The case for patient safety is obvious, no one would argue in favor of harming patients. The principle “First do no harm” is the fundamental stone to the provision of high-quality healthcare. The landmark paper To Err is Human, published in 2001, has become the main watershed of the global patient safety movement and since then, patient safety has been on the forefront of public health policy makers’ priorities. Yet, nearly two decades later, while progress has been made, harm to patients are still a reality, daily, in health systems over the world. Preventable patient harm is now estimated to be the 14th leading cause of the global disease burden, comparable to the burden from tuberculosis or malaria. In the US, medical errors are the 3rd leading cause of death, resulting in more than 251.000 deaths annually. In England, 3.6% of deaths in acute hospitals, happen due to wrong provision of care, while one incident of patient harm is reported every 35 seconds.
According to the World Health Organization (WHO), there is a 1 in a million chance of a person being harmed while travelling by an airplane compared to a 1 in 300 chance of a patient being harmed while receiving health care. In addition, new threats for safe provision of care are emerging. The rise of antimicrobial resistance increases the risk and severity of infections which were once under control, to re-emerge leading to complex efforts in mitigating patient harm. Also, patients are getting older, affected by multiple chronic conditions and thus, with more complex needs. The need for new and more advanced and complex treatments, generates new risks for error with high potential to harming patients. Consequently, as complexity of care increases, budgets are decreasing, putting at risk financial allocation for quality and patient safety improvement initiatives and negatively affect the economy and health security, especially in low- and middle-income countries (LMICs), with approximately two-thirds of all adverse events occurring in these countries.
Preventable adverse events also have significant economic implications on developed countries. Within the European Union alone, it is estimated that 15% of hospital expenditure can be attributed to treating safety accidents and its economic burden is between EUR 2.8 and EUR 84.6 billion of direct costs for the public health care sector and, globally, the cost associated with medication errors has been estimated at US$ 42 billion annually. This amounts to almost 1% of global expenditure on health, making harm to patients a threat to the sustainability of health systems. Unsafe health care exerts a very high burden on healthcare sector worldwide and has a significantly negative impact on staff morale and public trust in the health care system, putting at risk organizational reputations and thus sustainability.