On paper, patient safety is a universal value. Since 2019, when all 194 WHO Member States signed Resolution WHA72.6, the world has had a dedicated day, the World Patient Safety Day (WPSD), every 17 September, to remind us that avoidable harm in healthcare is unacceptable.
And yet, six years later, the numbers tell a different story. Every year, millions of people worldwide are harmed by unsafe healthcare practices. Newborns and children remain among the most at-risk patients worldwide. According to the data reported in the WHO web portal, in paediatric intensive care, up to 91.6% of adverse events are preventable; in general paediatric wards, the rate still hovers at a shocking 53.8%; and in neonatal care, almost 97% of reported harms could have been avoided.
If we already know this, if the evidence is overwhelming, why do we keep failing?
This year’s campaign theme, “Safe Care for Every Newborn and Every Child” probably forces us to confront an uncomfortable truth: healthcare systems worldwide are still not designed with child-centred safety in mind.
The main facts? Unsafe childbirth, infections, diagnostic delays, medication errors. We know them. We’ve studied them. And yet they keep happening, across high-resource and low-resource settings alike.
Patient Safety and Simulation: Evidence, Not Aspirations
One promising solution already lies within our reach: simulation. Not the futuristic kind with high-tech gadgets for show, but the structured, evidence-based training that saves lives.
A groundbreaking study published in The New England Journal of Medicine proves it. Across 125,000 individual training sessions and 1,300 group simulations, involving 280,000 mothers and newborns, researchers found an 18% reduction in perinatal mortality.
Read that again: 18% fewer deaths. In low-resource settings. Achieved not by new drugs or expensive technology, but by preparing teams to anticipate, respond, and adapt through simulation.
So I keep asking myself why simulation is not already at the heart of every national patient safety strategy?
Beyond Training: Exposing System Failures
Simulation is not just about teaching doctors and nurses how to perform a neonatal resuscitation or how to avoid medication errors. It’s about stress-testing the system itself.
In situ simulation, conducted in real hospital environments, serves to reveal critical vulnerabilities: missing equipment, flawed protocols, communication breakdowns between staff. These are not “bad luck” events; they are design failures, waiting to harm patients.
If we do not use simulation to identify and resolve these issues, then we are jointly responsible for allowing them to reach the patient’s bedside.
The Global Consensus: Enough Excuses
The Global Consensus Statement On Simulation-Based Practice In Healthcare couldn’t be clearer: simulation is a core methodology, not an optional extra. It should be embedded across health professions education, quality improvement, and system design.
Yet too often, simulation is dismissed as “too expensive,” “too complex,” or “not a priority.” Let’s be honest: what is more expensive than losing a child to a preventable error? What is more complex than repairing the lifelong consequences of unsafe care? What higher priority can a health system have than keeping its youngest patients alive and unharmed? Simulation will certainly not solve all problems, but it can and will play an important role.
Simulation Works but without Structure, it Remains a Boutique Activity
The problem is not whether simulation works, but whether health systems are willing to fund, regulate, and institutionalize it. A prime example that we reported in SIMZINE is that of Spain.
At the 11th congress of the Sociedad Española de Simulación Clínica y Seguridad del Paciente (SESSEP), experts acknowledged what many of us already know: simulation works, but its presence in hospitals is still uneven and fragile. Three pillars were identified as essential for embedding simulation into healthcare systems:
- Institutional regulations and ministerial support, without political will and policy backing, simulation remains an optional exercise rather than a structural component of patient safety.
- Functional structures, dedicated units or organizational models that coordinate simulation activities, ensuring they are not isolated initiatives but integrated into daily practice.
- Adequate resources, not only physical spaces and technology, but also trained specialists, technical staff, managerial oversight, and continuous professional development.
In other words, without structure and resources, simulation risks being reduced to a boutique activity: impressive in some centers, absent in many others, and ultimately incapable of producing the systemic impact that patient safety demands.
From Awareness to Accountability
World Patient Safety Day 2025 should not be another round of hashtags and panel discussions. We need to move beyond rhetoric: simulation must become mandatory, not optional, across clinical pathways and hospitals must use simulation to stress-test workflows and eliminate latent risks.
World Patient Safety Day 2025 is not about awareness. It is about accountability. And simulation is one of the sharpest tools we have to stop repeating the same mistakes.
So the real question is: what excuse do we have left for not using it?
PLI
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