“First, do no harm” is the most core principle that underpins all healthcare services. Nevertheless, there is strong evidence indicating a significant burden of preventable patient harm worldwide, affecting both developed and developing healthcare systems. This issue carries substantial human, moral, ethical, and financial consequences. Thus, the quality of care is nowadays a political priority worldwide. In this context, we spoke with Penilla Gunther, President of the European Patient Safety Foundation, to discuss the challenges and opportunities in enhancing patient safety with a focus on simulation as a contributing factor in creating safe health systems in Europe, and beyond.
Who is Penilla Gunther?
Penilla Gunther stands out as a key leader in European healthcare, especially in patient advocacy and policy. Currently serving as President of the European Patient Safety Foundation, Gunther brings decades of experience from her roles in the Swedish Parliament, the Nordic Council, and as a member of the EU Cancer Mission. Founder of FOKUS Patient, a unique platform centered on patient perspectives in healthcare, she has continuously advocated for more inclusive, patient-centered approaches. A heart transplant recipient and twice a cancer survivor, Gunther combines personal resilience with professional dedication, making her a powerful voice for patient safety and healthcare innovation.
What is the European Patient Safety Foundation?
The European Patient Safety Foundation (EUPSF) is an independent organization dedicated to advancing patient safety and quality of care across Europe. Founded in 2013, the Foundation unites patient advocates, healthcare professionals, providers, academics, and life sciences companies to address the complex challenges of patient safety. Guided by a holistic and systemic vision, EUPSF emphasizes that enhancing patient safety requires considering all factors influencing care quality, from equity and resilience to the interconnected roles of technology and human factors. EUPSF’s mission is to empower patients and healthcare workers through education and advocacy, drive meaningful change in patient safety policy, and foster a collaborative network that promotes innovative practices and shared solutions. With a strong commitment to ethics, quality, and European collaboration, EUPSF aims to create a healthcare environment where patient safety is a shared responsibility, upheld by all stakeholders.
Ms. Gunther, it is truly an honor to have you as a guest on SIMZINE. We know how busy you are, so we thank you right away. We would like to know what the European Patient Safety Foundation is directly from the voice of its president
It is a hive of leading organisations and experts in patient safety, where you can meet and interact with patient organisations and advocates, healthcare professionals, healthcare providers, academics and innovative companies, that want to make our healthcare systems really safer. The founding idea is that patient safety is a shared priority for everyone involved in healthcare, and that we need to cross different perspectives and foster collaboration to address the complex challenges of patient safety. We have a broad approach of patient safety, considering all the direct and indirect factors that condition safety and excellence in care, such as the healthcare professional wellbeing, the successful uptake and implementation of innovative solutions, the involvement of patients in their own care and organisational performance. We also believe strongly in education and empowerment, and simulation-based training is one of the tools we advocate.
As President of EUPSF, how has patient safety changed over the last few years? What will it look like in the future?
Patient safety has come a long way, particularly in terms of recognising preventable harm as a critical issue. Over the years, we have seen a growing awareness of the number of adverse events in healthcare, such as medication errors, misdiagnoses or procedural complications, which could be prevented through systemic improvements.
Today, we are witnessing unprecedented advances in technology, such as simulation, Artificial Intelligence, and telemedicine, that have the potential to help healthcare professionals better prepare for complex situations. But there are also persistent challenges, like workforce shortages and the impact of chronic fatigue among healthcare workers. These issues can undermine even the best tools and strategies.
Looking to the future, I think we’ll see a stronger emphasis on integrating safety-focused innovations into everyday practice. For example, simulation can train professionals to handle emergencies or even prepare patients for procedures, making care safer for everyone. However, the key will be collaboration, aligning innovations with the realities of healthcare settings. We need to ensure that technology is implemented thoughtfully, with input from professionals and patients alike, to build systems that truly prioritize safety.
Nowadays, simulation is recognized as a clinical risk management tool. What role do you think European governments and institutions should play in promoting simulation for healthcare education and patient safety?
European governments and institutions have a critical role in embedding simulation into healthcare education and practice. First,
they need to recognize simulation as a fundamental part of both initial and ongoing training for healthcare professionals.
This means creating policies that prioritize simulation-based learning and ensuring that trainers themselves are skilled in using these tools.
Additionally, governments should allocate funding to make simulation accessible, not just in large university hospitals but in regional and community settings as well. Equally important is addressing the barriers healthcare professionals face, like fatigue and time constraints. For simulation to be effective, professionals need protected time to participate fully. Finally, I think institutions like the European Commission can help by encouraging cross-border collaboration to harmonize standards and share best practices. By doing all of this, we can unlock simulation’s potential to reduce errors, avoid second victim syndromes, and ultimately improve patient safety.
What were the most pressing issues discussed at this year’s Patient Safety Conference 2024, and how do you believe they will shape patient safety policies across Europe in the coming years?
At the 2024 Patient Safety Conference, one of the main themes was bridging the gap between innovation and its implementation in real-world healthcare settings. We discussed the role of digital tools like simulation, telemedicine and predictive or remote monitoring in enhancing safety, but we also tackled the challenges healthcare professionals face, such as fatigue and heavy workloads.
Another concern that was voiced was equity, ensuring that these tools and practices are accessible to all, regardless of geography or resources. Patient involvement also emerged as a key focus, with discussions on how to better include patients in their care journeys and safety strategies. I believe these discussions will drive future policies to focus not just on technology but on creating the right conditions, like training, collaboration, and support systems, for innovations to achieve their potential. It’s about ensuring that advancements actually reach and benefit those on the front lines of care.
What strategies can scientific simulation societies at both the national and European levels adopt to effectively advocate for simulation to become a health systems standard?
The current momentum in technological development provides simulation societies with a unique opportunity to promote the integration of simulation into everyday healthcare. One key strategy is to move beyond academic or leading institutions and demonstrate that simulation is valuable in all healthcare settings. Societies can do this by showcasing how simulation improves outcomes, reduces errors, and fosters teamwork, making it clear that it benefits both patients and healthcare professionals.
Another important step is to ensure consistency in simulation practices by advocating for high-quality training methods and well-prepared instructors. Societies should also focus on gathering evidence to highlight simulation’s cost-effectiveness and its role in reducing adverse events. Building strong collaborations at European, national and local level with policymakers and healthcare providers will help translate these insights into actionable policies.
When we think of safety in a professional field, aviation immediately comes to mind. Simulation is still an underregulated area of healthcare (i.e., instructor certification, accreditation of simulation centers, minimum standards of simulation devices). Do you think this may be a brake on its extensive use?
Yes, the lack of regulation in simulation is in my view a major barrier.
Without clear standards for instructor certification, simulation center accreditation, or device quality, there’s a lot of variability in how simulation is used.
This can make it harder for healthcare organizations to fully trust and adopt it.
Regulation doesn’t just mean creating rules, it’s about ensuring quality and accessibility. For example, standards can help make simulation available not just in leading institutions but across all healthcare settings. Clear guidelines also ensure that simulation tools and training are consistent, which builds confidence among professionals. I think regulation, when done thoughtfully, can actually expand the use of simulation by creating a framework that supports its integration into healthcare systems.
Very often the cost of simulation devices, or of simulation in general, is cited as the main barrier to its diffusion. But is this, in your opinion, the real reason why such a powerful clinical risk reduction tool is not in current use?
While cost is often cited as a barrier, I think it’s more about priorities and awareness. Decision-makers sometimes don’t fully understand the long-term benefits of simulation, such as reducing adverse events and preventing second victim syndromes.
Investing in simulation is not just about buying equipment; it’s about integrating it into training and practice, which requires time, support and resources. However, when you consider the cost of medical errors and their impact on patients and professionals, simulation becomes a worthwhile investment. Governments and institutions need to allocate funding and create policies that make simulation accessible, especially in under-resourced areas. By doing so, we can ensure that cost doesn’t stand in the way of this powerful tool.
Today we are talking more and more about personalized medicine, and likewise about personalized simulation, as new technologies allow us to create virtual – and actually physical – copies of patients, think of digital twins or 3D printing from tomographic images. How might the implementation of tailored simulation impact patient safety?
Tailored simulation, such as digital twins or 3D printing, represents a major leap forward for patient safety. By creating scenarios based on specific patient profiles, healthcare professionals can practice procedures with incredible precision, improving their confidence and reducing risks.But it’s not just about the professionals; patients also benefit. For instance,
simulation can be used to prepare patients for surgeries or treatments, helping them understand what to expect and reducing anxiety.
This combination of professional readiness and patient involvement leads to better outcomes and fosters trust in the care process. Personalized simulation is a perfect example of how technology can make healthcare not only safer but also more patient-centered.
Last May, the Global Consensus Statement on Simulation-based Practices in Healthcare was released, bringing together insights from healthcare professionals representing 50 Societies and Networks across 67 countries. This statement underscores the critical role of simulation in healthcare. How do you see this statement influencing future policies and practices in patient safety across Europe and globally?
The Global Consensus Statement is a significant step forward for simulation in healthcare. It brings together voices from around the world to emphasize the critical role simulation plays in improving safety and outcomes. This kind of unified message is powerful. It sends a clear signal to policymakers that simulation isn’t just an add-on; it’s a necessity.
In Europe, I see this statement encouraging more countries to adopt simulation-based practices as part of their patient safety strategies. It also calls for sustained funding and collaboration, which are key to making simulation accessible and effective. At EUPSF, we fully support the statement and are committed to help turn its recommendations into actionable policies. It’s an exciting time for simulation, and I believe this statement will help drive its adoption globally.
Ms. Gunther, thank you for taking the time to share your perspectives with us. Your commitment to advancing patient safety is truly inspiring, and it’s been enlightening to learn about the progress and priorities of the European Patient Safety Foundation. Thank you again for your insights and dedication to this vital cause.
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