Keeping patients out of the red

A patient is lying in a hospital bed when a nurse approaches with medication. She checks the patient’s name and prepares to administer the dose. The patient recognizes the name on the chart, not the drug in the nurse’s hand. It is not one of the medications his doctor discussed with him, nor does it look like anything he has been taking since admission.

He asks a simple question: What is this medication for?

The nurse stops and checks again.

Perhaps the drug was intended for another patient. Perhaps two names were confused, an order was entered incorrectly, or information was lost somewhere between prescription and administration. No medication has been given; no harm has occurred. But for a few seconds, the patient has entered the space that patient-safety specialists worry about most: the point between an unnoticed mistake and an adverse event.

Inside a hospital, such risks can emerge from routine moments of care. A patient can be taken for an examination ordered for someone else. Someone weakened by illness can fall in an unfamiliar room. An infection can spread, or critical information can fail to move between healthcare professionals.

None necessarily begins with negligence. Hospitals are complex environments where healthcare workers make thousands of decisions every day, often while managing several patients at once. Patient safety therefore depends on systems designed to identify risks and prevent them from becoming harmful incidents.

For Dr. Rouba Rassi, Risk Management Coordinator at Hôtel-Dieu de France, the patient can be one of those safeguards. “A patient who questions an unfamiliar medication or unexpected test may help catch a mistake before it reaches them,” she told The Beiruter. Rather than remaining a passive recipient of care, an informed patient can play an active role in their own safety.

According to the World Health Organization (WHO), around 1 in 10 patients worldwide is harmed while receiving healthcare, with more than half of this harm considered preventable. Medication errors, healthcare-associated infections, diagnostic errors, unsafe surgery, falls, patient misidentification and other adverse events are among the risks identified by the WHO.

This year, however, the WHO is examining patient safety through a more specific lens.

Safety across a lifetime of care

World Patient Safety Day, observed on September 17, is focusing in 2026 on safe care for noncommunicable diseases (NCDs), under the slogan “Safe care for life!”

NCDs, including cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, account for around 74 percent of deaths globally and often require years of continuous care. That long-term relationship with the health system brings added risk: patients may move between multiple specialists, hospitals, laboratories and pharmacies, while taking medications prescribed by different doctors.

Up to 1 in 3 patients with some conditions, including cancer, may experience an adverse event during care. WHO says people with NCDs face greater safety risks because long-term conditions require repeated contact with different parts of the health system.

At Hôtel-Dieu de France, World Patient Safety Day is being marked with a public awareness event on chronic-disease risk factors, bringing several specialties together for checks including body mass index and blood pressure, alongside nutritional advice, smoking-cessation support, physical activity guidance, diabetes screening and lipid testing. Dr. Rassi explains that hospitals mark the day in different ways, using the WHO theme to help people identify risks early and raise awareness around prevention. But prevention is only one part of patient safety.

Inside hospitals, risk runs through every stage of care. “Patient safety therefore runs through every part of the hospital, from medicine and nursing to pharmacy, physiotherapy and other allied health services,” Dr. Rassi said.

Patient safety is often about catching risk before it turns into harm. The traffic-light analogy captures that approach: orange, the color associated with World Patient Safety Day, marks the warning stage, before risk becomes harm. Green is safety; red is danger.

The work is to keep moving from orange toward green, not toward red.

Asking why until the real problem appears

Over the past decade, Lebanese hospitals have increasingly established dedicated quality, patient safety and risk management departments, Dr. Rassi said, responsible for tracking performance, reviewing incidents and investigating their causes.

One key tool is root cause analysis, including the “five whys” method, which looks beyond who made the mistake to what allowed it to happen, where the process failed and what must change.

That matters in hospitals, where nurses may be managing several patients and doctors moving between departments and urgent cases. Training reflects those pressures.

Doctors, interns and residents take part in simulations, including CPR scenarios, while nurses practice preparing complex or high-risk medications and are assessed on both technique and safety procedures.

Communication is equally important: even the right treatment can become unsafe if patients do not understand what is happening or key information is lost between professionals. WHO lists poor communication, fatigue, staffing pressures and weak processes among the causes of patient harm, while medication-related harm affects an estimated 1 in 30 patients.

Lebanon has also promoted patient participation through the Stay Safe — “كن بأمان” initiative, developed by the Lebanese Society for Quality and Safety in Healthcare with WHO support and later linked to National Patient Safety Goals.

From hospital safety to a national system

Lebanon has had a hospital accreditation system for more than two decades, but successive crises repeatedly disrupted its implementation. In 2022, after years of economic collapse, COVID-19, the Beirut Port explosion, political instability and rising operating costs, the Ministry of Public Health revised the national standards.

The framework was developed with the French National Authority for Health (HAS) and ESA Business School, while the ministry created an Accreditation and Evaluation Office to oversee implementation. In 2023, the standards received ISQua EEA certification; at the time, 44 surveyors had been trained and more than 500 healthcare professionals were undergoing training.

Dr. Rassi stressed that the ministry has continued pushing the process forward despite limited resources and disruptions from conflict. The challenge is sustaining the cycle of setting standards, measuring performance, addressing weaknesses and reassessing progress.

Hospitals, meanwhile, have continued monitoring their own indicators, with some benchmarking themselves against international standards and maintaining internal quality and risk-management programs.

Work still rests on three essentials: qualified healthcare professionals, appropriate equipment and continuous training.

The remaining gap is national comparison. Hospitals may track falls, infections, medication errors and near misses internally, but without standardized data across institutions, comparing performance and assessing patient safety across the health system remains difficult.

Patient safety is often most visible after something goes wrong. Risk management works in the opposite direction. Safety is not one successful encounter; it has to be repeated every time a patient enters the health system.

Dr. Rassi’s traffic-light metaphor brings the idea down to its simplest form. Healthcare will always have its orange moments, points when risk appears and something could go wrong. The task is to recognize them early enough to turn back toward green.