# Development of the National Strategy for Quality of Care and Patient Safety for Greece: co-creation process and lessons learnt

## TL;DR

Greece developed its first national strategy for quality of care and patient safety through a collaborative process involving over 750 stakeholders, offering a model for other countries.

## Contribution

The paper presents a novel co-creation process for developing a national strategy for quality of care and patient safety in Greece.

## Key findings

- Stakeholders identified governance fragmentation and weak patient safety culture as key challenges.
- The strategy includes 47 actions focused on leadership, evidence, and engagement.
- The co-creation process enhanced stakeholder ownership and provided a foundation for sustainable implementation.

## Abstract

Improving the quality of care and patient safety is a global health priority. Before 2025, Greece lacked a comprehensive national strategy to address longstanding challenges such as fragmented service delivery, uneven care quality, and limited safety reporting. In 2023–2024, a multi-stakeholder initiative, led by the Ministry of Health, in collaboration with the WHO Regional Office for Europe, the Agency for Quality Assurance in Health, and the European Commission, supported the development of Greece’s first National Strategy for Quality of Care and Patient Safety (2025–2030).

A multi-method, co-creation approach was adopted, combining a scoping review, a nationwide needs assessment (405 survey responses and 14 interviews), seven regional workshops (348 participants), and a validation process. Over 750 stakeholders, including policymakers, professionals, patients, and academics, were engaged in shaping the strategy.

Findings highlighted governance fragmentation, limited monitoring, and a weak patient safety culture. Stakeholders prioritized improved governance, a national safety reporting system, better health worker training, use of digital tools, and greater patient involvement. These informed a strategy structured around three directions: (1) Leadership and governance, (2) Evidence and innovation, and (3) Literacy and engagement. The final framework comprises 47 prioritized actions, including the creation of regional quality departments, a national patient safety system, updated clinical protocols, and integration of patient-reported outcomes and quality training in medical education.

Greece’s co-created strategy offers a model for other countries aiming to advance whole-system approaches to quality of care through participatory, evidence-informed policymaking. The process not only enhanced relevance and ownership, laying a strong foundation for sustainable implementation, but also assured the use of existing resources to build future directions at national, regional, and local levels. Lessons from Greece’s experience can guide similar efforts to improve quality and safety across diverse health system contexts.