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This article explores how remote patient monitoring (RPM) is transforming patient safety by enabling continuous, real-time tracking of health data outside clinical settings. It provides a comprehensive overview of RPM technologies, their clinical benefits, implementation challenges and best practices. It highlights the growing importance of RPM in proactive care models and its role in reducing hospital readmissions, improving medication adherence and supporting vulnerable patient populations. How is remote patient monitoring changing patient safety? A Mass General Brigham study of 10,803 participants found that RPM reduced mean blood pressure from 150/83 to 145/83, which significantly lowers cardiovascular disease risk.[1] RPM technologies provide clinicians with real-time data streams; this allows for quick interventions when patient conditions change. The continuous monitoring bridges dangerous gaps between appointments where medical complications developed undetected. Beyond crisis prevention, RPM enhances medication safety through adherence tracking and creates comprehensive longitudinal health records revealing subtle trends conventional episodic care might miss. The benefits reach vulnerable groups—elderly, rural and mobility-limited patients—who now get regular supervision free of transportation constraints, creating safety nets once inaccessible under conventional care models. Real-time monitoring: a lifeline for early intervention and patient safety RPM provides regular data collection that serves as a buffer against avoidable harm by detecting minute physiological changes that indicate clinical deterioration. RPM significantly bolsters patient safety by enabling early detection of health deteriorations, thereby facilitating timely interventions. A study published in NPJ Digital Medicine analysed 29 studies across 16 countries and found that RPM interventions led to a reduction in hospital readmissions and emergency department visits.[2] Specifically, the study highlighted that RPM demonstrated positive outcomes in patient safety and adherence, and improved patients' mobility and functional statuses. This early warning feature considerably improves patient safety by enabling timely clinical interventions before symptoms worsen. A known patient with serious congestive heart failure can also be given diuretic adjustments remotely, avoiding hospitalisation. RPM also decreases the risks associated with medications by enabling physicians to identify missed doses and adverse reactions. Long-term data further strengthens safety by showing patterns—like low oxygen levels at night in chronic obstructive pulmonary disease (COPD) patients—that single tests might miss. Personalised interventions are supported by this fine-grained understanding, especially for high-risk populations such as patients living in rural areas that have improved access to attentive monitoring. By combining speed and accuracy, RPM transforms patient safety to an actionable, data-driven and efficient procedure rather than a fixed objective. Key technologies driving remote patient monitoring: enabling safer, data-driven care Remote patient monitoring depends on a complex ecosystem of linked technology that extends clinical supervision outside of facility boundaries. Wearable devices form the basic foundation of this system—with regulatory-approved sensors capturing vital metrics continuously. RPM is transforming healthcare by shifting from reactive to proactive safety strategies. These digital systems continuously track vital signs, medication compliance and physiological parameters outside traditional clinical settings. This enables early detection of deterioration before serious complications arise. Advanced cardiac monitors identify arrhythmias with 98% accuracy and smart glucose sensors provide real-time glycaemic information via subcutaneous readings. Connected devices for tracking urinary patterns help physicians diagnose various types of incontinence without requiring in-person assessments, improving dignity and convenience for patients with mobility challenges. Smart inhalers with embedded sensors record medication usage patterns and technique, enabling precise interventions for respiratory conditions. Mobile applications are a link between patients and clinical teams—with simple dashboards that show health trends and medication adherence. These platforms usually combine clinical protocols, secure messaging systems and alerts based on preset thresholds. Backend analytics platforms transform raw physiological data into clinically relevant insights through sophisticated algorithms. These systems analyse longitudinal data against established baselines to detect minor abnormalities that precede clinical deterioration. According to studies, these predictive capacities can detect sepsis 6–12 hours earlier than traditional approaches, considerably increasing survival rates.[3] Secure, Health Insurance Portability and Accountability Act (HIPAA) compliant electronic health record (EHR) integration—using end-to-end encryption and strict authentication—creates comprehensive patient profiles, enabling better-informed treatment decisions. Implementing remote patient monitoring: main challenges RPM has numerous benefits in healthcare, but putting it into practice involves challenges that need thoughtful solutions. Digital literacy gaps create accessibility barriers, particularly among elderly populations where only 64% report comfort with technology-based healthcare tools according to the Journal of the American Geriatrics Society survey of 3,450 seniors.[4] Privacy concerns are significant as continuous monitoring generates sensitive health data that requires strong security. To maintain patient trust while meeting regulatory standards, healthcare centres must use end-to-end encryption, unambiguous consent mechanisms and transparent data governance frameworks. Another problem is clinical workflow integration; RPM systems that function without the use of EHR platforms result in documentation silos. Customised integration pathways that embed remote monitoring data within regular clinical interfaces are required for successful RPM implementation. When clinicians get an overwhelming number of notifications, the intended safety benefits are undermined. Effective systems use tiered alert processes with tailored thresholds that are based on patient baselines rather than population norms. These graduated notification systems ensure that important notifications receive necessary attention while preventing frequent low-risk alerts. As healthcare organisations face these issues, good implementation frameworks that include technical assistance, privacy safeguards and workflow optimisation are relevant to fulfilling RPM's full potential. Best practices for patient-centered remote monitoring Effective RPM is beyond technological equipment; it requires an effective structure that can only come from consistent planning and review. Healthcare organisations should establish dedicated implementation teams comprising clinicians, IT staff and patient advocates to gather diverse viewpoints and boost adoption of RPM. This cross-functional strategy improves RPM acceptance and sustainability while lowering possible resistance. Healthcare administrators should train providers thoroughly on both technical use of medical devices and data interpretation. A 2023 NEJM Catalyst study of 76 healthcare centres showed that centres with robust training of healthcare professionals had 43% higher RPM use after a year compared to those with minimal training.[5] Healthcare professionals should also be trained to focus equally on patient support through easy enrolment, clear instructions in multiple languages and in-person device training. Dedicated tech support channels should be created for RPM users in order to prevent frustration whenever there is a network glitch. Clear clinical protocols defining intervention thresholds, escalation pathways and response timeframes should be made to transform data into actionable intelligence. Rigorous quality assurance measures—including regular connectivity testing, data validation audits and patient usability assessments—safeguard programme integrity. Periodic review cycles examining alert frequency, response times and intervention outcomes help refine system parameters for maximum clinical utility. The most effective RPM programmes integrate patient feedback mechanisms allowing continuous refinement of interfaces, alert frequencies, and educational materials based on real-world experience. Conclusion RPM is improving healthcare from reactive to preventive care. As technology advances, these systems will become standard practice. Future developments will include smaller sensors, longer battery life and better connectivity—making monitoring easier for patients while improving data quality. Better predictive analytics will help physicians identify health problems earlier with greater accuracy. Beyond helping patients, RPM is changing organisational safety culture by expanding care beyond hospitals. This shift represents a major advancement—creating continuous monitoring systems that protect patients throughout their healthcare journey and redefining patient safety for modern medicine. References 1. Mass General Brigham. Mass General Brigham Remote Healthcare Delivery Program Improves Blood Pressure and Cholesterol Level, 9 November 2022. 2. Ying Tan S, et al. A systematic review of the impacts of remote patient monitoring (RPM) interventions on safety, adherence, quality-of-life and cost-related outcomes. NPJ Digital Medicine 2024; 7: 192. 3. King J, et al. Early Recognition and Initial Management of Sepsis in Adult Patients. Ann Arbor (MI): Michigan Medicine University of Michigan, 2023. 4. American Geriatrics Society 2024 Annual Scientific Meeting. Journal of the American Geriatrics Society 2024; 72: III-VI. 5. Barrett JB, et al. Reduced Hospital Readmissions Through Personalized Care: Implementation of a Patient, Risk-Focused Hospital-Wide Discharge Care Center. NEJM Catal Innov Care Deliv 2025;6(6). DOI: 10.1056/CAT.24.0420. Further reading on the hub Putting patients at the heart of digital health Digital diagnosis—what the doctor ordered? Electronic patient record systems: Putting patient safety at the heart of implementation How do we harness technology responsibly to safeguard and improve patient care?

The work of the Department of Health and Social Care (DHSC) and its organisations touches the lives of an average of 1.7 million patients per day and costs the UK taxpayer around £187.3 billion per year. This report presents the Public Accounts Committee’s analysis of the DHSC Accounts for 2023/24. The Public Accounts Committee is a Select Committee in the House of Commons that examines value for money of Government projects, programmes and service delivery. This report highlights a number of issues of concern, including the two areas highlighted below. Abolition of NHS England The Committee points to several issues where it believes further clarity is required from the Government in this respect: The lack of a clear plan for how DHSC and NHS England will achieve significant headcount reductions, and the costs involved. How the reductions fit in with the wider 10 Year Health Plan for the NHS. How savings made from reducing NHSE staff costs help frontline services. How the institutional knowledge of NHSE would be preserved following its abolition. The scale of headcount reductions in the DHSC, and the geographical spread of the planned 50% headcount reductions in NHSE and across local Integrated Care Boards. Clinical negligence The Committee has expressed disappointment in this area and stressed the need for significant improvements, stating that: “Both patients and public money need to be better protected by the Department. Far too many patients still suffer clinical negligence which can cause devasting harm to those affected. It also results in large sums of public money being spent on legal fees and compensation, drawing resources from the wider health service.” Concerns it highlights include: £58.2bn has been set aside to cover the potential cost of clinical negligence events in the latest accounts – the second largest liability across government after nuclear decommissioning. 19% of money awarded to claimants in 2023-24 goes to their lawyers (£536m of the total £2.8bn paid that year), on top of the fees payable for the Government Legal Team. It recommends that within six months, DHSC should set out a plan with clear actions to: Reduce tragic incidences of patient harm to as low a level as possible Manage the costs of clinical negligence more effectively, including introducing a mechanism to reduce legal fees. Improve patient safety across the NHS and in particular in maternity services

Healthcare is undergoing rapid transformation, driven by digital innovation, medical advancements, and shifting care models. At the same time, growing demand for care, workforce shortages and financial constraints are putting pressure on healthcare systems, reshaping how care is delivered and how patient safety is ensured. As roles and responsibilities evolve, professionals must adapt to new ways of working, integrating innovation while ensuring human oversight remains central to patient safety. Meanwhile, staffing shortages and cross-border migration are redistributing tasks across professions, often beyond traditional boundaries, introducing new risks and requiring proactive approaches to provide safe, coordinated care. This conference will not only focus on risks but also on possible solutions. How can we anticipate rather than react; leverage innovation without increasing complexity; involve the patients in the safety of their own care; support those who work every day to keep patients safe? Register

The National Patient Safety Plan of the Republic North Macedonia is based on a comprehensive assessment of the situation conducted in December 2022, with technical support from the WHO Office for Quality of Care and Patient Safety in Athens. Its vision is that the Republic of North Macedonia will be an environment where no patient will experience harm from an adverse event and every patient will receive safe health care that will be timely, equitable, and available everywhere. Mission To implement policies, strategies and practices that are based on evidence, patient experience, appropriate system design, healthcare workforce and partnership in order to eliminate all sources of preventable risks and harm to patients and healthcare workers. Main dimensions The main dimensions for the advancement of the patient safety framework, consequently contributing to the improvement of the quality of care across the country are: Adopting policies that will eliminate preventable harm in health care Establishing stable health care systems Safety of clinical processes Involving the patient and their family in the care Education, skills and safety for healthcare workers Information, research and dealing with risks Synergy, partnership and solidarity For each of these domains, a group of objectives, activities, subjects in charge of the activities, a rough timeline and possible sources of financing have been developed in a period that is synchronized with the National Health Strategy of the Republic of North Macedonia, until 2030. These elements of the national plan are drawn from the existing results of research, accreditation standards related to the safety of patients, other legal regulations, the mission of international consultants conducted in December 2022, medical practice guides, WHO policy recommendations and other documents. Considering the context of the current healthcare system and patient safety situation in the Republic of North Macedonia, four core priorities arise from the main dimensions of the National Plan: Training of healthcare professionals Awareness and patient engagement Establishment of the Committee for Patient Safety Data infrastructure and IT-based systems to support patient safety interventions

Patient safety is the core foundation of healthcare quality. Unsafe care is a significant challenge globally, due to unsafe practices, processes, or structural inefficiencies within healthcare organisations, which in turn lead to patient safety incidents. This white paper from ISQua aims to address these challenging issues by providing a comprehensive framework to improve patient safety in hospitals and other healthcare settings. The white paper focuses on four foundation pillars that it identifies as critical for embedding patient safety into healthcare systems: 1) Advocacy and Leadership Advocate for prioritisation of patient safety within hospital policies, practices, and culture. Ensure that patient safety is embedded as a core organisational value in every level of healthcare delivery. Establish a strong hospital governance structure that ensures leadership commitment to patient safety and accountability. 2) Health Worker Education and Safety To empower health workers with the knowledge, skills, and tools to be proactive agents of patient safety within healthcare organisations through continuous education and training programmes. It prioritises the physical and psychological well-being of healthcare professionals to enhance workforce resilience to deliver safe and effective care. 3) Patient, Family and Carer Engagement and Empowerment To empower and engage patients, families, and carers in patient safety efforts. To ensure effective collaboration between healthcare providers and patients to improve safety and quality of care delivery 4) Improvement in Clinical Processes Adopt evidence-based practices to manage patient safety risks in clinical care. Ensure standardising care, utilising technology, and measuring progress and effectiveness.

Patient falls are a significant concern in healthcare settings, often leading to severe injuries, prolonged hospital stays and increased healthcare costs. The importance of fall prevention extends beyond patient safety—it reduces hospital liability, enhances patient outcomes and improves overall healthcare efficiency. By proactively assessing and addressing fall risks, healthcare providers can significantly lower the incidence of falls, ensuring a safer environment for patients. Given the aging population and increasing chronic disease burden, fall prevention remains a top priority in improving patient care and quality of life. This blog from Augustine Kumah, Deputy Quality Manager at The Bank Hospital, Accra, Ghana, explores the significance of fall risk assessment, its implementation and its role in reducing fall-related incidents in healthcare settings. Introduction Falls among patients, particularly in healthcare facilities, remain a pressing concern worldwide. These incidents not only lead to injuries, prolonged hospital stays and increased healthcare costs, but can also have lasting psychological impacts on patients. Preventing patient falls necessitates a multifaceted approach, with fall risk assessment at its core.[1] Understanding the impact of patient falls Patient falls are defined as unintentional descents to the ground that occur in healthcare facilities, including hospitals, nursing homes and rehabilitation centres. According to the World Health Organization (WHO), falls are the second leading cause of unintentional injury deaths globally, with older adults being most at risk.[2] In healthcare facilities, the consequences of falls extend beyond physical injuries; they also affect a patient’s confidence, independence, and quality of life. The financial burden of falls on healthcare systems is substantial. Costs include direct expenses such as treatment for fall-related injuries and indirect costs like litigation, reputation damage and loss of trust. Additionally, healthcare providers experience emotional distress and professional repercussions when preventable falls occur under their watch. Hence, fall prevention is not just a patient safety priority but also an ethical obligation and a cost-saving measure. The role of fall risk assessment Fall risk assessment is a systematic process to identify patients at risk of falling. Healthcare providers can implement targeted interventions to mitigate these risks by evaluating intrinsic and extrinsic factors. Intrinsic factors include age, medical history, mobility impairments and cognitive status, while extrinsic factors encompass environmental hazards, medication side effects and inadequate assistive devices. Risk assessment tools, such as the Morse Fall Scale, Hendrich II Fall Risk Model and STRATIFY Risk Assessment Tool have been widely used. These tools provide a structured approach to assess risk levels and guide preventative measures. However, their effectiveness depends on accurate application and regular updates based on patient conditions. Implementing effective fall risk assessments To maximise the efficacy of fall risk assessments, healthcare facilities must adopt evidence-based strategies and integrate them into their workflows. Key steps include: Standardised assessment protocols: Developing and adhering to standardised protocols ensures consistency in evaluating fall risks across different departments and shifts. Protocols should specify the frequency of assessments, criteria for reassessment and documentation requirements. Staff training: Comprehensive training programme for healthcare workers are essential to enhance their competency in conducting fall risk assessments. Training should cover assessment tools, recognition of risk factors and communication of findings to the care team. Patient and family education: Involving patients and their families in fall prevention efforts fosters a collaborative approach. Educating them about potential risks and preventive measures empowers them to contribute to safety. Technology integration: Advanced technologies such as wearable sensors, predictive analytics and electronic health records (EHRs) can augment traditional fall risk assessments. For instance, sensors can monitor patient movements and alert staff to potential falls, while EHRs can flag high-risk patients for closer observation. Challenges in implementing fall risk assessments Despite its benefits, implementing fall risk assessments is not without challenges. Common barriers include: Resource constraints: Limited staffing, time pressures and inadequate funding can hinder comprehensive risk assessments. Overburdened staff may struggle to prioritise fall prevention alongside other responsibilities. Inconsistent application: Variability in applying risk assessment tools can lead to inaccurate results. Subjective judgment, incomplete data collection and lack of protocol adherence contribute to inconsistencies. Resistance to change: Resistance from staff and administrators to adopt new practices or technologies can impede the integration of fall risk assessments into routine care. Patient non-compliance: Some patients may resist interventions such as bed alarms, mobility aids or supervision, increasing their risk of falling. Strategies to overcome the challenges To address these challenges, healthcare facilities can adopt the following strategies: Leadership support: Strong leadership commitment is crucial to allocating resources, establishing accountability and creating a safety culture. Interdisciplinary collaboration: Engaging multidisciplinary teams, including nurses, physicians, physical therapists and pharmacists, ensures a holistic approach to fall risk assessment and prevention. Continuous Quality Improvement: Regular audits, feedback sessions and performance evaluations help identify gaps in fall prevention efforts and drive improvements. Tailored interventions: Personalising interventions based on individual patient needs and preferences increases their acceptability and effectiveness. Conclusion Preventing patient falls requires a proactive and comprehensive approach, with fall risk assessment as a foundational element. Healthcare facilities can significantly reduce fall-related incidents and their associated consequences by identifying at-risk individuals and implementing tailored interventions. However, the success of fall prevention efforts hinges on overcoming implementation challenges through leadership support, interdisciplinary collaboration and continuous improvement. As healthcare systems evolve, leveraging technology and prioritising patient-centred care will be instrumental in advancing fall risk assessments. By embracing these advancements, healthcare providers can create safer environments that uphold all patients' dignity, independence, and well-being. References The Joint Commission. Fall Reduction Program - Definition and Resources, 28 August 2017 WHO. Falls Factsheet. World Health Organization, 26 April 2021.

This training will support the development of expert understanding and oversight of systems based patient safety incident response throughout the healthcare system - in line with NHS guidance, based upon national and internationally recognised good practice. This course covers the end-to-end systems-based patient safety incident response based upon the new NHS PSIRF and includes: PSIRF and associated documents (PSIRP, PSII standards) oversight framework effective oversight and supporting processes related to incident response maintaining an open, transparent, and improvement focused culture importance of communication and involvement of those affected (preventing further harm) commissioning and planning of patient safety incident investigations complex investigations spanning different organisational, care setting, and stakeholder boundaries Who should attend: Executives, commissioning, & service managers supporting service lead investigator roles The following only after attending the 2-day systems approach to patient safety incident response: All Executive, Commissioner and Service Leads for investigation; All Lead investigators conducting patient safety incident investigations investigators conducting Facilitator: Jo Perruzza is a former mental health nurse and has been a clinician, a clinical leader and a senior manager in mental health provider organisations. With a passion for patient safety and an expert in psychological safety she brings experience of leading internal and external investigations. Register hub members receive a 20% discount. Email [email protected] for discount code.

This document provides a framework for improving health care outcomes, patient safety and public trust in Greece. The Strategy includes 11 objectives and 47 prioritised actions, which are designed for phased, stepwise implementation. These actions focus on improving patient safety, governance, clinical guidelines and health literacy across all levels of the health care system. The vision of the Strategy is to build a health care system where quality is a daily commitment, ensuring that all individuals trust that health care will be safe, respectful, equitable and efficient. The Strategy aims to achieve the following key objectives: To nurture an efficient, accountable and data-driven health system: strong leadership and governance are essential for ensuring operational efficiency and evidence-based decision-making. Effective governance structures set clear policies, enforce accountability and ensure transparent oversight. By systematically collecting and analysing data, the country can continuously improve health care performance and decision-making. This approach fosters a culture of accountability and enables timely, informed responses to health care challenges. To foster trust in an effective and safe health system: building public trust requires a focus on patient safety, clinical outcomes and the reliability of health care services. Evidence-based practices, integrated with innovative solutions, are key to enhancing safety, accessibility and overall patient outcomes. This will help to ensure that the health care system operates reliably, fairly, and efficiently, increasing trust among patients, health care workers and the wider public. To create patient partnerships in health care provision: empowering patients to take an active role in managing their own health care is essential for developing a high-performing and cost-effective health care system. This approach leads to better resource allocation, enhanced satisfaction for both patients and providers, greater utilization of preventive services and improved health outcomes. Patients must understand their health conditions, treatment options and care processes if they are to make informed decisions. Health literacy, especially digital health literacy, equips individuals to engage effectively with health care providers. The Strategy aims to ensure that patients, families and providers collaborate to personalize care, respecting individual values and preferences and thereby improving the overall quality of care. The Strategy is structured using three strategic directions. Leadership and governance: this direction focuses on building a strong foundation for the health system through effective leadership, transparent governance and the integration of evidence-based practices. When the system operates efficiently and responsibly, it can better address the needs of the population. Evidence and innovation: this direction emphasizes the importance of continuous innovation and the integration of evidence-based practices and focuses on improving safety, effectiveness and equity in health care. By embracing new technologies and approaches, the country can enhance the reliability of its health system. Literacy and engagement: this direction emphasizes patient empowerment through improved health literacy and engagement of patients in care decisions. Ensuring that patients are well informed and fully involved in their care leads to better outcomes and strengthens the patient–provider relationship.

This conference focuses on improving patient safety in primary care and implementing the Primary Care Patient Safety Strategy which was published in October 2024. The conference will take an in depth look at the elements of the strategy and provide you with a guide to implementing both the strategy and improving patient safety in your practice. There will be an in depth look at the adoption of the Patient Safety Incident Response Framework (PSIRF) in primary care, and tools that can help you with incident reporting, investigation and learning in your practice. The conference will also highlight key clinical areas where patient safety improvement actions can have the most impact; improving and learning from errors in diagnosis, medication and prescribing related incidents, delayed referral and deterioration. The conference will conclude with a focus on learning from incidents and claims, and the role of the medical examiner in primary care which has become mandatory as of September 2024. For more information https://www.healthcareconferencesuk.co.uk/virtual-online-courses/improving-patient-safety-in-primary-care or email [email protected] hub members receive a 20% discount. Email [email protected] for discount code.

This report presents the first cross-sectional analysis of quality of care and patient safety in the World Health Organization (WHO) European Region. It is based on an analysis of macro-level data from international sources and the results of a WHO survey conducted in 53 Member States. Critical gaps identified include limited implementation of national action plans and policies for quality of care and patient safety and wide variations in indicator outcomes for dimensions of quality of care, health system functions and population health outcomes across the region. Key findings in this report included: A scaling up of implemented national action plans for quality and patient safety, including a demonstration of learning and continuous improvement of better practices, processes and outcomes, is needed in the majority of countries. Only one third of countries implemented both a national quality of care and patient safety action plan. Hospital accreditation systems are implemented in only a minority of countries, hindered by a limited availability of evidence, particularly on their cost-effectiveness. Antimicrobial resistance (AMR) plans are widely available in countries, but ample opportunities remain to combat AMR. The majority of countries (79%) have implemented an AMR plan, but persistent disparities in AMR prevalence for Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA) remain across the region. Patient or public representation in national health governance is nearly non-existent, with only 13% of countries using this policy mechanism. Health misinformation prevention plans are absent in nearly all countries. Only four countries reported the use of a health misinformation plan. Such plans are important because they allow countries to deal effectively with infodemics during emergencies, including disease outbreaks, as well as with behaviours related to immunization adherence and noncommunicable diseases. The scarcity of the health and care workforce has significant consequences for the delivery of high-quality care. A limited number of countries have a national approved priority/essential medical devices list. Data show that only 22 countries have a national list of approved priority/essential devices. Electronic health records (EHR) are implemented in a low number of countries, jeopardizing the effective uptake of quality improvement interventions. Less than three quarters of countries (70%) reported having implemented EHRs, with only 13% having guidelines for quality and safety in telehealth. Patient safety-related indicators suggest a need for improvement with a high number of patient-reported medical mistakes. People-centredness indicators highlight important gaps in data collection on patient-reported outcome measures and experiences. Less than one third of the countries report on people-centredness indicators. Patient-reported outcome measures (PROMs) and experiences (PREMs) have important consequences for public confidence in the health system, health-care utilisation patterns, retention in care, and people’s decision to bypass facilities. Aggregated data mask inequalities within countries, showing a need for local systems of data collection and an evidence-base for equity-oriented policies. Poor population health outcomes highlight the need for a life-course approach and intersectoral action taking a quality of care perspective on the health of individuals and generations. Policy actions Based on the findings of the survey and towards addressing some of the challenges revealed across countries, a number of prospective actions to promote and/or ensure quality of care and patient safety emerge from the analysis. Invest in whole-system quality that comprises integrated quality planning, quality control, and quality improvement activities. Invest in the development of national action plans and policies for quality of care and patient safety. Develop a harmonised set of indicators for measuring and continuously improving quality of care, including measures that matter most to patients. Ensure patient and public representation in national health governance. Establish clear, evidence-based standards for all care settings. Re-design models of care around the needs and preferences of patients. Invest in an health and care workforce with the capacity and capability to meet the demands and needs of the population for high-quality care. Invest in robust public budgeting for quality of care and reconfigure payments to incentivise value in health service delivery. Develop comprehensive and multistakeholder-led biotechnology sector policies to address quality and affordability for patients and health-care systems. Invest in digital health solutions that support quality of care.

This blog explores the ever-present risk of self-harm in inpatient mental health settings and looks at ways to reduce this risk.  Inpatient mental healthcare is intended to offer refuge. In theory, these are places where an individual in (mental health) crisis can step out of the chaos and venture into a structured environment that’s designed to stabilise and guide them back to balance. But for those struggling with self-harm, the reality of inpatient care is often far more complex: rules intended to keep these patients safe may suddenly become triggers. Research studies are unanimous: patients who rely on self-harm as a way to manage the intensity of their feelings can find inpatient spaces challenging. Deprived of a familiar coping mechanism, they might feel isolated or even punished (a situation that prompts an escalation of distress rather than relief). This paradox—the push and pull between patient safety and autonomy, control and compassion—makes managing self-harm in inpatient mental health settings a hefty ordeal. Self-harm in inpatient treatment: what do the studies reveal? One research study published in the Journal of Psychiatric and Mental Health Nursing has, among other results, concluded that, for some patients, the inpatient environment temporarily reduces the incidence of self-harm simply by making it physically more challenging to do so. Yet, the study underlines this sense of enforced security is fragile. For patients who have come to rely on self-harm as a form of release, removing that outlet without addressing the underlying pain can magnify feelings of helplessness. That also makes things difficult for the staff: they’re aware that while restrictions can reduce harm, they also risk pushing patients into more dangerous or desperate forms of self-harm. How to reduce the risk of self-harm in inpatient mental health settings Reducing self-harm risk in inpatient mental health settings requires a shift away from containment and toward a model that promotes healing through connection, trust and empowerment. Build authentic trust Safety isn’t simply about restrictions or even vigilance. Safety, in a setting meant for healing, is about creating trust. A staff member trained to listen without judgment and to approach the patient with calmness and empathy is often the first line of defence against self-harm. When patients feel they can freely communicate about their urges without the discouraging fear of punishment, it can reduce the compulsion to self-harm in secrecy. Offer practical coping tools Patients who self-harm typically do so because it serves as a reliable, although harmful, way to manage emotions they simply can’t handle. In an inpatient setting, replacing self-harm with skills like grounding techniques, mindful breathing, meditation or yoga, and keeping an everyday diary can be more than helpful. Introducing these skills as an alternative to self-harm will require time, practice and encouragement. Staff who guide patients through these techniques will be an important link; they’ll help patients see and feel that self-control, and not self-harm, is achievable. Provide plenty of safe outlets Patients frequently injure themselves because they don't have safe ways to express the overwhelming emotions they're experiencing. Establishing specific areas and times for patients to express themselves via art, journaling or group conversations provides a healthy means of processing challenging emotions. These kinds of therapeutic channels can lessen the urge for self-harm as a release mechanism while also making patients feel heard and understood. Collaborative care Involving patients in creating their treatment plans can foster a profound sense of agency they feel they lack. When patients participate in defining their goals and strategies, they are more likely to engage meaningfully with their treatment. Collaborative care doesn’t just manage symptoms—it affirms the patient’s role in their recovery. By involving patients as partners, we validate their insight and resilience, helping to counteract feelings of powerlessness that can trigger self-harming behaviours. Support staff resilience Working in mental healthcare, especially in crisis settings, demands both emotional endurance and self-care. In facilities where staff face constant pressure to prevent self-harm, the emotional toll can lead to burnout. A burnt-out staff member may unintentionally create a tense atmosphere that patients can sense. Facilities that invest in support systems—counselling, peer supervision or regular team check-ins—enable staff to maintain the compassion and resilience needed to connect with patients. When staff feel cared for, they can care more effectively, healing the inpatient environment. Conclusions Inpatient mental health settings face an immense challenge: to protect individuals from self-harm while also supporting the emotional work that is essential to recovery. Research underscores that while restrictions on self-harm may reduce immediate risk, they cannot address the pain that drives these behaviours. Without a shift in approach, the risk of self-harm in inpatient mental health settings remains. A treatment model that combines empathy with skill-building, collaborative care and staff support creates a space where healing can occur on a deeper level.