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17th ZEVA Symposium

Skopje, Macedonia, 2. October 2010

hosted by the Medical Chamber of Macedonia



The annual ZEVA Symposium provides a platform for exchange between physicians’ chambers from Central and Eastern European countries. During the symposium, representatives from EU and non-EU member states discuss common challenges and share experiences in order to find ways to improve the working environment of physicians and the quality of healthcare in the interest of all patients. The central focus of the 17th ZEVA Symposium, which was held in Skopje, Macedonia, was patient safety and quality in healthcare. After a fruitful discussion, the participating countries agreed on the:



Skopje Declaration on Patient Safety and Quality in Healthcare

Safety is the core element of quality in healthcare.

Physicians have an ethical and professional obligation to always strive for continuous quality improvement in healthcare and must ensure patient safety during all medical decision making.

Physician self-regulation is based on the trust invested in the medical profession. Physicians’ chambers assume this responsibility and guarantee high standards of medical practice and the ethical provision of medical services by physicians. Patient safety and quality in healthcare are core elements that drive the chambers’ decisions on policy, ethics, education and training.

By being competent advocates for patient safety, physicians prove their credibility in the political arena and to the public. Governments should recognize the crucial role of physicians and physicians’ chambers in all matters relating to patient safety.

Patient safety incidents are often reported as errors by individual physicians. However, research has shown that nearly all incidents are actually a result of system failure and rarely errors by individuals.


Physicians should take a leading role in patient safety and be included in analyzing complex health information processes that lead to errors or create the potential for errors.

A Critical Incident Reporting System could be a valuable and effective physician-driven instrument. A blame free reporting culture is a precondition for this.

Most countries face similar challenges in improving patient safety. These primarily concern the provision of appropriate education and training, ensuring a safe working environment, building and maintaining a suitable infrastructure, as well as guaranteeing sufficient financial and human resources.

Patient safety and quality of care should take particularly high priority when considering task shifting in the delivery of health services. The role of physicians as the health professionals with overall responsibility for diagnosis and treatment is crucial in this respect.

Physicians’ chambers should promote policies on patient safety to all physicians in their country and support the development of appropriate post-graduate medical education.

Physicians’ chambers in the ZEVA region should continue to share experiences in the field of patient safety and foster more intense collaboration.

The physicians’ chambers in the ZEVA region fully endorse the World Medical Association’s “Declaration on Guidelines for Continuous Quality Improvement in Healthcare” and the WMA “Declaration on Patient Safety”.


Physicians' self-governance