Patient safety is a key dimension of health care quality. Yet, health care-associated preventable adverse events, errors and risks continue to constitute one of the main challenges throughout the world. This motivated the adoption by the Seventy-Second World Health Assembly (in 2019) of resolution WHA72.6, which marked a turning point in recognizing the need for coordinated and sustained action on patient safety at the global level.

In the framework of this resolution, the Global Patient Safety Action Plan 2021–2030 was approved in 2021 with an ambitious but imperative vision: “a world in which no one is harmed in health care, and every patient receives safe and respectful care, every time, everywhere.”3

The plan provides a strategic framework for action for governments, health care institutions, health care professionals and communities to prevent and reduce avoidable harm and improve health care safety at every level of care. It does not only guide the development of national policy, but also promotes specific actions in everyday clinical practice.

Some of its key recommendations are the development of national patient safety policy—like the recently approved Patient Safety Strategy of the Spanish National Health System (NHS)— and the integration of patient safety system interventions across the health care continuum, including pediatric care. This approach allows the alignment of local strategies with global objectives and joining efforts in a collaborative ecosystem under a shared vision of care quality and safety.

In line with the Global Action Plan of the WHO, the Ministry of Health of Spain has taken a key step forward in approving the new NHS Patient Safety Strategy 2025–2035,4,5 aimed at reducing health care-associated harm through coordinated, sustainable and evidence-based actions.

This new strategy, which is an update and an expansion of the previous one (2015–2020), reasserts an essential tenet that is well known in the field of pediatrics: patient safety cannot depend solely on the good will of health care professionals, but requires solid structures, active leadership and sustained institutional commitment.

It was developed with a participatory approach, with involvement of regional governments, patient associations and experts in academia. The strategy is structured into seven lines of action:

• 1

  Safety culture, human and organizational resources and training: seeks to reinforce professional leadership and training in patient safety at every level of the NHS.

• 2

  Safe clinical practices: includes priority measures in the safe use of medicines, the prevention of health care-associated infections, safe practices in surgery and patient care, effective communication, unambiguous identification, management of serious adverse events and the safe use of ionizing radiation. In addition, as a new feature, this update adds a specific objective dedicated to reducing low-value practices through the implementation of Do Not Do recommendations.

• 3

  Risk management and incident reporting systems: promotes the implementation and use of systems that enable the identification, analysis and management of incidents, offering learning opportunities to prevent their recurrence.

• 4

  Involvement of patients, families and communities: recognizes the active role of patients in their own safety with the aim of promoting the engagement of patients and caregivers in patient safety, with a focus on shared decision-making.

• 5

  Research and innovation: promotes the generation of knowledge for the continuous improvement of healthcare safety, with the aim of raising awareness about risk prevention in care delivery.

• 6

  National and international engagement: promotes mutual cooperation and learning at the national and global levels.

• 7

  Patient safety across the care continuum, with particular emphasis on settings such as primary care, mental health, long-term care and social welfare and community-based care, with particular emphasis on transitions of care. This new action line aims to expand the sharing of information and implementation of safe practices in relation to patient safety in other spheres.

The Ministry of Health emphasizes that patient safety is not a responsibility that rests solely with health workers, but an institutional responsibility requiring the participation of administrators, policy-makers, health care professionals and the community at large. The Strategy 2025–2035 is a key tool to advance toward a safer, more efficient and person-centered health care model that minimizes risks, prevents avoidable harm and promotes collective learning.

Each year, on the occasion of World Patient Safety Day, which is observed on September 17, the Ministry of Health of Spain organizes a national scientific conference through the NHS Patient Safety Strategy. This in-person conference takes place in the auditorium of the Ministry and is devoted to the main challenges and advances in this area. The 2025 edition focuses on neonatal and pediatric patient safety, within the scope of the topic proposed by the WHO for this year,2 under the adapted slogan “Asistencia segura en neonatología y pediatría” (Safe care in neonatology and pediatrics).

The conference addresses the specific risks faced by children in health care, with participation of various scientific societies in the field of pediatric care that will share relevant experiences and proposals for improvement. It also features patient associations among its participants, which will provide the perspective of individuals who engage directly with the health care system on a daily basis.

The aim of the conference is to raise awareness, generate knowledge and promote institutional and professional commitment to safer, proactive and patient-centered pediatric care.

The pediatric population is particularly vulnerable for a variety of reasons, including the complexity of treatments, the need to individualize drug dosage, the indirect communication of symptoms and the dependence on caregivers. These characteristics, combined with the natural variation in child development and care settings that are frequently not adapted for pediatric care, increase the risk of adverse events during childhood and adolescence. This status quo calls for the development of safety strategies specifically tailored to this population, not as a simple extension of practices that target adults, but as a separate field of clinical and organizational development.

The American Academy of Pediatrics already emphasized in 2019 that improving the quality of pediatric care requires going far beyond ensuring safety: it involves structuring child-centered, effective, equitable and emotionally safe processes.6

As contemplated in the first 1000 days theory, the first years of life shape life-long health and also the way in which we interact with health systems. A good start does not only entail healing, but also preventing harm, promoting safe environments and building trust in health care.

The slogan of the WHO, “Patient safety from the start!”, is more than a catchphrase: it is an urgent call to act at every level of pediatric care. From the hospital—including settings such as pediatric intensive care, neonatal care and pediatric oncology—to primary care, in essential programs, such as the vaccination of healthy children, each setting is key in guaranteeing the safety and wellbeing of minors. Each of us has a key role to play.

A health care system can only be truly safe when safety is part of every clinical move, every decision and every relationship with families. Providing safe care from birth is an inescapable duty to the present and future of each child. Guaranteeing safety from the first contact with the health care system is an ethical and professional responsibility, but also an opportunity to transform pediatric care into a safer, more respectful and more child-centered model. As pediatricians, we have the opportunity and obligation to lead this transformation, promoting safer and higher-quality health care delivery.

Each child deserves a safe and healthy start.

“To protect the youngest is to guarantee the future of all.”