Intended for healthcare professionals

Feature Quality improvement

Patient safety lessons from the world’s experts

BMJ 2018; 363 doi: (Published 27 December 2018) Cite this as: BMJ 2018;363:k5211
  1. Jacqui Wise, freelance journalist
  1. London, UK
  1. jacquiyoung1{at}

Healthcare improvement leaders from the Netherlands, Saudi Arabia, Sweden, the UK, and the US tell Jacqui Wise what their countries have learnt in efforts to deliver safer care

This year patient safety leaders from five countries met in Saudi Arabia to share successes and challenges in their efforts to improve patient safety at a health system level. Hosted by the BMJ, last April’s meeting acknowledged a lack of evidence around what has been effective and the need to learn from global exemplars.

“Although healthcare systems differ from country to country,” said Fiona Godlee, editor in chief of The BMJ and chair of the meeting in Riyadh, “improving patient safety often faces similar obstacles, and we can learn from what has worked and hasn’t worked elsewhere.”

After the meeting, some participants travelled to Tokyo to join representatives from 44 countries to sign a declaration acknowledging patient safety as vital to universal health, calling for “high level political momentum” to push for safer care everywhere.1

Engage patients

A key message from the Riyadh meeting was that patient engagement is critical to improving safety. Mike Durkin, senior adviser on patient safety policy and leadership at the Institute for Global Health Innovation at Imperial College London and former national director of patient safety at NHS England, agrees. “Patients can drive the agenda for change—more so than professionals,” he says, giving the example of reducing venous thromboembolism in the UK.

Doctors knew that assessing patients for risk and prescribing anticoagulant drugs could help. But only in the late 1990s and early 2000s was there any “real action” to reduce deaths, he told The BMJ, resulting from a coalition of patient and parliamentary groups.

In the Netherlands, patients have had an enormous role in creating momentum for change, says Ian Leistikow, an inspector with the Dutch …

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