Enhancing quality of care and patient safety

Patient safety remains an issue of increasing concern for EU health systems. The Commission estimates that between 8% and 12% of patients admitted to hospitals in the EU suffer from adverse effects of health care[[Communication from the Commission to the European Parliament and the Council on patient safety, including the prevention and control of healthcare-associated infections (COM (2008) 836).]].

Overall, the most common types of in-hospital adverse effects are operative/surgical related, medication or drug related, and health care associated infections, half of them being preventable[[Schwendimann et al., The occurrence, types, consequences and preventability of in-hospital adverse events – a scoping review (BMC Health Services Research (2018) 18:521).]]. According to the Organisation for Economic Co-operation and Development (OECD), more than 7 million admissions in the OECD countries result from safety lapses in primary and ambulatory care[[The Economics of Patient Safety in Primary and Ambulatory Care: Flying blind (OECD, 2018).]]. Diagnostic errors persist throughout all settings of care and contribute to increased risks and harms from the treatment[[Erin P. Balogh et al., Improving Diagnosis in Health Care (The National Academy of Sciences, 2015).]]. Therefore, it is necessary to develop and implement coherent quality improvement and patient safety strategies in Europe. Harmonisation and standardisation of health care processes (Guidelines and Standard Operating Procedures) along the continuum of care contribute to improve quality and safety of health services, minimise the risk of errors and at the same time ensure the quality and comparability of health data. It is also a mean to address inequities in health care delivery.

The proposals should take into consideration the already existing EU-funded initiatives in this area and must address in a coherent manner at least three of the following items, but may also contain other research and innovations activities for improving patient safety:

• Fill knowledge and practice gaps in quality of care and patient safety, including through harmonisation and standardisation of health care delivery, optimizing inter-sectoral clinical pathways and decision-making processes and tools across regions and countries.
• Development and piloting of harmonised evidence-based interventions in a uniform and structured way in health care institutions of different EU regions and countries. This should be addressed in case studies at hospital, primary and outpatient care levels, and it should also take into consideration the diverse health care landscape across European Union and Associated Countries.
• Research on translation of international standards and clinical guidelines into national practice for improved quality of care and patient safety.
• Provide context-specific evidence on facilitators and barriers for transferring identified good practices across regions and countries.
• Comprehensive comparison of practices related to clinical guidelines in European Union and Associated Countries, including the regulatory basis underpinning guidelines in each health system, the guideline development process, mechanisms of quality control, implementation modalities, and evaluation of produced recommendations.
• Development of innovative approaches for the integration of harmonised and standardised practices with personalised treatment plans.

Proposals should consider a patient-centred approach that empowers patients/citizens, promotes a culture of dialogue and openness between health professionals and citizens/ patients, and unleashes the potential for social innovation.

The proposals should contribute to improved patient safety along the continuum of care in European Union and Associated Countries. The proposal should present a clear strategy for empowering and involving patients and caregivers in addressing the selected item(s), giving attention to both PROMs (Patient-Reported Outcome Measures) and PREMs (Patient-Reported Experience Measures). The research design, including the expected results, should carefully analyse and tackle the sex and gender dimension. The proposed evidence-based interventions, including clinical guidelines and standards, should meet health care providers’ needs and goals to increase patient safety and health care quality.

All projects funded under this topic are strongly encouraged to participate in networking and joint activities, as appropriate. These networking and joint activities could, for example, involve the participation in joint workshops, the exchange of knowledge, the development and adoption of best practices, or joint communication activities. This could also involve networking and joint activities with projects funded under other clusters and pillars of Horizon Europe, or other EU programmes, as appropriate. Therefore, proposals are expected to include a budget for the attendance to regular joint meetings and may consider to cover the costs of any other potential joint activities without the prerequisite to detail concrete joint activities at this stage. The details of these joint activities will be defined during the grant agreement preparation phase. In this regard, the Commission may take on the role of facilitator for networking and exchanges, including with relevant stakeholders, if appropriate.