Patient Safety in Public Health: Challenges and Strengthening Strategies in the Brazilian Unified Health System – A Narrative Review

Resumen

Patient safety is a fundamental component of healthcare quality, particularly within public health systems such as the Brazilian Unified Health System. This study aims to critically analyze patient safety in the SUS, identifying the main challenges and strategies for strengthening safe care practices. A narrative literature review was conducted using the PubMed, SciELO, and LILACS databases, including studies published in the last five years, as well as relevant institutional documents. The findings indicate that patient safety in the  Unified Health System is challenged by structural and organizational factors, such as underfunding, service overload, fragmentation of care, and regional inequalities. Additionally, cultural and professional barriers, especially the persistence of punitive approaches to error, insufficient professional training, communication failures, and underreporting of adverse events, limit the consolidation of a safety culture.On the other hand, the literature highlights important strategies to strengthen patient safety, including the implementation of the National Patient Safety Program, adoption of standardized protocols, investment in continuing education, use of health information technologies, and improvement of governance and management practices. It is concluded that advancing patient safety in the  Unified Health System requires integrated actions that combine structural investment, organizational strengthening, and cultural transformation. Promoting a non-punitive safety culture, enhancing professional training, and aligning public policies with local realities are essential to ensure safer, more effective, and equitable healthcare.