Building Safety Through Orientation: Current Practices of Client and Patient Safety Onboarding in Finland

Comprehensive orientation is essential for ensuring client and patient safety, strengthening safety culture, and supporting workforce competence in social and health care. Although orientation is recognized as an important patient safety intervention, little is known about how comprehensively client and patient safety topics are incorporated into orientation programs. This study evaluated the extent to which client and patient safety topics were incorporated into orientation programs across Finnish wellbeing services counties.

A cross-sectional electronic survey was conducted in 2024. The questionnaire was based on the Finnish national client and patient safety orientation framework and included thirty-nine orientation topics covering safety management, occupational safety, safety culture, risk management, medication safety, infection prevention, information security, and emergency preparedness. Responses were requested from ten predefined social and health care service areas in each of Finland's 23 wellbeing services counties. Fourteen counties participated, yielding 107 responses.

Traditional client and patient safety topics were widely incorporated into orientation programs. The highest affirmative responses concerned individual job responsibilities, confidentiality, processing of client and patient information, occupational safety, medication competence, and incident reporting (all 96-99%). In contrast, psychological safety (58%), second victim practices (14%), self-monitoring programs and plans (42% and 54%), safety culture assessment (41%), and client and patient safety in digital and remote services (62%) were incorporated less frequently.

This study provides a national overview of client and patient safety orientation practices based on responses from participating Finnish wellbeing services counties. Traditional client and patient safety topics were widely incorporated into orientation programs, whereas psychological safety, second victim support, self-monitoring, and digital safety were less consistently represented. The findings suggest that implementation of patient safety priorities is uneven across safety domains, with newer organizational and systems-oriented topics appearing less embedded in orientation than traditional clinical safety topics. Orientation may therefore be viewed not merely as an onboarding activity but also as a strategic mechanism for implementing patient safety priorities within healthcare organizations.