The Paciente Seguro project, a nationwide patient-safety initiative led by Hospital Moinhos de Vento and Brazil’s Ministry of Health, offers a natural experiment on how large health-care education programmes pivoted during the pandemic. In 2018 and 2019 the project relied primarily on face-to-face strategies: twenty-two internal training events and fifteen on-site Improvement Science workshops reached 5 731 participants; regional workshops engaged a further 126 professionals; and eleven distance-learning modules were planned while six reference documents were validated. In 2019, expansion to forty-five new hospitals intensified in-person learning: an international symposium (356 attendees), a two-day Learning Workshop (219), and forty-four Life QI training sessions complemented regional TeamSTEPPS® workshops. Overall, 1 066 professionals were formally prepared as multipliers and 18 765 individuals participated in 164 hospital-based educational actions, embedding leadership and teamwork concepts across 58 institutions.

The abrupt onset of COVID-19 in 2020 demanded an immediate shift to emergency remote teaching. All scheduled presential activities were converted to virtual formats within eight weeks. Eleven fully-online courses (25 h total) were launched, attracting 23 244 enrolments from every Brazilian state. Digital engagement tools multiplied: three physical board-games (Trilogia da Segurança) were shipped to hospitals alongside three new on-line games that logged more than 3 260 plays in their first year, while 70 micro-learning videos and a repository of infographics, check-lists and audio resources were made freely available through the Caminhos da Segurança website, whose traffic rose from 15 021 visits in 2019 to 26 196 in 2020. Virtual delivery scaled mentorship: 1 191 individual coaching calls and eleven all-hospital webinars supported 873 local safety campaigns that reached 212 152 participants. A virtual regional workshop replaced three planned onsite meetings, training 202 leaders; within three months 89 % of participating hospitals had tested at least one TeamSTEPPS® tool in clinical practice.

Comparative analysis shows that, although total synchronous contact hours fell, asynchronous digital resources and remote coaching more than tripled overall reach, preserved project momentum, and enabled rapid dissemination of leadership and management skills critical for crisis response. Lessons learned highlight the importance of agile instructional design, multisensory learning objects, and continuous virtual accompaniment to sustain quality-improvement capacity when conventional classrooms close.

Keywords: Leadership, Management, Public Health.