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Case Study: More Patient Safety by Design – System-based Approaches for Hospitals

Structural Approaches to Address Issues in Patient Safety

ISBN: 978-1-83867-085-6, eISBN: 978-1-83867-084-9

Publication date: 24 October 2019


Since the publication of the report “To Err Is Human: Building a Safer Health System” by the US Institute of Medicine in 2000, much has changed with regard to patient safety. Many of the more recent initiatives to improve patient safety target the behavior of health care staff (e.g., training, double-checking procedures, and standard operating procedures). System-based interventions have so far received less attention, even though they produce more substantial improvements, being less dependent on individuals’ behavior. One type of system-based intervention that can benefit patient safety involves improvements to hospital design. Given that people’s working environments affect their behavior, good design at a systemic level not only enables staff to work more efficiently; it can also prevent errors and mishaps, which can have serious consequences for patients. While an increasing number of studies have demonstrated the effect of hospital design on patient safety, this knowledge is not easily accessible to clinicians, practitioners, risk managers, and other decision-makers, such as designers and architects of health care facilities. This is why the Swiss Patient Safety Foundation launched its project, “More Patient Safety by Design: Systemic Approaches for Hospitals,” which is presented in this chapter.




We would like to thank the members of the expert group for their commitment to our project and their valuable input. We are also grateful to the Swiss Federal Office of Public Health, the Swiss Academy of Medical Sciences, and the Swiss National Science Foundation for their financial support, which has helped us not only in completing our project but also in producing our brochure, and in organizing the symposium.


Kobler, I., Angerer, A. and Schwappach, D. (2019), "Case Study: More Patient Safety by Design – System-based Approaches for Hospitals", Structural Approaches to Address Issues in Patient Safety (Advances in Health Care Management, Vol. 18), Emerald Publishing Limited, Leeds, pp. 1-17.



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