Safety and Quality in Healthcare


Among the concepts relevant to modern-day nursing practice and the medical industry in general, the safety of healthcare services and healthcare quality are two of the most important ones. Indeed, with medicine advancing toward error-free, high-quality, and evidence-based care, quality and safety become key ultimate outcomes. Thus, this paper will discuss and evaluate safety and healthcare quality as nursing concepts. Moreover, the concepts will be reviewed within the context of their impact on the nursing practice and the emergence of health initiatives driving the development of the sphere.


Safety in healthcare is related to the elimination of risks related to hospitalization and outpatient care. The safety concept involves prioritizing patient wellbeing at all times by preventing and addressing potential hazards. To preserve patient safety, healthcare systems also work to reduce harm to patients through delivering complex treatment. Overall, safety measures are the driving forces that guide nursing practice and the work of physicians throughout the healthcare system.

In particular, patient safety is ensured through the elimination of medical errors, which, as well as “harm from healthcare [are] an accepted risk of treatment” (Smith & Plunkett, 2019, p. 508). The acknowledgment of all risks that might lead to errors in medical practice is addressed through the framework of error management. Another important measure implemented for the maintenance of patient safety is the application of evidence-based care. Indeed, the advancement of research provides an abundance of knowledge, data, and evidence concerning different treatment methods. It allows for nurses to prioritize the proven practice methods that have demonstrated positive outcomes and eliminate the possibility of harm.

Healthcare Quality

Alongside safety, healthcare quality is one of the most tentative public concerns, which predetermines the level of trust of the people in medical facilities and healthcare systems in general. Therefore, organizations and individuals must ensure the provision of high-quality care. The definition of healthcare quality, as suggested by Allen‐Duck et al. (2017), holds that it is “the assessment and provision of effective and safe care, reflected in a culture of excellence, resulting in the attainment of optimal or desired health” (p. 377).

One of the issues concerning healthcare quality is patient satisfaction, which is an indicator of the attainment of anticipated health outcomes. Indeed, patient satisfaction is considered an important indicator of the culture of excellence in healthcare facilities (Allen‐Duck et al., 2017). For that matter, surveys and special patient-centered care protocols are initiated in hospitals to advance the quality of care. Consequently, patient-centered care is another important issue that contributes to improving healthcare quality (Allen‐Duck et al., 2017). If the patient is prioritized throughout the interaction with healthcare professionals, the quality of care is particularly preserved to meet the needs and expectations of the served population.

Impact of Safety and Healthcare Quality on Nurses’ Higher Level Clinical Judgment

As the definition of clinical judgment demonstrates, safety and quality are inherent in nurses’ clinical reasoning and decision-making. Indeed, Chin‐Yee and Upshur (2018) define clinical judgment as “the ability to form diagnoses, forward prognoses, and make choices of treatment which help the patient or which at least do him or her no harm” (p. 638). When working in an environment where evidence-based practice is prioritized, harm and error are eliminated and prevented. When discussing nurses’ critical thinking for delivering safe care to patients, one might emphasize that a nurse assesses and double-checks patients’ vital signs and comorbidities alongside other precautions.

When a nurse is not sure about a diagnosis or has difficulty choosing between alternatives, they contact physicians or peers, consult credible sources, and collaborate to make unbiased decision for patients’ safety. As for the high-level clinical judgment in relation to quality of care, a nurse should evaluate all data objectively, apply evidence-based practice, and act ethically to ensure high-quality care.

Safety-Related Health Initiatives

Healthcare systems in general and medical facilities separately implement an array of safety initiatives. Overall, safety science has advanced recently, yielding initiatives toward precautions and prevention of errors or harm. For example, safety protocols and checklists following the World Health Organization are initiated in hospitals to eliminate human error in such intrusive processes as surgeries or intravenous injections (Smith & Plunkett, 2019).

Indeed, WHO checklists ensure that the human factor is eliminated, which excludes the possibility of error, promotes clear step-by-step procedures, and intensifies patient safety. In addition, numerous initiatives are implemented to reduce hospital-acquired infections, considered some of the most prevailing patient safety hazards. They are designed to increase the level of caution among hospital staff in relation to hygiene and sterilization of surfaces and tools, which ensures patient safety.

Healthcare Quality-Related Health Initiatives

Similar to safety initiatives, quality-directed measures are implemented in larger medical communities and healthcare facilities to promote high-quality care at all patient service levels. In such a manner, quality assurance programs are executed, within which hospitals develop quality protocols and checklists for nurses, physicians, and staff (Allen‐Duck et al., 2017). For example, when promoting quality, a hospital initiates additional training for employees, advances their research practices, association participation, and conference attendance to facilitate continuous learning. In addition, regular quality assessment and patient surveys are conducted to ensure patient satisfaction and the overall alignment of practice with the quality-based clinical culture. These initiative allow for obtaining and analyzing work quality in short- and long-term perspectives for improvement.

Workplace Communication Advancement

When ensuring patient safety and healthcare quality, communication between the parties involved in the process is essential. Since both safety and healthcare quality aligns with the patient metaparadigm of nursing, they both might be effectively used to advance workplace communication to ensure consistency of safe and high-quality care. Therefore, to advance workplace communication between the members of medical teams, hospital management should ensure favorable working conditions and a stress-relieved atmosphere. The interaction between the parties “must be accurate, consistent, evidence-based, credible and reliable, and understandable” (Allen‐Duck et al., 2017, p. 384).

Firstly, when communicating clearly and accurately with patients, nurses can obtain the most tentative and objective health information, which later ensures patients’ safety. Secondly, evidence-based and consistent communication between team members helps to build a higher level of expertise, exchange knowledge, and find the most quality-directed decisions through productive collaboration.


In summation, among the many nursing concepts relevant to healthcare, safety and quality are considered most important in terms of the anticipated patient outcomes. When prioritizing safety, healthcare systems ensure evidence-based practice and the elimination and prevention of harm and error. For quality purposes, patient satisfaction and patient-centered care are advanced and measured for long-term results. Ultimately, through such initiatives as protocols, surveys, checklists, specifically designed programs, World Health Organization’s guidelines, and communication improvement, organizations are capable of delivering high-quality and safe care.


Allen‐Duck, A., Robinson, J. C., & Stewart, M. W. (2017). Healthcare quality: A concept analysis. Nursing Forum, 52(4), 377-386.

Chin‐Yee, B., & Upshur, R. (2018). Clinical judgement in the era of big data and predictive analytics. Journal of Evaluation in Clinical Practice, 24(3), 638-645.

Smith, A. F., & Plunkett, E. (2019). People, systems and safety: Resilience and excellence in healthcare practice. Anaesthesia, 74(4), 508-517.

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