Due to the nature of their activity, anesthesia and critical care have generally well-developed patient safety cultures, which are linked to a greater level of incident awareness and reporting during clinical activity. In order to determine the status quo and identify and adopt, where appropriate, techniques and instruments for further improving patient safety, it is necessary to evaluate the culture and barriers in these departments. The main objective of our study was to assess patient safety culture in Romanian anesthesia and intensive care departments (AICDs), to pinpoint the areas that may need improvement, and to examine the correlation between the prevalence of adverse event reporting, as well as the level of self-reported patient safety culture. To determine how anesthesia and intensive care department staff perceived patient safety, the Hospital Survey on Patient Safety Culture (HSOPSC) was used in a translated Romanian version. In total, 1200 employees from 36 anesthesiology and intensive care departments across 32 hospitals in Romania received the questionnaire, representing 42.66% of all anesthesia and intensive care departments in the country. In 7 of the 12 examined dimensions, significant differences between tertiary and secondary hospitals were observed. Among all dimensions, the highest positive score was for “organizational learning and continuous development”. In general, our study revealed a positive view on patient safety in anesthesia and intensive care departments. Further studies are required to determine a threshold of the level of culture development.

(1) Background: Patient blood management (PBM) program as a multidisciplinary practice and a standard of care for the anemic surgical patient has an increasingly important role in reducing transfusions and optimizing both clinical outcomes and costs. Documented success of PBM implementation is not sufficient for implementation of recommendations and correct use at hospital level. The primary objective of our study was to define a composite patient blood management process safety index—Safety Index in PBM (SIPBM)—that measures the impact of screening and treating anemic patients on the efficiency and effectiveness of the patient care process undergoing elective surgery. (2) Methods: We conducted a retrospective comparative study in a tertiary hospital by collecting data and analyzing the Safety Index in PBM (SIPBM) in patients undergoing major elective surgical procedures. (3) Results: The percentage of patients from the total of 354 patients (178 in 2019 and 176 in 2022) included in the study who benefited from preoperative iron treatment increased in 2022 compared to 2019 from 27.40% to 36.71%. The median value of the SIPBM was 1.00 in both periods analyzed, although there is a significant difference between the two periods (p < 0.005), in favor of 2022. (4) Conclusions: Measuring the effectiveness of PBM implementation and providing ongoing feedback through the Safety Index in PBM (SIPBM) increases the degree to which opportunities to improve the PBM process are identified. The study represents a first step for future actions and baselines to develop tools to measure the safety and impact of the patient blood management process in the surgical field.

Background/Objectives: Private dental markets operating under fee-for-service arrangements lack the structural accountability mechanisms that typically drive quality governance adoption in publicly funded systems. In Romania, where no private dental office currently holds formal accreditation, accreditation-seeking reflects a genuine behavioral choice rather than a regulatory compliance. This study examined whether financing structure and Professional Governance behavior operate as distinct determinants of accreditation-seeking intention among private dental practitioners and which pathway offers a more tractable entry point for quality policy intervention. Methods: A cross-sectional survey was conducted among 98 licensed private dental practitioners in Romania (November 2025–January 2026). Three domain composites were derived from a 31-item de novo instrument anchored in JCI, ANMCS, and EN ISO 9001:2015 standards: Professional Governance, Patient Rights and Ethics, and Patient Safety Behaviors. The financing profile was operationalized as engagement with the national public insurance system (CNAS). Binary logistic regression modeled high accreditation-seeking intention (Q31 ≥ 4) against standardized domain scores and financing engagement, with bootstrap confidence intervals from 2000 replicates. Results: Two predictors independently and significantly predicted high accreditation-seeking intention. CNAS engagement showed the strongest association (OR = 5.05, 95% bootstrap CI [1.87–17.91], and p = 0.003), while the Professional Governance score remained independently associated (OR = 2.68, 95% bootstrap CI [1.63–5.63], and p = 0.003). The Patient Rights and Ethics score was not significant. Practitioners actively exploring CNAS contracting showed the highest accreditation-seeking intention (exceeding that of established contractors), suggesting a possible transitional accountability dynamic during financing transition, though this interpretation requires prospective longitudinal validation. Model performance was good (AUC = 0.788; Nagelkerke R² = 0.339). Conclusions: Both financing engagement and governance behavior predicted accreditation-seeking intention after mutual adjustment, representing distinct pathways to voluntary quality adoption in private dental practice. Policy interventions aligned with entry into public contracting and with practice-level governance development are more likely to support accreditation uptake than normative appeals to professional ethics alone.

Background/Objectives: Healthcare systems increasingly rely on standardized diagnostic information to support clinical decision-making, reimbursement, and public health governance. Although accreditation of medical laboratories underpins trust in diagnostic services, in practice, it is encountered primarily through the way in which accredited status is communicated in routine healthcare documentation. This study examines national rules that govern the communication of accreditation-related information and their relevance for healthcare management and policy. Methods: A descriptive, document-based comparative analysis was conducted across all 42 national accreditation bodies participating in the European Co-operation for Accreditation Multilateral Agreement (EA-MLA). Official regulations and policies governing the use of accreditation symbols and references in medical laboratory documentation were analyzed. Only documents confirmed as valid and in force as of January 2026 were included. The analysis focused on report-level identification, differentiation of accredited and non-accredited results, use beyond reports, and consequences of misuse. Results: Across countries, accreditation communication rules define how laboratory results are recognized, reimbursed, and operationally used within healthcare systems. While regulatory detail varies, common requirements exist regarding clear identification of accredited results and safeguards against misinterpretation, which directly influence administrative processes and financing mechanisms. For example, in some healthcare systems, accredited reporting determines eligibility for public reimbursement, while in others, it constitutes a legal prerequisite for providing laboratory services. Conclusions: Accreditation-related communication functions as an element of healthcare information governance rather than a purely technical marker. National variations reflect healthcare policy and management priorities, with implications for efficiency, transparency, and access to care.

In proficiency testing (PT), a consensus assigned value is an estimate whose uncertainty can affect participants’ performance classifications. This study evaluated the relationship between formula-based assigned-value uncertainty, empirical sampling variability and classification discordance under limited participation. Using gravimetric calibration of a 100 µL micropipette, 147.2 million Monte Carlo PT rounds were simulated across 1472 scenarios combining participant numbers (N = 5–50), two dispersion levels referenced to ISO 8655-2:2022 and outlier contamination (0–30%). The arithmetic mean and ISO 13528 Algorithm A were compared regarding assigned-value variability, uncertainty calibration, stability and classification. The 95th percentile of the assigned-value uncertainty ratio frequently exceeded the ISO 13528 threshold of 0.3, particularly under contamination and limited participation. This ratio was strongly associated with scenario-level decisional discordance (Spearman ρ = 0.97–0.99). Formula-based uncertainty exceeded empirical Monte Carlo variability for Algorithm A in all 1472 scenarios (calibration ratios of 1.044–1.301), whereas the arithmetic mean’s ratios ranged from 0.856 to 0.998. Although Algorithm A generally improved empirical stability under contamination, this advantage did not consistently translate into lower participant-number requirements under the combined acceptance criterion. These findings demonstrate that estimator robustness and uncertainty-formula calibration are distinct properties requiring separate evaluation when designing PT schemes with limited participation.