Intended for healthcare professionals


Global priorities for patient safety research

BMJ 2009; 338 doi: (Published 14 May 2009) Cite this as: BMJ 2009;338:b1775
  1. David W Bates, chief 123,
  2. Itziar Larizgoitia, research lead4,
  3. Nittita Prasopa-Plaizier, technical officer4,
  4. Ashish K Jha, assistant professor of health policy123
  5. on behalf of the Research Priority Setting Working Group of the WHO World Alliance for Patient Safety
  1. 1Division of General Internal Medicine, Brigham and Women’s Hospital, 1620 Tremont St, Boston, MA, 02115 USA
  2. 2Department of Health Policy and Management, Harvard School of Public Health, Boston
  3. 3Harvard Medical School, Boston
  4. 4WHO World Alliance for Patient Safety, Geneva, Switzerland
  1. Correspondence to: David W Bates dbates{at}
  • Accepted 28 December 2008

With so many unanswered questions on patient safety, it is difficult for researchers to know where to start. David Bates and colleagues describe their attempt to identify the priorities

In response to the global need to improve patient safety the World Health Organization formed the World Alliance for Patient Safety in 2004.1 The alliance is working to improve awareness and political commitment in 10 areas from hand washing and safe surgery to taxonomy and solutions. One important area is research into patient safety.

Currently most research has been done on hospital care in developed nations, where studies show an adverse event rate of about 10%.2 3 4 5 6 7 8 Although fewer data are available from nations with transitional economies, single institution evaluations suggest comparable or even higher rates of injury from medical care.9 10 11 Unfortunately, there are few data from the developing world. Another problem is that little research has examined primary care, long term care, and mental health, even though the available data suggest that patient safety in these settings may be as great a problem as in secondary care.12 13

New research will be key to improving the safety of health care. However, it is unclear which of the many potential areas of research are most important. Should researchers test whether specific solutions identified in developed nations can be implemented in poorer nations? Should they conduct cost effectiveness analyses? To answer these questions the WHO World Alliance for Patient Safety set up an international expert working group to identify a global set of priorities for patient safety research. We describe below the group’s approach to developing priorities and the actual priorities themselves, and then discuss what our findings mean and next steps. The full report is available on the WHO website. …

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