Dr Subhrojyoti Bhowmick, Clinical Director for Academics, Quality and Research Depts, Peerless Hospitex Hospital and Research Center in a candid chat with Sanjiv Das informs about the urgent need to create awareness about patient safety and how certain adverse events can be avoided
Why is patient safety so important?
Patient safety is a discipline that emphasises safety in healthcare through the prevention, reduction, reporting, and analysis of medical error that often leads to adverse effects. The frequency and magnitude of avoidable adverse events experienced by patients were not well known until the 1990s when multiple countries reported staggering numbers of patients harmed and killed by medical errors. Recognising that healthcare errors impact one in every 10 patients in the developed world and four in every 10 patients in the developing, the World Health Organization calls patient safety a major healthcare concern.
Issues related to patient safety include diagnostic errors, medication errors, medical device and equipment safety issues, infection prevention and control, blood safety, radiation safety and safe surgery and safe childbirth
WHO celebrates World Patient Safety Day on September 17. What according to you should healthcare providers and doctors do to create more awareness about patient safety?
WHO has declared September 17, 2020, as the World Patient Safety Day since last year to mark a day in everyone’s calendar to remember the fact that medical errors in the form of diagnostic errors, medication errors and adverse patient events do happen while delivering healthcare services to patients worldwide.
I think doctors and healthcare providers need to be trained across the country on patient safety and medical error reporting culture. Unfortunately, until now, discussions about medical errors in hospitals are very limited and healthcare professionals are not encouraged much to report such errors. Regular training and capacity building workshops on patient safety for healthcare providers like doctors, nurses, pharmacists and other paramedical professionals will create more awareness about patient safety.
How can technology play a role in ensuring patient safety within healthcare set ups?
Hospitals and doctors need to develop an ‘environment of safety culture’ to promote patient safety. The initiative of the development of safety culture begins with senior management and leadership commitment. This is the most important step to make ‘patients safe’ in hospitals. The environment of ‘safety culture’ involves reporting, analysing and developing appropriate corrective and preventive strategies. Healthcare workers including doctors should acknowledge the medical errors caused while delivering healthcare and report them in a ‘blame-free environment.’ The incident reporting process should be accessible to all healthcare professionals and proper analysis of the adverse event should be performed by trained patient safety experts. The analysis report along with corrective action and preventive action report must be shared with all healthcare workers of the hospital along with the leadership team to ensure long term improvement of the patient safety culture.
Technology has a big role to play in patient safety. Many hospitals have implemented bar-coded medications to be used by patients to ensure correct individualised therapy. Computerised Physician Order Entry (CPOE) has been promoted as an important component of patient safety, quality improvement, and modernisation of medical practice. CPOE systems can allow providers to electronically enter medication orders as well as laboratory, admission, radiology, referral, and procedure orders. Strictly defined, it is the process by which providers directly enter medical orders into a computer application. Technology however cannot offer a complete solution to all kinds of medical errors like medication administration errors which are many times the error of commission. Adequate training and capacity building in the patient safety initiative will reduce errors in the long run.
What are the challenges faced by healthcare providers?
Major challenges in patient safety are the lack of properly trained patient safety professionals in a country like India. Hence, there is a requirement of a dedicated University courses in Patient safety for Indian healthcare professionals across the country.
Other challenges include inadequacy of the patient safety incident reporting systems in many hospitals and also the publication of patient safety issues by Indian hospitals in peer-reviewed journals or media channels.
How has the COVID-19 pandemic highlighted the issue of patient safety in India?
According to the WHO, the COVID-19 pandemic has unveiled the huge challenges and risks health workers are facing globally including healthcare-associated infections, violence, stigma, psychological and emotional disturbances, illness and even death.
I completely echo the same thoughts. Furthermore, working in stressful environments like the COVID-19 wards with full PPE and among very sick patients makes health workers more prone to errors which can lead to patient harm Hence, hospitals should take the proactive initiative to screen healthcare workers for emotional and social well being as well have double-checked system in place for all high-risk patient safety areas.
What should be the future course of action in this regard?
The future of patient safety in India is quite promising. The Ministry of Health and Family Welfare, Government of India has taken an initiative for patient safety by introducing National Patient Safety Implementation Framework (2018-2025) (NPSIF) which positions patient safety as a fundamental element of healthcare. NPSIF is intended to be adopted by both, public and private, sectors to address the various issues arising while providing quality healthcare services.
I am hopeful that government hospitals as well as the private hospitals would have a patient safety officer, who would be a healthcare professional passionate in patient safety and implement patient safety initiatives. The National Accreditation Board of Hospitals and Healthcare Providers (NABH), the accreditation body for hospitals in India has introduced a new domain of ‘Patient Safety and Quality’ in its mandatory accreditation process which is expected to promote patient safety initiatives in all the NABH accredited hospitals in the country. I am aware that many universities in the nation have introduced ‘patient safety’ training courses for healthcare professionals (I am faculty in few of them), which is expected to increase the number of trained patient safety professionals in our country. I am very confident that the patient safety scenario in India is going to improve in days to come.