Advancing patient safety in modern healthcare: policies, strategies, and practices.

Abstract

Patient safety is globally recognized as a strategic priority, as medical errors remain a leading cause of preventable morbidity and mortality with major medical, ethical, social, and economic consequences. The World Health Organization estimates that in low- and middle-income countries, approximately 134 million preventable adverse events occur annually, resulting in 2.6 million deaths, while in Europe 8–12% of hospitalized patients are affected, half of these events being avoidable.

This study aims to evaluate the particularities of patient safety culture in the Republic of Moldova, compare them with European models, and formulate recommendations for strengthening the national framework. The methodology was based on a narrative review of 131 international and national sources (2000–2025), selected using SANRA criteria, with a focus on the legislative framework, public policies, and internationally validated instruments (HSOPS, MaPSaF, SAQ, MOSPSC).

The results indicate that in Moldova, the regulatory framework is fragmented: general regulations and the National Council for Health Evaluation and Accreditation (established in 2024) exist, but a dedicated patient safety law, a non- punitive incident reporting system, and mandatory training programs are still lacking. In contrast, Romania, France, and the United Kingdom have established consolidated legal and institutional frameworks based on „just culture” transparent reporting, and integration of safety into accreditation processes.

The conclusions highlight the need to adopt dedicated legislation, create a national electronic reporting registry, integrate validated instruments into periodic evaluations, and develop continuous training programs. Strengthening an organizational culture of safety is essential for Moldova’s alignment with European and international standards.