Understanding the development and implementation of national quality of care and patient safety strategic documents: a scoping review

BACKGROUND: Several strategic documents aimed at integrating quality of care and patient safety into health systems have been developed, both as guiding documents produced by renowned international organisations and as national documents with a political purpose. However, the development, implementation and monitoring/evaluation of quality of care and patient safety strategic/policy documents are often delicate and challenging processes. OBJECTIVES: In order to support policymakers and decision makers who plan to develop or improve their national quality of care and patient safety strategic/policy documents, this study seeks to understand how the processes of developing, implementing, and monitoring/evaluating this type of policy have been carried out and how they should be conducted. METHODS: A scoping review was conducted by searching three major databases for relevant articles and by examining official strategic documents published on the websites of national and governmental authorities. The methodology followed the stages approach proposed by Arksey and O’Malley and was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. RESULTS: Key phases and tasks across each stage of the development, implementation and monitoring/evaluation of strategic/policy documents relating to quality of care and patient safety were identified. The identification, consultation and involvement of various stakeholders emerged as cross-cutting factors across all three processes and were regarded as highly important. CONCLUSION: This study maps key tasks and phases relevant to the effective development, implementation, and monitoring/evaluation of strategic health policy documents. By outlining a structured approach aligned with international best practices, it offers actionable insights that may support policymakers in designing sustainable and high-impact policies. These findings contribute to strengthening planning for quality of care and patient safety, with potential implications for the delivery of safe, high-quality healthcare services and the development of resilient, responsive health systems. REGISTRATION NUMBER OF THE STUDY: https://doi.org/10.17605/OSF.IO/K4HXD .