Despite major investments in healthcare access worldwide, patient harm remains a leading cause of preventable death. Health systems increasingly recognize that expanding services without improving quality may produce limited health gains.
What the Evidence Shows
Evidence across WHO and global health reports highlights three recurring drivers:
fragmented communication,
weak reporting systems,
resource–workflow mismatch.
Field Perspective
From a clinical anesthesia perspective, many adverse events are rarely caused by lack of knowledge, but rather by system pressures and workflow interruptions.
From 2017-2018, i had the opportunity to be a facilitator for the implementation of the WHO Safety Checklist in Cameroon. We studied the project implementation 4 months later (Read here).
It highlighted suggested good penetration as well as a hight fidelity for adherence to 6 basic safety processes. Nevertheless fidelity for nontechnical skills measured by the WHO Behaviorally Anchored Rating Scale was 4.5 of 7.
As a clinician working in operating rooms, i could go back to some of visited hospitals and only few of them were using the Checklist we created with them. But quiet shattered at some point. Each part was not done properly or completely.
Main reason of systematic application: it was mandatory from the top management.
Additionally, in others hospital, it depends on individual willing, and the type of surgery usually for major surgery; again without real communication among the whole team.
Systems Analysis
These patterns suggest that patient safety failures are less individual errors than predictable outcomes of system design and value of soft skills.
Expertise also relies on capacity for limited resources environments to conduct objectives audits without bias and complete impartiality.
Practical Implications
For hospitals : strengthen reporting culture, simplify protocols ;
For policymakers and firms: invest in measurement systems ;
For clinicians : focus on teamwork reliability ;
Improving safety is not primarily a technological challenge but a systems leadership challenge.