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Making existing technology safer in healthcare
  1. Richard C Newton1,
  2. Oliver T Mytton2,
  3. Rajesh Aggarwal3,
  4. William B Runciman6,
  5. Michael Free7,
  6. Bjorn Fahlgren8,
  7. Masanori Akiyama9,
  8. Barbara Farlow10,
  9. Sara Yaron11,
  10. Gerad Locke4,
  11. Stuart Whittaker4,5
  1. 1Institute of Biomedical Engineering, Imperial College, London, UK
  2. 2Department of Health, WHO Patient Safety, London, UK
  3. 3Division of Surgery, Imperial College, London, UK
  4. 4The Council for Health Service Accreditation of Southern Africa, COHSASA, Howard Place, South Africa
  5. 5School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  6. 6School of Psychology Social Work & Social Policy, University of South Australia, Australia
  7. 7Technology Solutions Global Program, PATH, Seattle, WA, USA
  8. 8Department of Essential Health Technologies, WHO, Geneva, Switzerland
  9. 9Center for Digital Business, Massachusetts Institute of Technology Sloan School of Management, Massachusetts, USA
  10. 10Patients for Patient Safety, WHO Patient Safety, Canada
  11. 11Patients for Patient Safety, WHO Patient Safety, Israel
  1. Correspondence to Dr Richard Newton, Institute of Biomedical Engineering, Imperial College, London SW7 2AZ, UK; r.newton{at}


Background Technology, equipment and medical devices are vital for effective healthcare throughout the world but are associated with risks. These risks include device failure, inappropriate use, insufficient user-training and inadequate inspection and maintenance. Further risks within the developing world include challenging conditions of temperature and humidity, poor infrastructure, poorly trained service providers, limited resources and supervision, and inappropriately complex equipment being supplied without backup training for its use or maintenance.

Methods This document is the product of an expert working group established by WHO Patient Safety to define the measures being taken to reduce these risks. It considers how the provision of safer technology services worldwide is being enhanced in three ways: through non-punitive and open reporting systems of technology-related adverse events and near-misses, with classification and investigation; through healthcare quality assessment, accreditation and certification; and by the investigation of how appropriate design and an understanding of the conditions of use and associated human factors can improve patient safety.

Results and discussion Many aspects of these steps remain aspirational for developing countries, where highly disparate needs and a vast range of technology-related problems exist. Here, much greater emphasis must be placed on failsafe, durable and user-friendly design—examples of which are described.

  • Safety
  • safety management
  • technology
  • risk management
  • quality of healthcare
  • adverse event
  • human factors
  • incident reporting
  • safety culture

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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  • Funding The project was funded by WHO Patient Safety.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.