Resilient health systems that can manage a global crisis while maintaining regular services and ongoing initiatives were crucial to managing the health of populations in 2020. One remarkable case of this is Oman's healthcare system, which maintained current initiatives and expanded its scope of work to address the pandemic's capacity needs. In particular, the Ministry of Health (MOH) was actively involved with COVID-19 efforts while continuing its duties as one of the global leaders of the patient safety movement.

During COVID-19, MOH's Directorate General Quality Assurance Centre (DGQAC), who leads Oman's patient safety initiatives, proactively supported several hospitals' audit activities to ensure patient and staff safety. Moreover, the Directorate contributed significantly to the efforts of the MOH call centre in educating people on COVID-19, a setup established mainly for responding to queries and concerns raised by healthcare workers and the general public. The DGQAC was also heavily involved in developing and updating several clinical guidelines, hospital regulations, and national policies to align with COVID-19 conditions and led a committee to document all efforts and processes conducted during the pandemic in the health sector.

The PSFHI was initiated in 2011 by EMRO in response to evidence of high rates of preventable adverse events, deaths, and permanent disabilities in hospital settings.[1] This initiative, technically supported by WHO, is under the stewardship of governments that lead on: establishing relevant national committees identifying and enrolling hospitals, providing coaching, and coordinating efforts to assess improving and sustaining PSFHI[2] After countries join the PSFHI, the selected hospitals undergo improvement processes (e.g. amendments of hospital policies or additional staff training) and assessment (internally through a self-assessment or externally by WHO).

As one of the leading implementers of the Patient Safety Friendly Hospital Initiative (PSFHI) in the Eastern Mediterranean Region, MOH continued to provide crucial mentorship to other countries that participate in PSFHI. Working with WHO, they continued supporting Pakistan in PSFHI implementation (building on the previous hosting for a ten-participant delegation from Pakistan in October 2019) by organizing a virtual surveyor training on the third edition of PSFHI standards in July 2020. This training was attended by 40 professionals from both Oman and Pakistan and was delivered using Oman's newly established web-based global resource platform for best practices in Patient Safety and Quality of Care.

Oman has become a prominent global pioneer in patient safety, establishing its first national patient safety day in 2018 (later endorsed by WHO as World Patient Safety Day in 2019). Despite MOH preoccupation with the COVID-19 response, Oman was able to celebrate the third National and second International Patient Safety Day under the theme of "Health Worker Safety: A Priority for Patient Safety" in September 2020. This two-day virtual event featured a message from EMRO's Director, Dr Ahmed Al Mandhari, and international, regional and local experts with more than 350 attendees. On this commemorative day, Oman also made headway on patient safety within primary care, officially launching the Patient Safety Friendly Framework for Primary Care. By December 2020, MOH completed a pilot test of this framework's standards and started adopting the framework within selected primary healthcare centres in Oman to better understand its field feasibility prior to its roll-out. MOH has also since developed tools and methodology for a patient experience survey planned for 2021.

As a long-standing WHO partner for patient safety, and the PSFHI specifically, Oman was hence able to swiftly sustain its patient safety activities during COVID-19. Dating back to 2016, Oman and WHO's PSFHI collaboration builds on a long history of joint progress towards Universal Health Coverage (UHC). The DGQAC considers PSFHI a natural step towards UHC, as access to safe and high-quality health service is essential to the UHC mission. As per 2019 MOH figures, Oman's UHC service coverage index stands at 75, well above the EMRO average. Moreover, Oman stands as a regional model, augmented by the designation of the DGQAC as a WHO Collaborating Centre for Quality and Patient Safety Training in 2018.

Some PSFHI achievements since its pilot in 2016 in Oman: 26 hospitals, both public and private, have joined PSFHI (almost 90% of hospitals in Oman) More hospitals have been assessed, all achieving 100% of the PSFHI’s critical standards and classified as either level 2 or level 3 (i.e., in addition to meeting the critical standards, they also achieved 60-89% or more than 90% of the core standards; respectively)

Since joining the global patient safety movement, Oman has comprehensively integrated the initiative into its strategic planning and health system targets. Oman has also embedded patient safety into curricula at health science universities that educate and train future health care professionals. Their well-established work in patient safety proved invaluable for both regular patient care and for addressing COVID-19, making hospitals better-equipped to stop transmission and spread of the virus within and beyond its doors. In showing its health system's resilience against a global pandemic, Oman has demonstrated the value of investing in safe and high-quality health services globally. Furthermore, these enduring efforts have demonstrated Oman's ability to be a reliable and sustainable partner for WHO and other countries involved in the patient safety movement. 

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[1]. https://pubmed.ncbi.nlm.nih.gov/22302070, accessed on 07 February 2021.

[2]. https://pubmed.ncbi.nlm.nih.gov/22302070, accessed on 07 February 2021.

Photo caption: Leadership engagement and oversight for patient and staff safety during COVID-19 pandemic- Visit of HE Dr Mohammed Al Saidi, Minister of Health in Oman to the COVID-19 Centers in Royal Hospital.

Photo credit: WHO