Stiftung Patientensicherheit Schweiz

BackgroundRising healthcare costs, limited resources, and fragmented systems challenge the sustainability of public health and social security. Persons with disabilities, especially those with acquired brain injury (ABI), face compounded risks due to service disconnection. In Switzerland, despite comprehensive social security schemes, fragmented service delivery, regional disparities, and rigid deadlines hamper effective coordination-especially within disability insurance, which seeks to support work capacity and prevent long-term disability.ObjectivesThis study aimed to (1) examine current service provision dynamics and interactions across sectors for persons with ABI, and (2) define key components of an optimal, lifelong service pathway supporting sustainable employment.MethodsUsing an Integrated Knowledge Translation approach, we partnered with knowledge users across healthcare, insurance, and policy to identify barriers and co-create solutions. We conducted a three-phase process-reviewing existing data, mapping the current ("As-Is") system, and envisioning an ideal pathway-drawing from prior research and new surveys with neurorehabilitation centers and disability insurance offices.ResultsThe current service landscape for ABI reveals critical gaps grouped into four domains: information, communication, coordination, and financing. Individuals and families often lack clarity about care steps and entitlements. Fragmented systems and minimal case management obstruct vocational reintegration. Financial insecurity, delayed support, and brief rehabilitation further undermine outcomes. Stakeholders underscored the need for lifelong case management and ABI-specific care guidelines.ConclusionsCoordinated service pathways enhance care by revealing structural barriers and guiding targeted action. Engaging diverse stakeholders in co-design strengthens policy relevance and implementation, helping bridge critical gaps in lifelong support for people with ABI.Key messages• Identifying key service gaps helps improve lifelong support for people with ABI and strengthens their chances of sustainable employment.• Co-designed pathways with stakeholders enhance coordination and drive practical policy change for ABI care in Switzerland.

Beim Training in einem Room of Horrors können Ärztinnen, Ärzte und MPA in ihrer Praxis Fehler und Risiken für eine sichere Patientenversorgung aufdecken und so die Aufmerksamkeit für Patientensicherheitsrisiken trainieren. Die ersten Arztpraxen haben das interaktive Training ­absolviert und berichten positiv darüber.

ObjectivesIn 2009, the World Health Organization (WHO) published the WHO Surgical Safety Checklist, and 3 years later, the Swiss Patient Safety Foundation adapted it for Switzerland. Several meta-analyses and systematic reviews showed ambiguous results on the effectiveness of surgical checklists. Most of them assume that the study checklists are almost identical, but in fact they are quite heterogeneous due to adaptations to local settings. This study aims to investigate the extent to which the checklists currently used in Switzerland differ and to discuss the consequences of local adaptations.MethodsFor the analysis, 24 checklists used in 18 Swiss hospitals are analyzed. First, general checklist characteristics are examined. Second, the checklist items are compared with the checklist items of the WHO and the Swiss Patient Safety Foundation.ResultsThe checklists contain a median of 34.5 items (range, 15–76). Compared with the checklists of WHO and Patient Safety Switzerland, which contain 12 and 21 process checks and 10 and 9 conversation prompts, respectively, the study checklists contain a median of 15.5 process checks (range, 3–25) and a median of 4 conversation prompts (range, 0–10).ConclusionsThere are major differences between the study checklists and the reference checklists that raise doubts about the comparability of checklists. More resources must be invested in proper checklist adaptions and better guidance on how to adapt safety tools such as the surgical safety checklist needed to local conditions. In any case, details of the checklists used need to be clearly described in studies on checklist effectiveness.

Die Organisation der Versorgung kann mit dem rasanten Tempo der Behandlungsmöglichkeiten nicht Schritt halten. Sicherheitsmaßnahmen, die an der Veränderung der Arbeitsumgebung ansetzen, sind hier erfolgsversprechender als solche, die sich auf die Leistungsfähigkeit der Mitarbeitenden stützen.