Patient safety is a critical dimension of Universal Health Coverage (UHC). In recognition of this, Nations across the world are now expected to commemorate the World Patient Safety Day every 17th day of September. Unfortunately, it still remains a challenge to all health systems, as outlined in the World Health Assembly’s resolution 55.18 of 2002.
Patient safety is the reduction of risk of unnecessary harm to a patient, during health care delivery. Harm to patients in healthcare delivery usually results from either a failure to carry out a planned action as intended, or application of an incorrect plan, all of which could have adverse effects on the patient.
Adverse effects include: wrong site surgery as was the case in one of our leading hospitals in Kenya recently, delayed diagnosis or diagnostic errors, medication errors, and even hospital acquired infections, among others.
According to the World Health Organization (WHO), the most common adverse safety incidents are related to surgical procedures (27%), medication errors (18.3%) and health care-associated infections (12.2%). There is actually a one in a 3 million chance of dying while flying in an airplane as compared to a one in 3 hundred chance of a patient being harmed in a hospital.
134 million adverse events and 2.6 million deaths occur annually due to unsafe health care practices or undue medical equipment use in in low and middle-income countries (LMICs). Worse still, more than half of LMICs have no national health technology policies to guide the use of medical devices and equipment for patient safety.
Globally, the annual cost of medical associated errors is 42 billion US Dollars. This represents almost 1% of the global expenditure on health, and 15% of hospital expenses annually. Though equally significant as well, the psychological cost to the patients and their families is difficult to measure.
The good news is, it has been observed that reducing the occurrence of adverse events and harm to patients, can reduce waste, release resources, and thus, help make the case for more efficient and effective health systems. This therefore, makes the economic benefits of improving patient safety very compelling.
In LMICs, a combination of various unfavorable factors often contributes to unsafe patient care. These include: weak safety and quality cultures, understaffing and hence fatigue, poor working conditions, lack of basic health care commodities, and poor hygiene and sanitation, among others.
For LMICs therefore, achievement of safe patient care must begin with eliminating all the unfavorable factors. The first step is providing good leadership. This will not only set the right environment for development of and adherence to effective patient safety guidelines, but also ensure adequate resource mobilization to support patient safety.
Industry-wide collaborations also need to be fostered. That way, there can be effective knowledge transfer and capacity building, geared towards patient safety. This could as well be boosted by interoperable Electronic Health Record (EHR) systems.
EHR systems hold great potential to both capture and share occurrences of harm, thus ensuring healthy flow of clinical information among providers. This would then enable learning from and correction of safety lapses in healthcare delivery.
In addition, patients also need to be empowered in order to further boost the efforts on patient safety. One of the ways this can be done is by first adopting and strengthening nationally consistent safety standards, linked to the accreditation of health care providers.
Thereafter, implement a fair and transparent Letter Grade Scoring System based on the accreditation. This would allow consumers to quickly assess the safety of their local hospitals, and choose the safest hospital to seek care. In turn, healthcare providers would then have the much-needed ‘motivation’ to always maintain and improve quality and safety of care provision. Third, patients must also be encouraged and provided with easy ways of reporting safety lapses, including near misses.
All the above, coupled with well trained and motivated Human Resource teams, should in the least begin to do the trick. In the United States, focused safety improvements reduced the burden of patient harm by up to 15% hence, 28 billion US Dollars in savings. This was in Medicare hospitals between 2010 and 2015; a very good return on investment!
In conclusion, if you are reading this, remember patient safety starts with you. Always ask questions if you have any doubts or concerns. Kindly note that it is both understandable and wise to get a second opinion on treatment options before you undertake any.