Strategies for Improving Patient Safety Amid Budget Constraints

As budgets grow tighter and staffing becomes increasingly strained, improving patient safety is essential to both care quality and financial sustainability. For healthcare organizations navigating budget cuts, shrinking resources, and workforce shortages, the question isn’t whether to invest in safety, but how to do it smarter. The answer lies in strategic, cost-smart care that aligns operational efficiency with safer outcomes, improving quality while protecting the bottom line.

The truth is that unsafe care is expensive.

According to the Organization for Economic Co-operation and Development (OECD), the direct costs of treating patients harmed during care amount to over 15% of hospital expenditures in high-income countries. These adverse events are estimated to cost the U.S. healthcare system $20 billion each year.

So, while safety interventions may require upfront investments, they ultimately pay for themselves through harm reduction, shorter hospital stays, fewer lawsuits, and better patient satisfaction.

Here are six evidence-based, cost-smart strategies that healthcare leaders can implement to improve patient safety without overspending.

1. Start with Targeted Risk Prioritization

Not all patient safety issues carry the same level of risk—or costs, for that matter. The first step to improving patient safety in a cost-smart manner is identifying the most expensive and preventable harms:

• Hospital-acquired infections (HAIs): Approximately 2 million patients suffer from HAIs, costing U.S. hospitals $28-45 billion.
• Medication errors: Medication errors cost around $42 billion globally each year and injure approximately 1.3 million people annually in the United States alone.
• Falls: Around $50 billion is spent on medical costs related to non-fatal fall injuries in the U.S., with another $754 million spent on the costs of fatal falls.

Healthcare organizations should begin by identifying frequently occurring safety events, including “near misses.” These events typically point to deeper systemic issues that are often inexpensive to fix but carry significant risk if left unaddressed.

To tackle these effectively, organizations should analyze internal incident and event data and incorporate staff feedback to pinpoint high-risk processes. Tools like Failure Mode and Effects Analysis (FMEA) and root cause analysis (RCA) can help prioritize which safety interventions will yield the highest impact.

2. Leverage Low-Cost, High-Impact Safety Practices

Some of the most effective interventions in improving patient safety cost little to implement. Consider the following:

• Standardized Communication Protocols like SBAR (Situation-Background-Assessment-Recommendation) reduce communication failures—a leading cause of harmful events—at no material cost beyond training time. In fact, one large hospital system that implemented SBAR communication saw a 50% reduction in adverse events, demonstrating the power of low-cost communication interventions to drive meaningful change.
• Checklists and cognitive aids for high-risk procedures (e.g., central line insertions or surgical prep) reduce variability and ensure critical safety steps aren’t missed. The World Health Organization Surgical Safety Checklist, for instance, has been shown to reduce complication rates by up to 37% and mortality by up to 62%—without significant capital investment. A case in point: Checklists saved one hospital over $55,000 for every 100 admissions.
• Hand hygiene audits and compliance programs, especially when supported by visual cues or peer reminders, can help prevent costly infections and save organizations thousands of dollars in avoidable expenses. According to the Healthcare Infection Society, hand hygiene can generate economic savings that are 16 times greater than the cost of implementation on average.

The key is not the sophistication of the tool, but how consistently and deliberately it’s used. Investing in frontline education, workflow integration, and leadership modeling is where the biggest safety gains happen.

3. Improve Safety Culture Without Adding Headcount

While safe staffing ratios are a critical foundation for patient safety, a strong safety culture in healthcare doesn't always require expanding your workforce. Rather, it often requires engaging existing staff more effectively.

Research shows that employees are far more likely to report safety issues and proactively identify risks when they feel psychologically safe. A 2020 study found that nurses who reported high levels of psychological safety were significantly more likely to share important information about patient safety, actively engage in teamwork behaviors, and report safety events and near misses.

Unfortunately, financial constraints can lead to a culture of silence if staff worry that speaking up will be met with punishment or ignored due to resource limitations.

One low-cost way to maintain engagement is implementing short, focused “safety huddles.” These 10 to 15-minute team-based daily check-ins encourage staff to voice concerns, share observations, and suggest process improvements. They also reinforce accountability and transparency.

Organizations can also embed safety into existing meetings or use anonymous reporting tools to reduce hesitation and make it easier for staff to speak up. Just as importantly, they should also celebrate those who report safety observations.

4. Reduce Redundancy and Waste in Safety Workflows

Safety processes that are inefficient or redundant can drive up administrative costs. A review of patient safety investments by Compass One Healthcare found that many health systems overspend on disconnected safety processes—duplicated audits, manual compliance tracking, or decentralized documentation—without improving outcomes.

For example, the Journal of American Medical Association estimated that administrative complexity accounts for approximately $266 billion of the annual waste in the U.S. healthcare system.

Instead, consider centralizing safety documentation using a unified incident reporting system. Automating routine tasks like workflow routing and follow-up task assignments frees up time for more meaningful quality improvement efforts.

Additionally, embedding safety protocols into clinical workflows—like prompts for high-risk medications or allergy alerts—helps reduce rework and support consistent compliance.

5. Invest in Preventive Infrastructure That Pays Off

While some safety investments require capital, those that prevent downstream harm often ultimately result in measurable cost savings. When finances are tight, leaders should make a clear distinction between expenses and investments.

For example:

• Antimicrobial surfaces and UV disinfection in high-risk units can reduce environmental transmission of HAIs. A “Frontiers in Health Services” study estimated that implementing UV disinfectant equipment to sanitize healthcare employees’ phones—rather than relying solely on hand hygiene protocols—could save hospitals approximately $389 per bed per year by reducing the risk of HAIs.
• Bar-code medication administration (BCMA) systems, though costly upfront, can dramatically reduce medication errors and related litigation costs. One study found that implementing a BCMA system costs around $40,000 per bed over five years. However, by preventing harmful medication errors—each of which can cost upwards of $2,000—the system can yield substantial long-term savings while significantly improving patient safety.
• Pressure injury prevention programs reduce treatment costs associated with advanced-stage ulcers. The Agency for Healthcare Research and Quality (AHRQ) reports that individual patient care costs for pressure ulcers range from $20,900 to $151,700 per ulcer. Implementing prevention strategies, such as moisture-wicking mattresses and regular skin assessments, enables healthcare organizations to avoid these costs while improving patient outcomes.
• Even something as simple as investing in non-slip flooring or improved lighting in inpatient bathrooms can prevent costly falls—one of the most common and expensive inpatient incidents.

6. Engage Patients as Safety Partners

Patient engagement and education are low-cost, high-leverage strategies for improving patient safety. Educated patients are less likely to experience adverse drug events, miss follow-up appointments, or misunderstand care instructions.

In fact, a study conducted by the University of Oregon found that patients with higher engagement levels incurred nearly $2,000 less in annual healthcare costs compared to less engaged patients—a 31% cost reduction.

Simple, cost-effective tools include:

• Medication education cards with dosing visuals
• “Teach-back” protocols during discharge planning
• Patient-centered rounding, where patients can ask questions and flag concerns in real time

Patients who feel empowered to speak up can also act as an extra layer of defense, catching potential mix-ups in medication, procedures, or communication.

Final Thoughts

Improving patient safety during times of fiscal strain may seem counterintuitive, but it’s one of the smartest investments a healthcare organization can make—for both patient outcomes and financial performance.

Unsafe care is costly care. The tools that help reduce preventable harm—be it a checklist, a safety huddle, or a digital reporting system—often deliver returns far beyond their initial cost.

By adopting a cost-smart approach that targets high-risk areas, empowers existing staff, reduces inefficiencies, and actively involves patients, healthcare organizations can make real strides in patient safety without compromising financial stability.