Patient safety

From information to action

Reporting and learning for patient safety

The most important knowledge in the field of patient safety is how to prevent harm to patients during treatment and care. The fundamental role of patient safety reporting systems is to enhance patient safety by learning from failures of the health care system. Health-care errors are often provoked by weak systems and often have common root causes which can be generalized and corrected. Although each event is unique, there are likely to be similarities and patterns in sources of risk which may otherwise go unnoticed if incidents are not reported and analyzed.

Professor Lucian Leape

WHO has worked with Professor Lucian Leape in the preparation of WHO Draft Guidelines for Adverse Event Reporting and Learning Systems to help countries develop or improve reporting and learning systems in order to improve the safety of patient care.

Reporting is fundamental to detecting patient safety problems. However, on its own it can never give a complete picture of all sources of risk and patient harm. The guidelines also suggest other sources of patient safety information that can be used both by health services and nationally.

International Reporting and Learning Systems Community of Practice

In July 2008, WHO launched an International Reporting and Learning Systems (RLS) Community of Practice at a conference in Baltimore, MD at Johns Hopkins University.  Since its inception the RLS Community has grown to include hundreds of patient safety and adverse event experts from around the world working together. The RLS Community has charged itself with the purpose of sharing learning, innovations, solutions and best practices. In addition, the RLS community aims to validate interventions and work to enhance awareness of reporting and learning systems issues globally.

To join the RLS Community of Practice or learn more about the Reporting and Learning Programme please send an email to psrlscommunity@ezcollab.edgeof.net

Related documents

WHO Draft Guidelines for Adverse Event Reporting and Learning Systems

For more information please email patientsafety@who.int