Introduction: hospital accreditation requires hospitals to reach organizational levels of excellence. To achieve accreditation, it is necessary to promote improvements in the quality of care, thus, educational activities stand out. The development of Permanent Education is still a challenge for health care institutions when carrying out actions with the aim of training, updating and developing human resources to promote safe, quality, humanized, harm-free care and focused on patient safety. Goal: to understand the challenges faced by Permanent Education to achieve quality improvement and patient safety in an accredited public hospital in the state of Pará. Methodology: this is a single integrated case study, carried out at the Holy House of Mercy of Pará Foundation Hospital, with a descriptive, cross-sectional and qualitative approach. The Case Study methodology proposed by Robert K. Yin was used. Data collection took place through semi-structured interviews with 22 professionals. The interviews were audio-recorded on a Smartphone, with an average of 22 minutes and 40 seconds, later they were completely transcribed, analyzed and interpreted through Bardin's thematic content analysis, in the light of Paulo Freire’s ideas. The IRAMUTEQ software (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires) was used to analyze the textual corpus and the BioEstat 5.3 software was applied to analyze the participants’ profile. Data collection took place in June 2022. Results: most participants were women (90.9%), with a mean age of 43.7 years; average time of professional experience of 18.1 years; working time at the institution was 11.4 years; 81.8% were nurses; and 77.3% had a lato sensu graduate degree. It was generated three analyzes by IRAMUTEQ: word cloud, similarity analysis and Descending Hierarchical Classification (CHD). It was obtained five classes, which originated three categories: Challenges faced by Permanent Education to guarantee the process of continuous improvement; Permanent Education for the promotion of quality and patient safety in the context of hospital accreditation; and Educational strategies for improving quality and patient safety. Conclusion: there are challenges inherent to Permanent Education in Health (PEH) actions, such as resistance to change, adherence to activities, high turnover of professionals and difficulty in releasing workers to participate in activities. In addition, PEH proved to be fundamental in promoting a culture of quality and safety, thus contributing to hospital accreditation. The results also pointed out to strategies for carrying out PEH activities such as the use of realistic simulation, carrying out educational activities in loco, in all work shifts and promoting remote educational activities (online).
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