Patient safety About us

In October 2004 WHO launched a patient safety programme in response to a World Health Assembly Resolution (2002) urging WHO and Member States to pay the closest possible attention to the problem of patient safety. Its establishment underlined the importance of patient safety as a global health-care issue. The programme, WHO Patient Safety, aims to coordinate, disseminate and accelerate improvements in patient safety worldwide. It also provides a vehicle for international collaboration and action between WHO Member States, WHOs Secretariat, technical experts, and consumers, as well as professionals and industry groups. Each year, WHO Patient Safety delivers a number of programmes covering systemic and technical aspects to improve patient safety around the world.

What is patient safety?

Patient safety is the absence of preventable harm to a patient during the process of health care . The discipline of patient safety is the coordinated efforts to prevent harm, caused by the process of health care itself, from occurring to patients. Over the past ten years, patient safety has been increasingly recognized as an issue of global importance, but much work remains to be done.

Who we are
WHO Patient Safety was created to facilitate the development of patient safety policy and practice across all WHO Member States and to act as a major force for patient safety improvement across the world.

Our vision
Every patient receives safe health care, every time, everywhere.

Our mission
The mission of WHO Patient Safety is to coordinate, facilitate and accelerate patient safety improvements around the world by: being a leader and advocating for change; generating and sharing knowledge and expertise; supporting Member States in their implementation of patient safety actions. WHO Patient Safety
Resolutions & related documents

World Health Assembly & Regional Committee documents

Our action areas

Main areas of work

Secretariat staff

More information Programme Leads & Collaborators

Our external expert leads

Programme Leads
International Organizations

More information
National Organizations

More information The launch of the World Alliance for Patient Safety, Washington DC, USA - 27 October 2004

WHO Patient Safety - programme areas

action area 1
The Global Patient Safety Challenges aim to identify a topic that covers a major and significant aspect of risk to patients receiving health care and which is relevant to every WHO Member State. At present we have three such Challenges: 1. Clean Care is Safer Care Health care-associated infection was chosen as the first Global Patient Safety Challenge, focusing on the Clean Care is Safer Care theme. As part of this Challenge, we have developed WHO Guidelines on Hand Hygiene in Health Care and a set of complementary implementation tools. Clean Care is Safer Care 2. Safe Surgery Saves Lives Safer surgery was chosen as the second Global Patient Safety Challenge, with the theme Safe Surgery Saves Lives. The focus of the campaign is the WHO Safe Surgery Checklist. The checklist identifies three phases of an operation, each corresponding to a specific period in the normal flow of work: Before the induction of anaesthesia (sign in), before the incision of the skin (time out) and before the patient leaves the operating room (sign out). In each phase, a checklist coordinator must confirm that the surgery team has completed the listed tasks before it proceeds with the operation. Safe Surgery Saves Lives

action area 2
Patients for Patient Safety In the area of patient and consumer involvement, Patients for Patient Safety is building a patient-led, global network of patients and patient organizations to champion patient safety. Patients for Patient Safety

action area 3
Research for Patient Safety Research for Patient Safety undertakes global prevalence studies of adverse effects and is developing a rapid assessment tool for use in developing countries. WHO Patient Safety is undertaking a major research project to understand the nature of patient harm in ten developing countries and those with economies in transition, and to develop measurement tools for use by WHO Member States. The first round of the Small Grants for Patient Safety Research was launched in June 2008 aiming to build capacity in this area. Research for Patient Safety

action area 4
International Patient Safety Classification The International Patient Safety Classification aims to define, harmonize and group patient safety concepts into an internationally agreed classification. This will help elicit, capture and analyse factors relevant to patient safety in a manner conducive to learning and system improvement. International Patient Safety Event Classification

action area 5

Reporting and Learning Reporting and Learning aims to generate best practice guidelines for existing and new reporting systems, and facilitate early learning from information available. WHO has drafted Guidelines on Adverse Event Reporting and Learning Systems, which are the subject of a consultation exercise during 2007-8. Reporting and Learning

action area 6
Solutions for Patient Safety Solutions for Patient Safety are interventions and actions that prevent patient safety problems recurring and thus reduce risk to patients. WHO Patient Safety and the WHO Collaborating Center on Patient Safety (Solutions) is promoting existing interventions and coordinating activity internationally to ensure that new solutions are delivered. Solutions for Patient Safety

action area 7
High 5s The High 5s initiative will spread best practice for change in organizational, team and clinical practices to improve patient safety. High 5s

action area 8
Technology for Patient Safety Technology for Patient Safety focuses on the opportunities to harness new technologies to improve patient safety.

action area 9
Knowledge Management Knowledge Management will work with Member States and partners to gather and share knowledge on patient safety developments globally.

action area 10
Eliminating central line-associated bloodstream infections WHO Patient Safety will ensure that the results of the work in the State of Michigan, USA, to eliminate central line-associated bloodstream infections is replicated in other settings, this could change the lives of tens of thousands of patients worldwide, especially on intensive care patients.

action area 11
Education for Safer Care Education for Safer Care will develop a curricular guide for medical students as well as other resources. Education for Safer Care

action area 12
Safety Prize The Safety Prize will be an international award for excellence in the field of patient safety that will act as a driver for change and improvement.

action area 13
Medical Checklists After the success of the Surgical Safety Checklist developed by Patient Safety last year, which was shown to decrease morbidity and mortality by over one-third, WHO Patient Safety is working on additional checklists in order to determine if this approach is effective in other areas of medicine as well. As part of WHO's response to the H1N1 pandemic, WHO Patient Safety earlier this year has developed a checklist for health care workers treating patients with pandemic influenza A (H1N1). The programme is

currently developing a Safe Childbirth Checklist in collaboration with three WHO Departments (Making Pregnancy Safer, Reproductive Health Research and Child and Adolescent Health). WHO Patient Safety is also developing a Trauma Care Checklist in collaboration with the Department of Violence and Injury Prevention and Disability.

Evidence of unsafe care in developing and transitional countries

Unsafe medical care is a major source of morbidity and mortality throughout the world
Low income countries are faced with many competing challenges and public health threats, which are exacerbated by the burden caused by health care. It is not the intent of health professionals to fail patients. Rather, the harm caused by health care is often the result of failing processes and weak systems. This is especially true in developing countries where health professionals are expected to carry out their job and deal with complicated situations with very limited resources. Often doctors and nurses have not received adequate training, are not adequately supervised, do not have protocols to follow or the means to record patients' information, and in some cases do not even have running water with which to wash their hands. Therefore, patient safety has to be addressed from a systems perspective examining the situation and putting in place mechanisms to minimize the risks, addressing some of the main latent causes that lead to poor outcomes. Everywhere effective change requires a multi-faceted systemic approach. Among the main actions in tackling unsafe care is the need to strengthen the capacity of health systems, with stronger education of the workforce and with ensuring more rigorous processes of care. Fostering cultural change towards better and safer care, based on the commitment of leaders and practitioners at all levels of care, is also necessary. It is essential to understand which practices can work effectively in different contexts. Safety practices that work in one context may not work in another one. Inequity is also a major problem in many contexts. A challenge is to ensure that patients at every level, particularly the disadvantaged populations, can be reached with cost-effective and safe care. Lack of adequate data and of robust communication structures between health authorities, providers, the public and private sectors and the research community hampers understanding of the problems associated with patient safety. These problems are being made more urgent by the growth in privatization and trade in health services. Healthcare systems and institutions that start to look at their own problems, with an aim to understanding their failures and improve, are already making gigantic steps in the quest towards safer care.

First Global Patient Safety Challenge

The goal of Clean Care is Safer Care is to ensure that infection control is acknowledged universally as a solid and essential basis towards patient safety and supports the reduction of health careassociated infections and their consequences. As a global campaign to improve hand hygiene among health-care workers, SAVE LIVES: Clean Your Hands is a major component of Clean Care is Safer Care. It advocates the need to improve and sustain hand hygiene practices of health-care workers at the right times and in the right way to help reduce the spread of potentially life-threatening infections in health-care facilities.

SAVE LIVES: Clean Your Hands - WHO's global annual campaign

Five steps to 5 May 2012 - What's YOUR plan? Our 2012 call to action was "create your action plan based on your facility's results using the WHO Hand Hygiene Self-Assessment Framework". Congratulations to everyone who has worked hard to be part of the celebrations for the fourth year of WHO SAVE LIVES: Clean Your Hands. The commitment again has been overwhelming and demonstrates that there is truly a global momentum for improving patient safety through clean hands year on year.

Background to Clean Care is Safer Care

WHO Global Patient Safety Challenges have represented calls from around the world on specific patient safety issues and have been reflected in global campaigns which bring together expertise and evidence to raise awareness and to catalyze political and professional commitment on these important patient safety aspects. They also generate knowledge, recommendations and actions to improve the safety of patients receiving care globally. The focus and objectives of Clean Care is Safer Care The first of these Challenges, Clean Care is Safer Care, was targeted at the important aspect of reducing health care-associated infections (HCAIs). HCAI is the most frequent harmful event in health-care delivery and occurs worldwide in both developed and developing countries. Hundreds of millions of patients are affected each year, leading to significant mortality and financial losses for health systems. The initial focus of Clean Care is Safer Care, launched in October 2005, was to promote best hand hygiene practices globally, at all levels of health care, as a first step in ensuring high standards of infection control and patient safety. Hand hygiene, a very simple action to ensure hands are free of germ, is well accepted to be the primary measure to reduce HCAI, enhancing patient safety. The vision of Clean Care is Safer Care is to make infection prevention and control a priority in health care everywhere, with clean hands as the basis, and for this

reason an annual campaign to maintain a global profile; SAVE LIVES: Clean Your Hands, was launched in 2009. Awareness raising on the burden of HCAI and the importance of hand hygiene, catalyzing political and stakeholders' commitment to reduce HCAI, developing technical guidance and recommendations and supporting actions in Member States have been the main objectives of Clean Care is Safer Care. This has included coordinating the sharing of information about activities among existing country/area hand hygiene campaigns, through an informal but well-established network called CleanHandsNet. Key accomplishments of Clean Care is Safer Care More than two thirds of Ministries of Health from Member States having signed formal statements pledging their commitment to take action to reduce HCAI at the country level, in particular through hand hygiene improvement. WHO Guidelines on Hand Hygiene in Health Care; the first international guidelines on this topic, providing technical recommendations to health-care facilities worldwide. The WHO "My Five Moments for Hand Hygiene"; a user-friendly, innovative way to understand, monitor and practice hand hygiene action at the point of patient care. A Multimodal Improvement Strategy based on the recommendations in the Guidelines; field tested in a wide range of different health-care settings for feasibility, adaptability and success, subsequently demonstrated both in high and low-/middle-income countries. A package of 32 implementation tools to support the Strategy (thus far in three official WHO languages) including posters, templates, instructions. WHO Hand Hygiene Self-Assessment Framework, to help track progress with hand hygiene sustainability. WHO Moment 1 'before touching a patient' global observation survey report (2010). 64 scientific publications and 49 abstracts at international conferences. Engagement of leading infection prevention and control societies and institutions. Cascade training on infection control to build capacity globally and at country level and establishment of regular virtual training sessions. Sign-up from well over 15 000 health-care facilities in support of SAVE LIVES: Clean Your Hands; the overall approach to hand hygiene improvement provided by WHO has been extremely successful and widely adopted in health-care settings worldwide. A Guide to the Application of the WHO Multimodal Hand Hygiene Improvement Strategy and the "My Five Moments For Hand Hygiene" approach in Outpatient and Home-based Care and Long-term Care Facilities, accompanied by adapted tools. WHO Hand Hygiene Self-Assessment Framework global survey report (2012) Moving forward WHO Clean Care is Safer Care will continue to provide leadership and advocate to support a reduction of the global endemic burden of health care-associated infections, including: Promotion of activities for hand hygiene improvement and sustainability, primarily through the SAVE LIVES: Clean Your Hands campaign, moving countries from commitment to true action at the point of care. Coordination of WHO CleanHandsNet. Updating the WHO Guidelines on Hand Hygiene in Health Care and including new information on our web pages. Estimating the burden of endemic HCAI worldwide, in particular by evaluating the magnitude of the problem in settings with limited resources where available data are very scarce but where HCAI is much more frequent than in developed countries. Identifying specific new solutions to be developed and promoted in addition to hand hygiene. Special focus is being put on the prevention of specific infection types, in particular surgical site and bloodstream infections, in collaboration with other WHO programmes and global experts. Identification of feasible infection control strategies to be adapted for settings with limited resources. Supporting knowledge transfer of key infection control principles through a range of mechanisms. Identifying gaps in the infection control evidence and new threats, working alongside other global experts. Team members Professor Didier Pittet, an internationally renowned expert in the field of infection prevention and control, is the external lead of Clean Care is Safer Care. He provides leadership and technical input through the activities of the WHO Collaborating Centre on Patient Safety at the University of Geneva Hospitals, supported by a core team.

A small team is the core of Clean Care is Safer Care and exists within the WHO Patient Safety Programme at WHO headquarters in Geneva to facilitate delivery of the above plans. In addition, a core group of international experts significantly contribute to the work of Clean Care is Safer Care, especially regarding the preparation of the WHO Guidelines on Hand Hygiene in Health Care and the development of hand hygiene tools. The Programme also works in close collaboration with leading international and national organizations in the field of infection control and infectious diseases.

The Second Global Patient Safety Challenge

The goal of the Safe Surgery Saves Lives Challenge is to improve the safety of surgical care around the world by ensuring adherence to proven standards of care in all countries. The WHO Surgical Safety Checklist (above) has improved compliance with standards and decreased complications from surgery in eight pilot hospitals where is was evaluated.