Communication and Marketing Management in Patient Safety within Healthcare Organizations: A Scoping Review

Abstract

Introduction

Patient safety (PS) is a fundamental pillar of healthcare quality. The effective dissemination of information and knowledge management regarding PS is essential to foster safe practices. Despite significant progress in recent years, gaps remain in how knowledge and information on PS are managed and disseminated across healthcare organizations.

Objective

The aim of this study was to map the scientific evidence concerning knowledge management strategies and the dissemination of information related to PS, as implemented by healthcare organizations for healthcare professionals.

Methods

A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology. Searches were performed in Portuguese, English, and Spanish, with no time limitations, across databases including PubMed, Scopus, and Web of Science, as well as grey literature sources such as NOVA Discovery (EBSCO) and selected institutional websites. The review was reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.

Results

Of the 247 publications identified, 16 were included. Three principal strategies for PS-related knowledge management emerged: acquisition, dissemination, and mediation. Continuous training and the adoption of innovative educational methodologies were found to enhance knowledge acquisition. Digital platforms and health marketing tools facilitated dissemination. Knowledge mediation was supported by strategic leadership, informal networks, and interdisciplinary partnerships involving risk managers, clinical leaders, and subject matter experts.

Discussion

Knowledge management strategies demonstrated potential to strengthen PS, with continuous training, organizational culture, and innovation standing out in knowledge acquisition. Dissemination was effective through digital platforms and marketing, while mediation relied on leaders and managers. Challenges remain, such as validating the impact and updating the content. Future research should assess the impact of these strategies on clinical practice, including the perspectives of patients and carers.

Introduction

Healthcare systems are inherently complex and susceptible to errors, and patient safety (PS) is widely acknowledged as a global concern [1, 2]. It is defined as the reduction of the risk of unnecessary harm associated with healthcare to an acceptable minimum [3] and has become a strategic priority in health policy over the past 15 years.

The multiple challenges raised by the World Health Organization (WHO) over time have led to global action and improvements in PS culture. Among these challenges is the adoption of the Global Patient Safety Action Plan 2021–2030 [4], which aims to ensure a continuous flow of information and knowledge in order to minimize risk, eliminate avoidable harm, and enhance the safety of care delivery. This document outlines various national strategies, including those that contributed to the development of Portugal’s National Patient Safety Plan 2021–2026 [5], implemented within the national health system and the Serviço Nacional de Saúde (SNS).

Each institution’s approach to PS reflects its actions, values, and beliefs, which have a substantial impact on the health outcomes achieved [6]. It is widely recognized that improved access to information and scientific knowledge on PS could promote the delivery of care with higher quality and safety standards [7]. Nevertheless, access to evidence-based information that fosters professional learning and enhances clinical practice continues to pose a challenge for many healthcare organizations [8]. The vast amount of information generated through incident reporting systems, as well as its analysis in team meetings, often results in reports that, despite fulfilling legal and regulatory obligations, are underutilized in driving change in clinical practice [1].

To support organizational learning, it is essential to implement a range of strategies, including knowledge management (KM), which is defined as the process of creating, identifying, managing, and disseminating knowledge within organizations [9]. KM is commonly structured around three key stages: knowledge acquisition, dissemination, and utilization [10]. Acquisition involves developing insights, skills, and relationships; dissemination refers to the sharing of acquired knowledge; and utilization concerns the application of this knowledge in new situations [10]. To enhance dissemination, Health Services Marketing can play a significant role and is increasingly seen as a strategic tool for improving care quality and reinforcing PS [11].

The global production of knowledge on PS has increased considerably, making it imperative to share this knowledge among healthcare organizations in order to support the development of strategies and processes that strengthen care quality and safety [12]. However, turning this aspiration into practice remains a challenge [2], demanding more robust efforts toward effective dissemination – understood as making organizational knowledge publicly accessible [13].

Despite recent advances, gaps persist in the management and dissemination of knowledge relating to PS. The present review seeks to map the existing scientific evidence regarding strategies for KM and information dissemination on PS developed by healthcare organizations for their professionals.

To date, no scoping reviews have been identified that systematically map existing knowledge in this field. Accordingly, this study was conducted to address the following review question:

Review Question

• What knowledge management and information dissemination strategies related to PS are currently being implemented for professionals within healthcare organizations?

Inclusion Criteria

The scope of the review was defined using the Population, Concept, and Context (PCC) framework [14]:

• Population: healthcare professionals;

• Concept: strategies for KM and information dissemination related to PS;

• Context: healthcare organizations, regardless of level of care or geographic location.

Sources of Information

This scoping review included empirical studies such as population-based cross-sectional studies, randomized clinical trials, and ethnographic research. It also encompassed exploratory studies, critical reflections, and institutional or strategic documents, published in Portuguese, English, or Spanish.

Methods

An initial search was performed across platforms including the International Prospective Register of Systematic Reviews (PROSPERO) and the Open Science Framework (OSF), as well as in the PubMed, Scopus, and Web of Science databases. No reviews – completed or ongoing – were identified on this topic. A Scoping Review was therefore deemed appropriate, given its capacity to provide a comprehensive and systematic overview of the existing body of literature [15]. The review was conducted in accordance with Joanna Briggs Institute (JBI) guidelines [14] and followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) [16], ensuring methodological transparency and replicability.

Research Strategy

The search strategy was designed in multiple stages to ensure both comprehensiveness and methodological rigour in identifying relevant publications. An initial exploratory search was conducted in MEDLINE (PubMed) to identify appropriate keywords, incorporating both natural language terms and controlled descriptors. The viability of the topic was further confirmed by verifying the existence of previously published or ongoing reviews on the subject.

The keywords identified in the titles and abstracts of relevant articles were subsequently used to construct the complete search strategy. This strategy was then adapted for each of the selected databases – PubMed, Scopus, and Web of Science, as well as for grey literature sources, particularly NOVA Discovery (EBSCO). Descriptors were combined using Boolean operators “OR” and “AND” to optimize both the sensitivity and specificity of the searches.

The final search strategies, including all identified keywords and descriptors, were customized for each database and information source, as detailed in Table 1. To further broaden the scope of the search, a selection of authoritative websites recognized for their relevance in the field of PS was also consulted. These included the WHO, the Directorate-General for Health (Portugal), Patients for Patient Safety Canada, and the Agency for Healthcare Research and Quality (AHRQ), as shown in Table 2.

Table 1.

The first search strategy

Database	Expression	Results
PubMed	((((“Patient Safety” [Title] OR “safety culture”[Title] OR “safety management” [Title]) OR (“Patient Safety” [MeSH Terms])) OR (“safety management” [MeSH Terms])) AND ((Knowledge [Title] OR evidence [Title] OR information [Title] OR “education* material*” [Title]) OR (“Knowledge Management”[MeSH Terms]))) AND (((Disseminat*[Title] OR Marketing[Title] OR promot*[Title] OR distribut*[Title] OR shar*[Title]) OR (“Information Dissemination”[MeSH Terms])) OR (“Marketing of Health Services”[MeSH Terms]))	82	210
Scopus	(TITLE (“Patient Safety” OR “safety culture” OR “safety management”) AND TITLE (knowledge OR evidence OR information OR “education* material*”) AND TITLE (disseminat* OR marketing OR promot* OR distribut* OR shar*))	33
Web of Science	TI = (“Patient Safety” OR “safety culture” OR “safety management”) AND TI = (Knowledge OR evidence OR information OR “education* material*“) AND TI = (Disseminat* OR Marketing OR promot* OR distribut* OR shar*)	25
NOVA Discovery	TI (“Patient Safety” OR “safety culture” OR “safety management” OR “segurança do doente” OR “cultura de segurança” OR “gestão da segurança”) AND TI (Knowledge OR evidence OR information OR “education* material*” OR conhecimento OR evidência OR informação OR “materiais educativos”) AND TI (Disseminat* OR Marketing OR promot* OR distribut* OR shar* OR disseminação OR promoção OR distribuição OR partilha)	70

Table 2.

Complementary search strategy

Websites Consulted
WHO	https://www.who.int/teams/integrated-health-services/patient-safety/policy/global-patient-safety-action-plan
Directorate-General for Health. Ministry of Health (DGS)	Direção-Geral da Saúde [dgs.pt]
Agency for Healthcare Research and Quality – Patient Safety Network	https://psnet.ahrq.gov; https://www.safetyandquality.gov.au/
Patients for Patient Safety Canada	https://www.patientsafetyinstitute.ca/en/Pages/default.aspx; https://www.patientsafetyinstitute

The choice of databases and websites was based on their inclusion of high-quality, peer-reviewed scientific literature and thematic relevance, ensuring extensive coverage of the healthcare and PS domains. The institutional websites were selected according to predefined criteria, namely: relevance to the topic, scientific credibility, timeliness of the information, comprehensiveness, and ease of access [2]. No date restrictions were applied in the search process.

Data Selection

Following the search process, all identified citations were exported to the Rayyan platform [17], and duplicate records were removed. At each stage of the selection process, two reviewers independently assessed the studies. Mendeley reference management software [18] was used to organize and manage the bibliographic records.

An initial screening was conducted based on the titles and abstracts, followed by a full-text review of the selected studies, applying the inclusion criteria previously defined for this review. There was full agreement between the two reviewers, and any discrepancies were resolved through discussion until consensus was reached.

Studies such as these, journalistic articles, and any publications whose content did not align with the objectives of this review were excluded. The outcomes of the screening process are presented in a PRISMA flow diagram [16].

To support data extraction and highlight the key features of each included study, Table 3 was developed. It contains information such as study authors, year of publication, country of origin, study objectives, methodology, population and context, and the main findings. The studies were subsequently grouped according to the distinct KM strategies in PS identified in the literature.

Table 3.

Results extracted from the publications included in the review

Author, year, country	Objective publication	Type of publications	Population and context	Results: PS KM strategies
				knowledge acquisition	dissemination of information	mediation of knowledge	limitations of the strategies
Lebre et al. [19] (2022), Portugal	Contribute to the success of health policies and quality and health in the National Health Service	Document: health policies and strategies related to PS	Health professionals, directors, healthcare managers	Promoting the training of health professionals in the field of PS	Implementation of an annual training plan Online courses, covering different health professionals Actions and campaigns for health professionals and citizens
WHO [4], (2021), Switzerland	Provide strategic guidance to improve PS	Global Action Plan for PS (2021–2030)	Health professionals, patients/relatives, and organizations	Analysing and sharing data and good practices to generate learning in a consistent and reliable way Gathering information from different sources to understand PS incidents and develop preventive measures	Inclusion of PS in team and leadership training Participation in online courses
Garcia et al. [20] (2021), Portugal	Critically reflect on the contribution of simulation to PS	Critical reflection on simulation to promote PS	Health professionals and students (mainly in hospital settings)	Simulation at the various learning levels Debriefing session for analysis, reflection, feedback, problem-solving, and skills development			Difficulty in scientific validation on the impact of simulation on patient outcomes
Elrod and Fortenberry [21] (2020), USA	Sharing perceptions about marketing communications in healthcare organizations	Debate/reflection	Health organizations		Integrated marketing communications: –Coordination of verbal and visual information (logos, slogans, signage, digital variants) –Development of communication objectives/message consistency for the target audience	Recourse to professionals considered “outstanding communicators” in healthcare institutions
		Review
Solano et al. [7] (2019), Spain	Identify, disseminate and improve access to information on PS through a catalogue available on the internet and intranet	Experience report on the creation of a catalogue of reference documents in PS	PS/Risk Management Units	Development of a catalogue of reference documents in PS –Bibliographical research with the participation of experts –Use of language that is understandable to inexperienced professionals and citizens –Organization by the thematic area	Dissemination of the catalogue through: Intranet; email; personal contacts; forums, congresses, and magazines	Participation of nurses, doctors, pharmacists, and librarians	Difficulty updating access links Selection of documents based on expert opinion
			Health professionals; PS specialists; newly recruited professionals; students; patients/citizens
Australian Commission on Safety and Quality in Health Care [22] (2019), Australia	Publicising the state of PS and quality in Australian public hospitals	Report with information on safety and quality improvements	Health professionals; patients/carers/citizens; public hospital managers		Creation of a national safety and quality portal: –Compile bibliography on PS practices –Sharing and comparing knowledge and evidence to support the effectiveness of PS in professional practice –Meeting the neePS of healthcare professionals and organizations, patients, users, and carers
Purcarea [23] (2019), UK	Addressing marketing strategies and their impact on healthcare organizations	Critical reflection	Professionals from health organizations	Marketing as a strategy to support professionals in creating, communicating and adding value to their message Using digital marketing to track, measure, and help professionals and organizations make informed decisions	Creation of informative blogs, websites Identification of digital platforms used by the organization and creation of personalized messages
Agra et al. [24] (2018), UK	To evaluate an e-learning course on “risk management” for healthcare professionals in terms of its acceptability and usefulness for developing projects to improve PS in different clinical contexts	Exploratory study	Managers and clinicians involved in PS in their healthcare organization	Development of: course with e-learning methodology; PS improvement projects based on teamwork Recognize and talk openly about mistakes	Develop online courses (PS training for more health professionals) Creation of an online database to disseminate and share the projects developed Course in Spanish and English to reach more trainees The e-learning methodology		Isolation of the student less interaction with the teacher and difficulties in clarifying doubts properly
		Use of evaluation questionnaires at four levels: reaction, learning, behaviour, and results
Dave Davis and McMahon [25] (2018), Europe	Outline recommendations to help organizations improve care and health and reduce costs	Critical reflection	Doctors and other health professionals	Continuous professional development: –Adoption of self-directed learning principles and practices –Educational interventions that foster curiosity, build capacity, require cognitive effort, and provide feedback and opportunities for practice –Involvement of professionals in collaborative problem-solving		Creation of partnerships with health system leaders, developing integrated and impactful training
Frankel et al. [1] (2017), UK	Guiding healthcare organizations to improve the safety, reliability and effectiveness of care	“Framework for safe, reliable and effective care”	Professionals Health organizations; patients/family members/citizens	Ensuring continuous learning within and between organizations Proactively identify problems and act on them, rewarding this proactivity	Share: –clinical and operational data with professionals/patients/family members –learning resulting from damage, but also from successes –near-miss data and provide timely feedback	Having leaders who play a supporting role in a solid learning system
Cunningham et al. [26] (2017), Australia	To analyse the perception of health professionals regarding their learning and changes in clinical practice, by reading case studies	Cross-sectional population-based study	Health professionals and managers (of hospitals; most represented roles were doctors and nurses)	Clinical communication as a training resource: –reflection of case studies in which avoidable deaths occurred –Inclusion of key themes (communication, supervision, decision-making) –fosters team dialogue	Publication A quarterly clinical communication, via email Transmission of information in a classic way (storytelling)		Impossibility to confirm reported changes and their continuity
			Total = 1,008 individuals
Heinrich et al. [27] (2017), Germany	Demonstrate the processes of developing and publishing a website based on scientific research on dementia care networks	Randomized clinical trial	People who intend to disseminate the results of the research to groups associated with professionals		Information sites can be successful tools for disseminating information: –practical structure of recognized and credible information –continuous evaluation and implementation of marketing strategies –development of an English-language version of the site (to reach more users)		Need to evaluate the effectiveness of this strategy
Leotsakos et al. [28] (2014), New Zealand	Critically reflect on the need to integrate PS into higher education curricula in health	Critical reflection/expert consensus	Health professionals and students	Recognizing PS as everyone’s responsibility Sharing learning and knowledge between professions Promoting collaborative care Preparing to work in a culture that does not identify all mistakes and errors as reprehensible Teaching methods that include varied pedagogical activities, role modelling, and team learning projects, participation in training and simulation	It encourages the sharing of information, experiences, and synergies between institutions
		WHO curriculum guide for PS, multiprofessional edition
Waring et al. [8] (2013), UK	Comparing the role of different players in mediating knowledge in PS	Exploratory study with ethnographic research	Professionals from three UK hospitals			Recourse to “Hospital’s leading communicators”: Clinical Leaders and Professional Leaders – occupy hybrid organizational roles and are often best placed to support the sharing of PS knowledge within the organization
Zipperer and Amori [29] (2011), USA	Introducing KM as a strategy to support risk management and improve organizational performance (with regard to quality and PS)	Critical Reflection	Leaders, risk management professionals, and healthcare professionals from hospital organizations		Collecting, organizing, and sharing information and experiences (developed inside or outside the organization) using Information Technology: –Managing and monitoring the flow of information through: databases and knowledge sources –Knowledge of successful knowledge-sharing practices already in place in the organization	Creation of interprofessional partnerships and involvement of leaders and risk managers Valorization of informal relationships for sharing knowledge	Costs can compromise the choice of options
Stock et al. [9] (2010), USA	Examining the effects of organizational culture and KM practices on PS performance in hospitals	Exploratory study (questionnaires in hospitals nationwide)	Quality director; risk manager, nursing director, and information systems director of 202 hospitals (N = 626)	Implementing KM Different dimensions of organizational culture lead to more effective KM and better performance by the PS		The combination of group and rational culture to promote and implement KM practices

Results

Following the evaluation and selection process, and in line with the predefined eligibility criteria, a total of 16 publications were included in this scoping review. Figure 1 presents the PRISMA flow diagram illustrating the stages of selection and the number of articles assessed at each step.

Fig. 1.

Flowchart of study selection according to the PRISMA methodology.

The database search initially retrieved 210 publications. After the removal of 65 duplicates, 145 records remained. Screening of titles and abstracts led to the exclusion of 113 publications, resulting in 32 studies selected for full-text review. Of these, 11 were included in the final analysis.

In parallel, a grey literature search identified 37 publications, of which 5 were included: 2 obtained from institutional websites (WHO and the Directorate-General for Health), 1 from a reference website in the area of PS, and 2 identified through reference list screening. The findings from the 16 included studies are summarized in Table 3, organized chronologically from most recent to oldest. The years with the highest number of publications were 2019 (n = 3) and 2017 (n = 3), followed by 2021 (n = 2) and 2018 (n = 2). The remaining years – 2022, 2020, 2014, 2013, 2011, and 2010 – each contributed one publication.

In terms of geographical distribution, the majority of studies were conducted in the UK (n = 4), followed by the USA (n = 3), Portugal (n = 2), and Australia (n = 2). One study each was conducted in Spain, Switzerland, New Zealand, and Germany, and one was a pan-European publication. Across the included studies, strategies relating to KM in PS were identified and classified into three main categories:

• knowledge acquisition (n = 11),

• information dissemination (n = 12), and

• knowledge mediation (n = 7).

Additionally, a fourth category emerged based on findings from six studies that reported limitations in the implementation of the identified strategies – particularly regarding simulation-based learning, e-learning, and the accessibility of digital platforms dedicated to PS. The principal KM strategies, their reported limitations, and the key actors involved in knowledge mediation are synthesized in Table 4.

Table 4.

Summary of knowledge management strategies in patient safety

Categories	Strategies
1. Knowledge Acquisition Strategies in Patient Safety [1, 4, 7, 19, 21–24, 26–29] (11 publications)	Training and Continuous Professional Development –Implementation of structured and integrated training programmes –Use of simulation across multiple levels of learning –Facilitation of debriefing sessions –Promotion of self-directed learning –Analysis and dissemination of data and good practices –Collection and synthesis of information from diverse sources Organizational Learning –Promotion of intra- and inter-organizational learning processes –Encouragement of proactive problem identification and implementation of corrective measures –Engagement of professionals in collaborative problem-solving initiatives –Development and reinforcement of various dimensions of organizational culture Development of Training Resources –Production of institutional communications to promote safer care delivery –Use of case-based reflection for experiential learning
2. Information Dissemination in Patient Safety [1, 4, 7, 19, 21–24, 26–29] (12 publications)	e-Learning Methodologies and Digital Technologies –Use of digital platforms –Delivery of courses using online methodologies and e-learning formats, available in multiple languages to broaden accessibility –Development of online databases for the sharing of PS initiatives and projects Building on Successful Practices –Identification and adaptation of successful models within the organization Creation of Online Catalogues with Reference Documents –Literature reviews conducted with the involvement of subject matter experts –Use of accessible and inclusive language aimed at both professionals and the general public –Organization of content by thematic area to facilitate navigation and relevance Use of Digital Marketing Strategies –Strategic approaches for creating, communicating, and enhancing the value of information –Application of digital marketing tools to support decision-making and monitor impact
3. Knowledge Mediation in Patient Safety [1, 7–9, 21, 25, 29] (7 publications)	Engagement of reference professionals within healthcare institutions Development of strategic partnerships with leadership figures Integration of Clinical and Professional Leaders to facilitate knowledge exchange in PS Active involvement of risk managers in knowledge mediation processes Recognition and valorization of informal communication networks Participation of experts from diverse fields, including nurses, physicians, pharmacists, and health sciences librarians
4 - Limitations of Knowledge Management Strategies [7, 20, 24, 26, 27, 29] (6 publications)	Difficulty in scientifically validating the impact of simulation-based training on patient outcomes Challenges in maintaining updated access links to PS websites, despite regular revisions Reliance on expert opinion for the selection and appraisal of content quality High operational costs as a barrier to evaluating the effectiveness of healthcare-related websites

Knowledge Acquisition Strategies in Patient Safety

Eleven publications [1, 4, 7, 9, 19, 20, 23–26, 28] describe strategies, notably continuous professional education and development, or approaches that incorporate innovative methodologies and educational practices. A culture of non-punitive response to error is advocated, as it promotes an educational approach based on collaborative learning [28]. In a publication, reference is made to the importance of reporting and analysing errors in order to prevent future occurrences [4].

The promotion of continuous training for healthcare professionals has been identified as a key element in consolidating competencies and ensuring the implementation of quality and PS policies [4, 19]. In this context, the importance of systematic analysis and sharing of data and good practices, as well as the collection of information from various sources to support learning processes and the implementation of preventive measures, is emphasized [4]. The use of innovative teaching methodologies, such as clinical simulation at different levels of complexity, accompanied by structured debriefing sessions, has been highlighted as an effective practice for the development of both technical and behavioural skills, in addition to fostering critical analysis and problem-solving in teams [20, 28]. Self-directed learning is also recommended as an educational strategy to stimulate curiosity, autonomy, and cognitive effort among professionals [25, 28]. The development of e-learning courses focused on risk management and PS improvement has likewise been identified as an effective solution for acquiring knowledge in a flexible manner, adapted to the needs of professionals in various contexts [24]. Furthermore, marketing applied to healthcare organizations has been recognized as a supporting strategy for knowledge acquisition and dissemination, enabling the creation, communication, and addition of value to safety messages, while using digital tools to track, measure, and guide informed decision-making by professionals and organizations [23].

Information Dissemination in Patient Safety

Twelve publications [1, 4, 7, 19, 21–24, 26–29] address this topic, identifying various technological tools, organizational networks, and communication practices. The use of digital platforms for disseminating information is highlighted by two authors, who emphasize the role of websites and databases in the management and monitoring of knowledge flows [7, 27, 29]. The development of institutional databases for recording and sharing good practices is also discussed, with particular emphasis on the importance of centralizing and structuring information [7]. One study identifies the creation of regularly updated scientific websites as a successful tool for disseminating knowledge on PS [28], while other authors propose an internal approach, involving structured KM within organizations [29].

Knowledge Mediation in Patient Safety

Knowledge mediation in PS was addressed in seven studies [1, 7–9, 21, 25, 29], with emphasis on the role of organizational leadership and collaborative networks in facilitating knowledge flow and sharing. Two studies specifically highlighted the importance of clinical and professional leaders as knowledge mediators, recognizing leadership as a driving force for organizational learning and change [8, 29].

Additionally, the influence of organizational culture on knowledge sharing and the relevance of collaborative work environments in promoting safe practices were also emphasized [9, 29]. One study focused on micro-level dynamics, analysing interactions within hospital teams [8], while another adopted a macro-level approach, examining data from 202 hospitals to explore the relationship between KM, different dimensions of organizational culture, and the PS culture [9].

Limitations of Knowledge Management Strategies

Six publications [7, 20, 24, 26, 27, 29] identify barriers to knowledge dissemination, including limited accessibility to PS platforms, challenges related to simulation and e-learning, and the need for more effective strategies to ensure professional engagement.

Discussion

The findings of this review enabled the identification and mapping of KM and information dissemination strategies related to PS, developed within healthcare organizations and directed at their professionals. KM – comprising the acquisition, dissemination, and application of knowledge to achieve organizational objectives – appears to contribute to improvements in both PS and overall organizational performance [9].

Among the sixteen publications included, three main categories of PS KM strategies were identified: Knowledge Acquisition, Information Dissemination, and Knowledge Mediation. Additionally, limitations in the application and effectiveness of these strategies were also reported.

Knowledge Acquisition

Training and Continuous Professional Development

The reviewed studies suggest that learning in the field of PS can be enhanced through strategies centred on training, continuous professional development, organizational learning, the cultivation of a safety culture, and the development of specific educational resources [1, 4, 7, 19, 20, 24–26, 29]. Continuous professional development is regarded as an effective approach to fostering learning within healthcare systems, ultimately contributing to improved outcomes [1, 4, 9, 19, 25, 28, 29]. Key strategies include engaging professionals in problem-solving methodologies tailored to the organizational context [1, 25], promoting self-directed learning, stimulating curiosity and cognitive engagement, and developing impactful, interactive educational activities [25].

The importance of incorporating PS as a core attitude early in professional training and consolidating it through lifelong learning is reinforced in the literature [30]. Simulation was identified as a valuable tool across various levels of learning, facilitating the acquisition of both technical and non-technical skills [20]. Debriefing sessions were shown to create space for critical reflection, feedback, and problem-solving based on simulated scenarios [20]. These findings are echoed by other research advocating regular training sessions, safety briefings, and debriefings to promote a culture of continuous learning [31, 32]. Furthermore, continuous professional development, simulation-based education, and the integration of technology have been associated with increased adherence to best practices [20, 24, 31]. The role of teamwork was also emphasized as a critical factor in effective learning and safe practice [9, 31, 32].

Organizational Learning

Intra- and inter-organizational learning emerged as fundamental to the sharing of knowledge and best practices, fostering a collaborative and safe environment [1, 27]. These approaches were also described in experiential reports on the development of annual PS campaigns within Portuguese hospital centres [32].

Proactive identification of problems and the implementation of corrective actions were associated with the promotion of a robust safety culture [1, 27]. One study examining the relationship between organizational culture, KM practices, and PS performance reported that specific cultural dimensions facilitated KM and organizational performance [9]. Moreover, it was argued that improvements in PS outcomes could be achieved through collective behaviour and engagement [9].

Development of Training Resources

The creation of targeted materials and training courses on PS has a demonstrable impact on the enhancement of clinical practice [4, 19, 32]. Institutional communications aimed at promoting safer care and reflective analysis of case studies involving avoidable harm were identified as effective in improving professionals’ awareness of error and response strategies [26].

Innovative teaching methodologies, such as e-learning, were recognized for their ability to foster team-based dialogue, improve care quality, and overcome economic and geographical barriers [24]. The availability of training in multiple languages was highlighted as a means to extend reach and facilitate international dissemination of best practices [24].

Information Dissemination

The effective dissemination of PS-related knowledge was facilitated through online catalogues, institutional communications, websites, professional forums, and quality and safety platforms [2, 7, 22, 23, 26, 27]. These tools contributed to the promotion of best practices and the improvement of care delivery. They also enabled the rapid sharing of reliable and up-to-date information [7, 22, 27], playing an important role in the ongoing education of healthcare professionals.

This type of information sharing was shown to raise awareness of adverse event prevention [7], enable benchmarking of professional practices [22], and contribute to strengthening safety culture within organizations [7]. The materials disseminated included bibliographies, reports, educational programmes, incident data, case studies, and national and international standards [2, 7, 19, 25, 26]. Dissemination channels included internet/intranet platforms, email, conferences, and peer-reviewed publications, often supported by marketing strategies [7, 23, 24, 27]. Several studies recommended thematically organized content and the active promotion of shared learning [1, 4, 7, 26].

Consultation of international websites [33–35] confirmed the relevance of these strategies and highlighted the importance of effective site design. The use of marketing and communication strategies was reported to support professional engagement and coordination, contributing to consistency in messaging [21, 23]. Four studies underlined the importance of using clear language and varied communication formats to enhance comprehension across different audiences [1, 7, 19, 21]. E-learning methodologies and digital technologies were recognized as crucial for both the production and dissemination of PS knowledge [4, 7, 19, 22, 27, 29], with findings supported by additional studies [32].

Knowledge Mediation

So-called “knowledge brokers” were identified as key figures in PS knowledge sharing and organizational learning processes [8]. Professionals with hybrid roles, combining managerial and clinical responsibilities, were especially influential in the dissemination of PS knowledge [8, 29]. These individuals, referred to as Clinical Leaders (those active in practice and management) and Professional Leaders (individuals recognized for their role in quality and safety), were viewed as essential references by their teams [8].

Building strategic partnerships across professional domains was seen as vital to effective knowledge mediation [1, 8, 25, 29]. Collaborative efforts involving experts in technology, design, marketing, and information science (e.g., librarians) were found to strengthen the development and dissemination of PS content [7, 21, 23, 27, 29].

Experts in PS, often responsible for risk management, were typically charged with organizing and validating this knowledge [7–9, 25, 29]. However, their impact was occasionally limited by the bureaucratic nature of their role and by limited legitimacy in clinical settings [8]. One study further supported this finding by highlighting the role of informal communication networks in facilitating the internal exchange of PS knowledge within organizations [36]. Organizational leaders were also recognized as playing a vital role in supporting and sustaining learning systems [1, 8, 12, 29].

In a systematic review examining teamwork improvement strategies, leadership involvement was again identified as a key factor [31]. Effective leadership was seen as essential to cultivating a culture of transparency and accountability, where mistakes and near misses are approached as learning opportunities, not as grounds for blame [37]. Another study, with a sample of 351 nurses, highlighted the non-punitive attitude towards errors as important for improving PS [38]. Finally, knowledge sharing was also seen to depend on the involvement of those responsible for training future professionals, positioning education as a critical bridge between evidence and practice [12, 28].

Limitations of Knowledge Management Strategies

Six publications [7, 20, 24, 26, 27, 29] reported limitations related to the difficulty in scientifically validating the impact of KM strategies, particularly in assessing their effect on patient outcomes and professional performance. Other limitations included the challenge of keeping access links to online PS resources up to date, despite routine reviews [7], and the financial costs associated with maintaining effective KM systems [29]. In the context of e-learning, learner isolation, limited interaction with instructors, and difficulties in resolving queries were identified as significant barriers to effective knowledge dissemination [24].

Limitations of the Review

The main limitations of this review include the lack of integration of patients and caregivers within the considered population, which may restrict the perspective on the dissemination of information regarding PS. Furthermore, the language restriction to English, Portuguese, and Spanish, as well as the inclusion of only full-text articles, may have resulted in the exclusion of potentially relevant studies.

Additionally, the inclusion of institutional articles and documents sourced from websites may limit the methodological rigour of the review, as such sources often lack formal peer-review processes and standardized reporting frameworks. Nevertheless, the inclusion of grey literature and the conduct of supplementary searches contributed to broader coverage of the available evidence, partially mitigating these limitations.

Conclusion

This review identified a range of strategies for KM and information dissemination in PS, highlighting good practices while also recognizing existing limitations in their implementation. The acquisition, dissemination, and application of knowledge contribute to enhanced PS and improved organizational performance.

Training and continuous professional development emerged as fundamental strategies for knowledge acquisition in PS. Organizational learning, the promotion of a safety culture, and the active engagement of healthcare professionals in training processes were associated with improvements in clinical practice. The use of simulation, debriefing, and innovative methods, such as e-learning, facilitates both the acquisition of knowledge and its application in clinical settings.

Regarding information dissemination, tools such as thematic catalogues, clinical communications, digital platforms, and health marketing strategies have demonstrated effectiveness in sharing knowledge. Organizing information by topic, using accessible language, and employing diverse formats contribute to greater reach and understanding of PS-related content.

Knowledge brokers, such as clinical leaders and managers, along with the active involvement of risk managers, were identified as key figures in promoting and integrating PS practices within healthcare organizations. Informal communication networks and strong organizational leadership were also highlighted as essential to consolidating a safety-oriented culture.

However, challenges persist – such as the difficulty of validating the impact of the implemented strategies, the need for continuous updating of digital content, and the financial costs associated with KM. Moreover, the absence of PS in academic curricula may hinder the effective dissemination of knowledge.

The findings of this review reinforce the need for ongoing investment in the training of healthcare professionals in PS, integrating the subject into both initial and continuing education. Active teaching methodologies, such as simulation and debriefing, should be incorporated into curricula and training programmes. Furthermore, strengthening of communication networks and leadership engagement are fundamental to fostering a robust safety culture within organizations.

Future research should prioritize the evaluation of the impact of KM strategies on clinical practice and PS outcomes. Additionally, incorporating the perspectives of patients and informal carers may offer a more comprehensive understanding of information dissemination in PS and support the development of more effective, person-centred strategies.

Statement of Ethics

The ethical principles outlined in the Declaration of Helsinki were fully respected in the preparation of this scoping review. Ethical approval was not required, as no direct research involving human participants was conducted.

Conflict of Interest Statement

The authors have no conflicts of interest to declare.

Funding Sources

This study received no external funding or sponsorship.

Author Contributions

Maria Diniz Nogueira contributed to study design, data collection, storage and analysis, results review, and interpretation, and drafted and revised the manuscript. Ana Marinho Diniz contributed to data collection, storage, analysis, results review, and interpretation, and drafted and revised the manuscript. Cláudia Tartaglia Reis contributed to study design, data analysis, results review, and interpretation, and revised the manuscript. Susana Ramos contributed to study design, results interpretation, and manuscript revision. Paulo Sousa contributed to results review and interpretation and revised the manuscript. All authors have read and approved the final version of the manuscript.

Funding Statement

This study received no external funding or sponsorship.

Data Availability Statement

All data generated or analysed during this study are included within this article. Further enquiries may be directed to the corresponding author.