quality and performance targets are defined in the hospital contract nearly of the total hospital budget is allocated to hospital according to their performance levels these indicators relate to access clinical performance and economic performance patient safety is one of the seven strategic priorities of the national strategy for quality in health in portugal which defines the development of following specific actions elaboration of guidelines in the field of patient safety namely in surgical and medication safety the creation of the national system of notification of incidents and adverse events and the coordination of the prevention and control of health care associated infections