Determinants, patterns, and gaps in patient safety and quality of care research in Israel: a scoping review

以色列患者安全和医疗质量研究的决定因素、模式和差距:一项范围界定综述

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Abstract

BACKGROUND: Patient safety and healthcare quality are central priorities, yet preventable harm persists across health systems. Although Israel has implemented quality indicators, safety-culture initiatives and system-level reforms, the national evidence base has never been systematically reviewed. This scoping review aimed to map the extent, range and nature of empirical patient-safety and healthcare-quality research conducted in Israel between 2015 and 2025. METHODS: The review followed JBI and PRISMA-ScR guidelines, with a protocol registered on the Open Science Framework. Systematic searches were conducted in MEDLINE, CINAHL, PubMed and Scopus to identify empirical studies examining patient safety or healthcare quality within the Israeli health system. Eligible studies were charted by design, setting, population, methods and thematic domain, and findings were synthesised narratively. RESULTS: Twenty-eight studies met inclusion criteria, reflecting six thematic domains: organisational culture and reporting behaviour; medication and clinical-process safety; national quality-indicator performance; simulation and accreditation; ethics and patient rights; and crisis preparedness and resilience. Most studies were hospital-based and cross-sectional, drawing heavily on national indicators, structured safety-culture tools and simulation-based methods. Major gaps included limited research in community, mental-health, rehabilitation and long-term care settings, minimal use of interventional or longitudinal designs and scarce inclusion of patient or family perspectives. The evidence base remained predominantly focused on acute-care environments, with little attention to primary care or the wider care continuum. CONCLUSIONS: Israel has a growing but uneven published evidence base in patient safety and healthcare quality, characterised by strong hospital-focused research and comparatively limited representation of community and long-term care sectors in the peer-reviewed literature, even though national safety initiatives and monitoring frameworks operate across these settings. Advancing the field requires expanding research into under-examined settings, diversifying methodological approaches and more fully integrating patient perspectives. The findings provide an essential foundation for national improvement efforts and contribute to global discourse on patient-safety and quality advancement.

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