The work done to date for designing and unrolling the Patient Safety Reporting and Learning System could be summarized overall into the following stages:

• Review of the literature for the evaluation of the impact of the existing systems in terms of their characteristics and the recommendations of the experts regarding the design and implementation of reporting systems.
• Contacts and visits to entities which had adverse event reporting and record-keeping systems in operation, more specifically a thorough review of some reporting systems of a nationwide scope implemented at the international level in order to know how they work and the lessons learned during their design, development and implementation (the systems mainly in Denmark, England and Wales were visited).
• The conducting of a study/survey of 18 representatives of Autonomous Communities and another 12 experts in patient safety so as to know their opinions, expectations and positioning and they being able to contribute to defining the characteristics of a possible future reporting systems for the National Health System.
• Definition of the basic principles of the Patient Safety Reporting and Learning System.
• Survey of professionals through the Scientific Societies in order to assess the feasibility of this project of developing a reporting system of the characteristics proposed (based on the previous stages) and, above all, to identify the possible barriers and the facilitating elements in the opinion of the healthcare professionals. A total of 59 representatives from 53 societies completed the questionnaire.
• Design and development of the data collection questionnaire and of the Reporting System computer application based on the information gathered throughout the prior stages. It was aimed for it to be compatible (insofar as possible) with the different reporting systems already in place in our country, that it be simple, fast to complete and that it be in line with the initiatives of the World Health Organization and other initiatives at the international level.
• Pilot experiment at two hospitals in different Autonomous Communities and assessment of the system following the pilot experiment: evaluation of the reports gathered, the opinion of the professionals (by way of a questionnaire) and the system managers (by means of an interview).