Development of national competence areas and competence goals for patient safety using a modified Delphi method

The WHO calls for integrating patient safety curricula in healthcare education globally, but the limited contextual applicability of existing frameworks constrains national implementation. This work aims to describe the development of Swedish national competence goals in patient safety to establish patient safety as a distinct field summarised within a comprehensive framework of competency areas.

The national competence goals were developed in a project initiated by the Swedish National Board of Health and Welfare that commissioned a group of academics with expertise in patient safety to work on the project. The development entailed an iterative process involving both physical and digital meetings, individual work and two rounds of questionnaires. Initially, drawing on expert knowledge and international literature, a set of competence areas based on key concepts in patient safety was proposed and defined. Within each competence area, several competence goals were developed. A modified Delphi process was then employed to collect insights from two multidisciplinary panels of experts (n=23). Finally, competence areas, key concepts and competence goals were refined based on feedback from the two Delphi panels.

The project resulted in a national framework comprising 15 competence areas and 113 competence goals, highlighting key dimensions of patient safety such as foundational concepts, professional roles, systems thinking, patient involvement, human factors, communication and teamwork, organisational culture, risk awareness, learning from adverse events, evaluation, safe practices, technology, leadership, emergency preparedness and high-risk care situations.

The development of national competence areas and goals marks an advancement in establishing patient safety as a distinct scientific discipline, where they collectively provide a broad and structured set of educational goals and standards. This initiative provides a foundation for integrating patient safety curricula into national healthcare education and strengthening patient safety practices, which can serve as an inspiration to others.