This report, subtitled “Health worker education, skills and safety,” focuses on Strategic Objective 5 which aims to inspire, educate, skill, and protect health workers to contribute to the design and delivery of safe care systems. It underscores that understanding patient safety is essential for all health workers, although its comprehensive integration into professional education globally remains limited.
The report is structured around five strategic objectives designed to enhance patient safety through the health workforce:
- Strategy 5.1: Patient safety in professional education and training
- Strategy 5.2: Centres of excellence for patient safety education and training
- Strategy 5.3: Patient safety competencies as regulatory requirements
- Strategy 5.4: Linking patient safety with appraisal system of health workers
- Strategy 5.5: Safe working environment for health workers
Key Findings and Insights from the Report:
The report reveals that the world is less than halfway to achieving the Global Patient Safety Action Plan 2021–2030 recommendations related to health worker education, skills, and safety, with an average global performance score of 42 out of 100 for Strategic Objective 5. Only 22% of criteria were fully met by responding countries, and 35% were partially met. There is significant variation across individual criteria and WHO regions. High-income countries (HICs) generally show higher median scores but inconsistencies exist across all income groups.
Details on Each Strategic Objective:
- Patient safety in professional education and training (Strategy 5.1):
- Globally, only one fifth of countries have incorporated patient safety into their undergraduate and postgraduate professional education curricula. A quarter of countries provide specialized in-service training courses on patient safety.
- The WHO Patient Safety Curriculum Guide, a multi-professional guide, is designed to be easily integrated into existing healthcare education curricula. Only 17% of countries have adopted or adapted this guide nationally, with another 45% indicating that adoption is underway. Most early adopters are HICs and upper middle-income countries (UMCs).
- Patient safety has been included in undergraduate curricula for all health professionals in 20% of countries, and in at least one course in 53% of countries. For postgraduate streams, these figures are 23% and 43% respectively.
- Nursing education is the most progressive field, with 67% of countries incorporating patient safety principles into their nursing education programs. Traditional and complementary medicine practitioners, optometrists, and audiologists have the least developed patient safety education frameworks.
- Only a quarter of countries have well-established in-service training programs focused on patient safety, and 19% have continuing professional development programs for patient safety.
- Centres of excellence for patient safety education and training (Strategy 5.2):
- Only 22% of countries have an operational national institution that offers education and training in patient safety for various health worker categories. An additional third of countries are working towards making such a center operational.
- A significant challenge is the global shortage of trainers on patient safety, with only 14% of countries reporting sufficient training capacity. Only 10% of countries report having enough specialized trainers capable of providing patient safety training.
- 19% of countries fully incorporate innovative teaching methods and simulation techniques into their patient safety curricula, with another 33% conducting pilot trainings.
- Patient safety competencies as regulatory requirements (Strategy 5.3):
- A quarter of surveyed countries have established patient safety competencies for all categories of health workers. This is most common in the European and Western Pacific Regions.
- Only 14% of countries incorporate core patient safety competencies into licensing and re-licensing requirements for health workers. Another 21% are in the process of doing so.
- 31% of countries have established specific criteria for competencies required for health workers to practice in high-risk clinical areas, such as intensive care and emergency medicine.
- The Safety Competencies Framework by Healthcare Excellence Canada is highlighted as a tool to integrate patient safety principles into curricula, covering domains like patient safety culture, teamwork, communication, risk management, human factors, and incident disclosure.
- Linking patient safety with appraisal system of health workers (Strategy 5.4):
- Only 26% of countries have a regular system for evaluating the performance of all health workers, and only 8% consider health workers’ participation in patient safety programs in their performance evaluation.
- A significant performance gap exists in incorporating patient safety metrics into health worker appraisals across all WHO regions.
- Only 12% of countries have established reward or recognition schemes for health workers who achieve exceptional results in patient safety. About a quarter of countries are developing such incentives.
- Safe working environment for health workers (Strategy 5.5):
- There is a strong interdependence between patient safety and health worker safety, highlighted during the COVID-19 pandemic. Unsafe working conditions, stress, burnout (rates between 41% and 52% globally), violence, and occupational infections like hepatitis B and C pose significant risks to health workers and patient safety.
- The WHO Health Worker Safety Charter calls on governments to protect health workers from violence, improve mental health, protect from physical/biological hazards, advance national safety programs, and connect policies to patient safety strategies. Only 18% of countries have formalized their commitment to this charter by signing it, with 22% considering it.
- Around 70% of countries have established or are working towards establishing a national program for occupational health and safety of health workers. 41% have programs in place, and 30% are developing them. HICs show the highest proportion of implementing these programs (56%).
- Only 28% of countries provide mental health support for health workers, with significant disparities across income groups (e.g., 43% in HICs vs. 8% in LICs).
- While 88% of countries have a vaccination program for health workers, only 55% ensure that all at-risk health workers are vaccinated according to national policy.
- 70% of countries investigate serious incidents of violence at healthcare facilities, but only 34% have enacted specific laws or policies to prevent and eliminate violence against health workers in a sustained way.
This report provides a comprehensive overview of the current landscape of health worker education, skills, and safety, highlighting both progress and persistent challenges across various regions and income levels. It emphasizes the critical need for continued efforts and investments to ensure a safe, skilled, and protected health workforce, which is foundational to delivering high-quality, safe patient care.
Reference: Global patient safety report 2024. Geneva: World Health Organization; 2024.
