication and coordination, and latent organizational failures.

  • Locally effective & affordable solutions
  • Cost-effectiveness of solutions
  • Counterfeit & substandard drugs
  • Competences, training & skills
  • Maternal & newborn care
  • Health care-associated infections
  • Extent and nature of unsafe care
  • Knowledge translation
  • Safe injection practices
  • Unsafe blood practices
  • Communication & coordination
  • Safety culture
  • Latent organizational failures
  • Safety indicators
  • Human factors for procedures
  • Health information technology & systems
  • Role of the patient in patient safety
  • Human factors in devices
  • Adverse drug events

These priorities represent a useful start for research commissioners and other bodies. Further specification of priorities at local level is also most desirable, as suggested by the group. Clearly, much more investment in patient safety research is needed, especially in transitional and developing countries. The priority list must be revised periodically to ensure that it remains useful for improving patient safety.