Effectiveness of the booster dose of COVID-19 vaccine in the Basque Country during the sixth wave: A nationwide cohort study.

The aim of the study was to assess the effect of a booster dose of COVID-19 vaccine on the rates of hospital ward and intensive care unit (ICU) admissions around the time of emergence of the Omicron variant in the Basque Country. A retrospective cohort population-based study was conducted. The population with any records related to COVID-19 vaccination up to 28 February 2022 was classified into four cohorts by vaccination status.

Implementing the WHO Safe Childbirth Checklist: lessons from a global collaboration.

The WHO Safe Childbirth Checklist (SCC) was developed to ensure the delivery of essential maternal and perinatal care practices around the time of childbirth. A research collaboration was subsequently established to explore factors that influence use of the Checklist in a range of settings around the world. This analysis article presents an overview of the WHO SCC Collaboration and the lessons garnered from implementing the Checklist across a diverse range of settings.

How safe is primary care? A systematic review.

Importance: Improving patient safety is at the forefront of policy and practice. While considerable progress has been made in understanding the frequency, causes and consequences of error in hospitals, less is known about the safety of primary care.

Objective: We investigated how often patient safety incidents occur in primary care and how often these were associated with patient harm.

WHO Efforts to Promote Reporting of Adverse Events and Global Learning.

Despite the importance of reporting systems to learn about the casual chain and consequences of patient safety incidents, this is an area that requires of further conceptual and technical developments to conduce reporting to effective learning. The World Health Organization, through its Patient Safety Programme, adopted as a priority the objective to facilitate and stimulate global learning through enhanced reporting of patient safety incidents. Landmark developments were the WHO Draft Guidelines for Adverse Event Reporting and Learning Systems, and the Conceptual Framework for the International Classification for Patient Safety, as well as the Global Community of Practice for Reporting and Learning Systems.

Case studies of patient safety research classics to build research capacity in low- and middle-income countries.

Background: Strengthening research capacity is a key priority and rate-limiting step for conducting patient safety research, particularly in low- and middle-income countries, but also in other settings where such research is currently limited. Case studies of classic publications in patient safety research were therefore developed as part of a larger strategy aimed at increasing the knowledge base and building the research capacity required for making health care safer and reducing harm to patients.

Methods: A multistep method was used to develop the case studies, which involved developing a theoretical framework for classifying patient safety research articles; purposively selecting articles to illustrate a range of research methods and study designs; and involving the articles' lead authors to provide context, review the summaries, and offer advice to future patient safety researchers.

Global research priorities to better understand the burden of iatrogenic harm in primary care: an international Delphi exercise.

Using a modified Delphi exercise, Aziz Sheikh and colleagues identify research priorities for patient safety research in primary care contexts. Please see later in the article for the Editors' Summary.

The global burden of unsafe medical care: analytic modelling of observational studies.

Objective: To contextualise the degree of harm that comes from unsafe medical care compared with individual health conditions using the global burden of disease (GBD), a metric to determine how much suffering is caused by individual diseases.

Design: Analytic modelling of observational studies investigating unsafe medical care in countries' inpatient care settings, stratified by national income, to identify incidence of seven adverse events for GBD modelling. Observational studies were generated through a comprehensive search of over 16 000 articles written in English after 1976, of which over 4000 were appropriate for full text review.

Impact of a national multimodal intervention to prevent catheter-related bloodstream infection in the ICU: the Spanish experience.

Objective: Prevention of catheter-related bloodstream infection is a basic objective to optimize patient safety in the ICU. Building on the early success of a patient safety unit-based comprehensive intervention (the Keystone ICU project in Michigan), the Bacteremia Zero project aimed to assess its effectiveness after contextual adaptation at large-scale implementation in Spanish ICUs.

Design: Prospective time series.

Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital.

Objective: To assess the frequency and nature of adverse events to patients in selected hospitals in developing or transitional economies.

Design: Retrospective medical record review of hospital admissions during 2005 in eight countries.

Setting: Ministries of Health of Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen; the World Health Organisation (WHO) Eastern Mediterranean and African Regions (EMRO and AFRO), and WHO Patient Safety.

Prevalence of adverse events in the hospitals of five Latin American countries: results of the 'Iberoamerican Study of Adverse Events' (IBEAS).

Background: Interest in patient safety (PS) is growing exponentially, fuelled by epidemiological research unveiling the extent of unsafe care. However, there is little information about the frequency of harm in developing and transitional countries. To address this issue, the authors performed a study known as the Iberoamerican Adverse Event Study, through a collaborative between the governments of Argentina, Colombia, Costa Rica, Mexico and Peru, the Spanish Ministry of Health, Social Policy and Equality, the Pan American Health Organization and the WHO Patient Safety.

[How does collective violence shape the health status of its victims? Conceptual model and design of the ISAVIC study].

Objectives: Epidemiologic research on collective violence (violence exerted by and within groups in pursuit of political, social or economic goals) is very scarce despite its growing recognition as a major public health issue. This paper describes the conceptual model and design of one of the first research studies conducted in Spain aiming to assess the impact of collective violence in the health status of its victims (study known as ISAVIC, based on its Spanish title Impacto en la SAlud de la VIolencia Colectiva).

Methods: Starting with a comprehensive but non-systematic review of the literature, the authors describe the sequelae likely produced by collective violence and propose a conceptual model to explain the nature of the relationships between collective violence and health status.

[Sequelae of collective violence: victims' voices in the ISAVIC study].

Objective: Despite the significant influence of collective violence on the health status of its victims, there are still many gaps in our understanding of the nature of the functional limitations this violence produces and its impact on victims' wellbeing and quality of life. The ISAVIC study was carried out in the autonomous region of the Basque Country from 2005-2008 to estimate the effects of collective violence on health. The assessment included victims' perceptions of these sequelae and their impact on health.

[Impact of collective violence on health status. Results of the ISAVIC study in the Basque Region (Spain)].

Objectives: Despite the ubiquity of violence and its possible impact on individual and collective health, the role and causal pathways of this phenomenon as a health determinant have not been widely studied. The present study was conducted between 2005 and 2008 in the Basque Region of Spain and aimed to estimate the health effects of collective violence on its primary victims.

Methods: A purposive sample of 33 primary victims (direct victims of collective violence and the first degree relatives of murder victims) was matched (1:5 ratio) with a random selection of persons drawn from a representative sample of the population aged more than 16 years old living in the Basque Region.

Core competencies for patient safety research: a cornerstone for global capacity strengthening.

Background: Tens of millions of patients worldwide suffer disabling injuries or death every year due to unsafe medical care. Nonetheless, there is a scarcity of research evidence on how to tackle this global health priority. The shortage of trained researchers is a major limitation, particularly in developing and transitional countries.

Tracing the foundations of a conceptual framework for a patient safety ontology.

Background: In work for the World Alliance for Patient Safety on research methods and measures and on defining key concepts for an International Patient Safety Classification (ICPS), it became apparent that there was a need to try to understand how the meaning of patient safety and underlying concepts relate to the existing safety and quality frameworks commonly used in healthcare.

Objectives: To unfold the concept of patient safety and how it relates to safety and quality frameworks commonly used in healthcare and to trace the evolution of the ICPS framework as a basis of the electronic capture of the component elements of patient safety.

Conclusion: The ICPS conceptual framework for patient safety has its origins in existing frameworks and an international consultation process.

Measures of patient safety in developing and emerging countries: a review of the literature.

Context: The World Alliance for Patient Safety was formed to accelerate worldwide research progress towards measurably improving patient safety. Although rates of adverse events have been studied in industrialised countries, little is known about the rates of adverse events in developing and emerging countries.

Purpose: To review the literature on patient safety issues in developing and emerging countries, to identify patient safety measures presently used in these countries and to propose a method of measurably improving patient safety measurement in these countries.

Patient safety research: an overview of the global evidence.

Background: Unsafe medical care may cause substantial morbidity and mortality globally, despite imprecise estimates of the magnitude of the problem. To better understand the extent and nature of the problem of unsafe care, the WHO World Alliance for Patient Safety commissioned an overview of the world's literature on patient safety research.

Methods: Major patient safety topics were identified through a consultative and investigative process and were categorised into the framework of structure, process and outcomes of unsafe care.

[Violence is also a public health issue].

In 1996, the World Health Organization declared violence a major and growing public health problem across the world. In Spain, despite the growing incidence of reports of deaths and abuse due to intimate partners violence; the emergent data on school-based violence among children and adolescents; the persisting political violence and the tragic experience of the 11-M attacks in Madrid; a clear positioning over the role of the public health structures in the study and intervention of violence has not taken place. This article provides a characterization of the impact of violence in the health of its victims, as derived from a non-systematic review of the clinical, psychological and social literature.

[Public health professionals and professional competences debate].

Despite its historical contribution to the improvement of health, public health occupies a marginal position in health systems. This lack of correspondence between impact and power is related in part to its scarce recognition as a profession, and in consequence to the lack of recognition of the professionals in the field. The strengthening of the public health profession requires recognising the coherence of their objectives and scientific basis, but it also requires the establishment of mechanisms to guarantee professional competence.

Reform of primary health care: the case of Spain.

Different approaches to health reform are proposed in many countries to overcome inefficiencies in care delivery. This paper assesses an incremental reform initiated in Spain 10 years ago, which sought to improve the efficiency of the entire health system through changes in the organization and delivery of primary care. In this study, aspects of accessibility, comprehensiveness, longitudinality and technical quality of reformed versus unreformed care were assessed for respondents to a household interview survey conducted in the Basque Region of Spain in 1992.