Published research

Latest Articles

Recent published articles from Journal of Healthcare Quality and Safety.

Original Article

Lessons from Beijing for Lahore: Toward an Evidence-Based National Clean Air Policy for Pakistan

Background: Pakistan was ranked the most polluted country in IQAir’s 2025 report, with a national annual mean PM2.5 of 67.3μg/m³, roughly 13 times the WHO guideline, and nine of the world’s 25 most polluted cities. The country adopted its first National Clean Air Policy in 2023, yet Lahore still sits near 90μg/m³. Beijing brought its annual mean from close to 90 down to 30.5μg/m³ between 2013 and 2024. Objective: To identify which parts of Beijing’s clean air governance can reasonably be carried over to Lahore, and to locate the gaps in Pakistan’s current framework. Methods: Qualitative, desk-based comparative policy analysis of peer-reviewed studies, official documents, multilateral project records and monitoring reports available to October 2026, organized around eight governance domains. Findings: Beijing’s improvement rested on a time-bound national plan with binding targets, simultaneous control of coal, industry, vehicles and dust, official accountability, and openly reported monitoring. Pakistan’s framework is advisory rather than statutory, proposes an annual PM2.5 target of 35μg/m³ against an existing standard of 15, had minimal regulatory monitoring outside Punjab in late 2023, lacks an agreed public account of Lahore’s pollution sources, has no airshed-level authority, and gives the health sector no defined role. The methods behind Lahore’s competing source estimates cannot be ranked with confidence, and eye-disease odds ratios from lower-exposure settings cannot be transferred to Lahore. Conclusions: Eight reforms are proposed, starting with a statutory basis for ambient standards and an independent source apportionment for Lahore. The reforms take their design logic from Beijing; they do not copy China’s institutional model. Personal accountability of named officials is placed at provincial level, where legal authority sits.

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Opinion Article

The Fragility of Critical Medication Alerts in Electronic Prescriptions: The Need for Governance and Organizational Culture

This opinion article discusses the limits and fragility of automated prescription alerts for critical medications when implemented in healthcare systems without proper clinical governance and cultural alignment of the teams. Although Clinical Decision Support Systems (CDSS) are designated as essential barriers to error prevention, excessive and miscalibrated signaling triggers the phenomenon of alert fatigue, leading professionals to compulsively dismiss warnings and become desensitized to risk. Additionally, it examines how the high cost of acquiring and maintaining these technologies, when isolated from improvements in care processes, pressures public and private budgets without generating effective safety gains. It is concluded that technology is not self-sufficient and that the effectiveness of alerts depends on the consolidation of the triad between people, processes, and technology, supported by standardized clinical protocols and ongoing continuing education programs.

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