Patient safety risks and mitigation strategies during COVID-19 pandemic

Purpose of review This narrative review aimed to examine patient safety incidents (PSIs) and mitigation strategies during Public Health Emergencies over the past five years. Although the scope included multiple public health emergencies (PHEs), the available evidence was limited to studies conducted during the COVID-19 pandemic. Recent findings Nine observational studies met the inclusion criteria, all of which were conducted in hospital settings during COVID-19. The findings indicated that PSIs encompassed both COVID-19 infection-related risks, particularly healthcare-associated infection (HAIs) and non-infectious adverse events, including procedural complications, medication-related events, and disruptions in care processes. These risks were closely associated with system-level pressures, such as workforce strain, resources constraints, and rapid reorganization of services. Mitigation strategies were predominantly implemented at the system level, including strengthening infection prevention and control measures, screening and early identification of COVID-19 cases, service reorganization and infrastructure segregation, perioperative pathway redesign, and reinforcement of clinical safety practices. Summary The findings of this review were primarily derived from COVID-19 related evidence and a small number of observational studies, which may limit generalizability to other types of PHEs. Within this context, patient safety risks were shaped not only by infection-related hazards but also by disruptions to routine healthcare delivery. Maintaining patient safety during PHEs therefore requires adaptive, adaptive system-level mitigation strategies that address both clinical and operational risks. Further research is needed to examine patient safety across a broader range of PHE contexts and to strengthen the evidence base for effective mitigation strategies.