Janet García González[1], Felipe Arturo Treviño Acosta[2]
and Sorely Miranda Rangel González[3]
Introduction. Context and Relevance of Quality and Safety in Patient Care
Quality and safety in patient care are fundamental aspects of healthcare, as they have a direct impact on the effectiveness of treatments, patient satisfaction and the prevention of adverse events. Patient safety, defined as the reduction of unnecessary harm associated with healthcare to an acceptable minimum, is a relatively new area of focus that has gained significant momentum since the 2000s (Simplício, 2023).
The importance of patient safety is underscored by alarming statistics from the World Health Organization, which indicate that the risk of a patient dying from a preventable clinical mishap is significantly higher than the risk of dying in a plane crash (Gupta, 2023). In developed countries, one in ten patients is harmed while receiving care, and the situation is even more serious in developing countries due to inadequate information on adverse events (Rahman, 2023).
Factors such as teamwork, time management, workload, and patient safety culture are critical to ensuring high-quality care and staff well-being (Alzahrani, 2023). Effective communication between healthcare providers, including doctors and nurses, is essential to fostering a culture of safety and addressing the technical and functional dimensions of patient safety (Jasinska, 2022). The implementation of quality management systems and external evaluations is necessary to ensure transparency and minimize preventable adverse effects (Gupta, 2023). In addition, social determinants of health, such as economic stability, education, and access to healthcare, significantly influence patient safety and quality of care. Addressing the determinants can help reduce health disparities and improve patient safety outcomes (Wu, 2023).
Innovative activities that engage healthcare professionals in quality and safety procedures can also improve compliance with safety protocols and foster a culture of quality. In an increasingly complex and demanding medical environment, ensuring quality and safety in care has become a priority for health professionals, healthcare institutions and health systems in general.
Currently, technological advances, the diversity of available treatments and the growing demand for health services have generated an environment where quality and safety in patient care are aspects that cannot be overlooked. Patients expect high-quality care that not only addresses their medical needs but also respects their dignity, promotes their well-being, and ensures optimal outcomes.
Scientific Paradigms
Quality and safety in patient care represent a major challenge that goes beyond simply being a subject of work or study in the medical field. According to Moreno Monsiváis (2013), guaranteeing these aspects requires an institutional, multidisciplinary, interdisciplinary, and individual commitment on the part of both healthcare providers and recipients. This commitment is crucial to maintaining quality and safety standards in the patient care process. If any of the parties or components involved fail to understand or perform their functions effectively, the patient care process may suffer from a deficiency in quality and safety.
To further elucidate and define the scope of this research, it is imperative to identify the scientific paradigms that revolve around the issue of quality and safety in patient care. These paradigms encompass scientific advances and beliefs, established values, and methodologies that are universally recognized, but only for a specific period (Álvarez Vega et al., 2022). The analysis of these scientific advances within such paradigms helps to recognize the distinct elements, whether overt or covert, on which researchers and members of the scientific community have focused (Kuhn, 1971). This comparative analysis helps to understand the evolution of ideas and practices in the field of quality and safety of patient care, thus contributing to improving the general standards in the provision of health services.
Scientific Paradigms on Innovation in the Quality and Safety of Patient Care
Innovation in the quality and safety of patient care has been a focal point of numerous paradigms and scientific studies, reflecting a multifaceted approach to improving health outcomes. Scientific research on innovation in the field of quality and safety in patient care is a vast and constantly evolving domain, characterized by the convergence of various studies and research efforts that delve into novel technologies, methodologies and practices aimed at improving healthcare processes.
The application of technology to optimize healthcare stands out as a common theme in several studies. For example, there are advocates of data-driven approaches to assess and mitigate risks in care processes; Cascini et al. (2021) highlight that “data-driven technologies work […] by utilizing machine learning or other forms of artificial intelligence, which helps to harness and enhance the scope and depth of electronic health data to facilitate better healthcare delivery” (p.2). Similarly, Pinto et al. (2023) focus on analyzing the evolution of electronic platforms to improve health. Both studies reflect the growing inclination towards digitalization and the incorporation of technology in the health sector, with the aim of improving the effectiveness and efficiency of services.
The field of telemedicine emerges as an area of innovation and shared interest in numerous research areas. Briglia de Santana et al. (2023), who state that “telemedicine is a subset of telehealth […] designed to provide medical care and health information in various locations” (p. 276), explore its application in the monitoring of chronic patients; for their part, Silva Vervloet et al. (2023), who specify that telemedicine involves the provision of remote health services using information and communication technologies for patient diagnosis, treatment, and monitoring, seek to investigate its integration into primary care. Both studies underscore the ability of telemedicine to expand access to care and improve the treatment of diseases, but they also present challenges in relation to equity and accessibility.
Inclusion and accessibility in healthcare are topics that are addressed from various points of view. While the ONCE-Vía Libre e Ilunion Foundation (2020) advocates technological solutions aimed at improving the user experience to strengthen accessibility, Alves da Silva et al. (2023) assess, through a mobile apps rating scale, the quality of mobile apps in health management, focusing on postpartum bleeding and covering aspects of usability and accessibility. These studies underscore the importance of recognizing the variety of user requirements and ensuring that technology solutions are comprehensive and accessible to all.
However, there are also perceived disparities between research efforts. For example, while some studies highlight the efficacy and desirability of technology in healthcare, others warn of potential risks and obstacles, such as data security and privacy issues; Crawford and Serhal (2020) identify elements such as poverty, restricted access to digital health services, low participation in specific communities, and barriers to digital literacy as contributing factors to adverse health outcomes.
Building the Object of Study for the Application of Innovation in the Quality and Safety of Patient Care
The construction of the object of study involves the intricate design and advancement of a technological platform aimed at fostering a culture of quality and patient safety within clinical hospital services. This initiative plays a critical role in mitigating adverse events or negligence in healthcare, often associated with care provided by healthcare professionals.
These efforts not only establish, but also reinforce a multidisciplinary system that focuses on identifying, evaluating, prioritizing, selecting, and improving the processes that are essential to the establishment and management of an organizational quality system in healthcare. In accordance with the stipulations of the Sistema Nacional de Certificación de Establecimientos de Atención Médica (SiNaCEAM), organizations are encouraged to cultivate a culture that values quality and patient safety, fostering a learning environment that recognizes errors and, at the same time, strives to prevent their recurrence through the systematic integration of safety measures in health centers.
The inclusive nature of the certification process, which encompasses both public and private medical institutions, extends the benefits to the entire population of Mexico, including those with limited or no access to medical services. By leveraging technological innovations across various processes, healthcare professionals can better understand the complexities of implementing SinaCEAM’s patient safety model. Consequently, an exhaustive analysis of innovative processes is proposed in two different areas.
First, the innovative approach to hospital processes involves considering health centers as interconnected systems, in which medical personnel from all departments perform integral functions. To ensure the efficiency of these systems, it is necessary to actively participate in the adoption of safety models that aim to improve critical processes and obtain optimal results focused on the well-being of patients.
Second, technological advancements are critical to modernizing hospital operations, encompassing infrastructure, medical devices, and clinical protocols. Integrating technology not only facilitates the cultivation of a culture focused on quality and safety in patient care, but also streamlines processes and activities in a technology-driven way, fostering significant social and health-related impacts.
Based on this framework, and recognizing the scientific paradigms that underpin the broader discourse on quality and safety in patient care, the object of study is constructed with a focus on innovative processes and technologies.
Conclusions and Recommendations
Innovative activities involving health professionals outside their routine tasks have managed to promote compliance with quality procedures and improve interdepartmental cooperation, thus reinforcing a culture of safety (Seaume et al., 2022). One of these is accreditation, which plays a crucial role in the patient’s perception of quality, as demonstrated by De la Puente (2023), who compared accredited and non-accredited hospitals, where patients in accredited facilities reported better adherence to innovative practices.
The importance of a comprehensive approach to patient safety, including both technical and functional dimensions, is highlighted by the need for a centralized system to collect and analyze safety issues reported by medical staff (Jasinska, 2022).
Systematic reviews have identified effective interventions such as medication reconciliation, surgical safety checklists, and electronic health records as significant contributors to patient safety, reducing adverse events and preventable harm (Lungu, 2023).
Specific interventions, such as correct patient identification and effective communication, have been shown to have a significant impact on the quality of health services in hospital settings (Fitriani, 2022). Communication and teamwork are critical, as the exchange of information between hospital staff can prevent errors and improve patient safety.
Together, these paradigms underscore the importance of continuous innovation, effective communication, and comprehensive safety protocols to improve the quality and safety of patient care. Specific interventions, such as correct patient identification, effective communication, and reduction of the risk of falls, have been shown to significantly impact the quality of health services.
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