More with less: Low-tech solutions to patient safety problems

Slawomirski L Klazinga N. The economics of patient safety: from analysis to action. OECD working papers No. 145. 12 August 2022. https://www.oecd.org/content/dam/oecd/en/publications/reports/2022/08/the-economics-of-patient-safety_dda2a072/761f2da8-en.pdf (Accessed April 1, 2026).

Bommer C Heesemann E Sagalova V , et al. The global economic burden of diabetes in adults aged 20–79 years: a cost-of-illness study. Lancet Diabetes Endocrinol 2017; 5: 423–430.

Duckett S Jorm C Moran G , et al. Safer care saves money: how to improve patient care and save public money at the same time. Grattan Institute. 2018. ISBN: 978-0-6483311-1-7 https://grattan.edu.au/wp-content/uploads/2018/08/Safer-care-saves-money.pdf (Accessed April 1, 2026).

OECD. The economics of diagnostic safety: setting the scene. Paris: OECD Publishing, 2024, https://doi.org/10.1787/bb24ea76-en. (Accessed April 1, 2026).

Nixon J Smith IL Brown S , et al. Pressure relieving support surfaces for pressure ulcer prevention (PRESSURE 2): clinical and health economic results of a randomised controlled trial. EClinicalMedicine 2019; 14: 42–52.

Sutton RT Pincock D Baumgart DC , et al. An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ Digit Med 2020; 3: 17.

Mehta I Hsueh HY Taghipour S , et al. UV disinfection robots: a review. Rob Auton Syst 2023; 161: 104332.

Lazarus C Joseph C Johnson M , et al. Automated hospital room disinfection utilizing a novel aerosolized hydrogen peroxide microdroplet disbursing technology. J Vis Exp 2026; 228: e69913.

Kim M Choi J Jo JY , et al. Video-based automatic hand hygiene detection for operating rooms using 3D convolutional neural networks. J Clin Monit Comput 2024; 38: 1187–1197.

Henry KE Adams R Parent C , et al. Factors driving provider adoption of the TREWS machine learning-based early warning system and its effects on sepsis treatment timing. Nat Med 2022; 28: 1447–1454.

Murphy JG Dunn WF . Medical errors and poor communication. Chest 2010; 138: 1292–1293.

Do T Pham Quoc T Bui TH , et al. Physicians’ perceptions of patient safety culture in public hospitals in Vietnam, a cross-sectional study. J Patient Safe Risk Manage. 2026; 31: 82–90.

Creazione di una rete sanitaria in Kenya, Tanzania e Uganda. Risultati, Taggiunit, calore creato. Centro Salute Globale 2026: 1–24. https://www.centrosaluteglobale.eu/wp-content/uploads/2026/03/CSG-KTU-Report-2026_21x27-cm_06.pdf (Accessed April 1, 2026).

Patient safety initiatives. Technical topics. World Health Organization. https://www.who.int/teams/integrated-health-services/patient-safety/research

WHO Safe Childbirth Checklist. Implementation guide. World Health Organization. 2015. https://iris.who.int/server/api/core/bitstreams/6a71d103-ddb4-4464-a95d-d6600082bd55/content (Accessed April 1, 2026).

Interagency Integrated Triage Tool. World Health Organization. https://www.who.int/tools/triage (Accessed April 1, 2026).

Mitchell R Bue O Nou G , et al. Validation of the interagency integrated triage tool in a resource-limited, urban emergency department in Papua New Guinea: a pilot study. Lancet Reg Health West Pac 2021; 13: 100194.

Abdalla Elsheikh NE Osman HM Alfaki Ahmed SA , et al. Effectiveness and implementation of obstetric triage during pregnancy and childbirth: a systematic review. Cureus 2025; 17: e89215.

Gachau S Ayieko P Gathara D , et al. Does audit and feedback improve the adoption of recommended practices? Evidence from a longitudinal observational study of an emerging clinical network in Kenya. BMJ Glob Health 2017; 2: e000468. Erratum in: BMJ Glob Health. 2017 Dec 7;2(4):e000468corr1. doi: 10.1136/bmjgh-2017-000468corr1. Oliwa, Jacqiue [corrected to Oliwa, Jacquie].

English M Irimu G Akech S , et al. Employing learning health system principles to advance research on severe neonatal and paediatric illness in Kenya. BMJ Glob Health 2021; 6: e005300.

Pronovost P Lorenz J Glotzbecker B , et al. University Hospitals. UH Management Accountability Systems toolkit. 2026 Quality Goals.

Rösner H Boy S Katantha M , et al. Implementierung von Patientensicherheitsmaßnahmen in Ländern mit niedrigem Einkommen am Beispiel des Klinikpartnerschaftsprojekts SAFE@KCH. Präv Gesundheitsf 2026; 21: 64–69.

Haynes AB Weiser TG Berry WR , et al. Safe surgery saves lives study group. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009; 360: 491–499.

Your 5 moments for hand hygiene. World Health Organization. 5 May 2009. https://www.who.int/multi-media/details/your-5-moments-for-hand-hygiene-poster (Accessed April 1, 2026).

5 moments for medication safety. World Health Organization. 10 June 2019. WHO-HIS-SDS-2019.6-en https://www.who.int/publications/i/item/WHO-HIS-SDS-2019.6 (Accessed April 1, 2026)

Gullo S Galavotti C Sebert Kuhlmann A , et al. Effects of a social accountability approach, CARE's community score card, on reproductive health-related outcomes in Malawi: a cluster-randomized controlled evaluation. PLoS One 2017; 12: e0171316.

Imam A English M Aluvaala J , et al. Evaluating the effects of increasing nursing numbers on quality of newborn care in understaffed neonatal units in Kenya: a prospective intervention study. BMJ Qual Saf Epub ahead of print 15 October 2025. bmjqs-2025-019024. doi: 10.1136/bmjqs-2025-019024. PMID: 41093659.

Odinga N Waithira C Maluni J , et al.; HIGH-Q Hospital Group. Nurses experiences with an intervention enhancing skill-mix in Kenyan neonatal units with severe workforce deficits: a qualitative study. Int J Nurs Stud 2025; 171: 105202.

Kagonya VA Odinga N Onyango O , et al.; HIGH-Q Hospital Group. Implementation of a task-shifting and task sharing intervention: a case of ward assistants in Kenyan neonatal units. Int J Nurs Stud 2025; 171: 105176.

Pronovost P Glotzbecker B. University Hospitals. Get Rid of Silly Stuff (GROSS) toolkit. 2026 Quality Goals.

Choosing Wisely. Promoting conversations between patients and clinicians. ABIM Foundation. https://abimfoundation.org/what-we-do/choosing-wisely (Accessed April 1, 2026).

Moses JC Adibi S Wickramasinghe N , et al. Smartphone as a disease screening tool: a systematic review. Sensors (Basel) 2022; 22: 3787.

Souza GS Furtado BKA Almeida EB , et al. Enhancing public health in developing nations through smartphone-based motor assessment. Front Digit Health 2024; 6: 1345562.

Elendu C Amaechi DC Okatta AU , et al. The impact of simulation-based training in medical education: a review. Medicine (Baltimore) 2024; 103: e38813.

Simms C. Cheap AI chatbots transform medical diagnoses in places with limited care. Nature Epub ahead of print 6 February 2026. doi: 10.1038/d41586-026-00345-x. PMID: 41652199. https://www.nature.com/articles/d41586-026-00345-x (Accessed April 1, 2026).

Qazi IA Ali A Khawaja AU , et al. Large language model diagnostic assistance for physicians in a lower-middle-income country: a randomized controlled trial. Nat Health 2026; 1: 198–205. https://www.nature.com/articles/s44360-025-00007-8

Rutunda S Williams G Kabanda K , et al. Large language models for frontline healthcare support in low-resource settings. Nat Health 2026; 1: 191–197.

Bayala YLT Zabsonré/Tiendrebeogo WJS Ouedraogo DD , et al. Performance of the large language models in African rheumatology: a diagnostic test accuracy study of ChatGPT-4, Gemini, Copilot, and Claude artificial intelligence. BMC Rheumatol 2025; 9: 54.

Mlouki I Trigui A Ajmi Blout A. Knowledge-practice disparity in healthcare waste management: a comparative survey during and after the COVID-19 pandemic in a Tunisian university hospital. J Patient Safe Risk Manage 2026; 31: 73–81.