Patient safety and quality care | Political Economy

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Atient safety is an umbrella term that encompasses a number of processes. It aims at the absence of preventable harm to a patient during the healthcare process and involves reducing the risk of unnecessary harm to an acceptable level. It includes a framework of organized activities designed to permanently and sustainably reduce risk in health care cultures, procedures, practices, technologies and environments. reduce the occurrence of avoidable harm; reduce the likelihood of errors; and reduce its effects when damaged. Despite advances in treatment; technologies; And care models that have therapeutic potential introduce new risks to safe care, making patient safety a dynamic and critical aspect of healthcare systems globally.

The World Health Organization’s Global Patient Safety Report 2024 provides the first comprehensive insight into the state of patient safety worldwide. It states that while progress has been made in implementing policies, programs and strategic interventions since the adoption of the Global Patient Safety Action Plan 2021-2030, progress against several key indicators has been limited. The report emphasizes the importance of establishing systems to support safe practices, technologies and environments to prevent avoidable harm and reduce risk to patients.

Looking at the different health care systems globally, we see that the implementation process requires a systematic approach. In the United States, the Joint Commission is a notable organization committed to improving health care safety by incorporating patient safety standards into various domains, such as medication use, infection control, surgery, emergency management and Other These efforts are part of a broader strategy to create safe healthcare environments and cultures that reduce the risk and incidence of patient harm. One of the core initiatives of The Joint Commission’s Patient Safety Strategy is the National Patient Safety Goals. For 2024, these goals include specific actions such as implementing suicide prevention resources to improve mental health care. In addition, information management standards, aimed at eliminating dangerous acronyms, abbreviations, symbols and dosage designations to prevent medication errors. In collaboration with health care providers, The Joint Commission continuously analyzes emerging patient safety issues and develops evidence-based approaches to address them. This iterative approach allows the organization to integrate lessons learned from the field into operational strategies, which enhance patient safety in a variety of healthcare settings.

The Institute of Medicine in the USA has proposed the following six key goals for health care systems to ensure quality care: effectiveness, efficiency, safety, timeliness, equity and patient-centeredness. These goals are ensuring safety, including the prevention of medical errors and adverse effects associated with health care. Efficiency, which focuses on avoiding both underutilization and misuse of health care services. A patient-centered approach emphasizes the importance of involving patients in their care and tailoring services to meet their specific needs. It is important to reduce waiting and sometimes harmful delays for both recipients and caregivers. It also aims to improve the flow of patients through the health care system and minimize the time patients wait for diagnosis, treatment and other services. Efficiency involves avoiding waste and maximizing resources without compromising quality of care and ensuring equitable care.

Patient education initiatives that inform patients of their rights and the importance of speaking up are essential to patient empowerment.

In the United Kingdom, the National Health Service Patient Safety Strategy highlights the importance of building a safe culture and system, empowering both patients and staff with the necessary skills and confidence to improve safety. , which can significantly reduce the incidence of avoidable harm and associated injuries. Spending The NHS Patient Safety Strategy aims to continuously improve patient safety by building on the foundations of a safe culture and safe system. It outlines how the NHS will support staff and providers to share safety insights and empower both patients and staff with skills, confidence and procedures to increase safety. Additionally, it is developing a strategy to address current challenges and priorities, focusing on areas of greatest need. It is structured around three strategic objectives: insight, inclusion and improvement, all underpinned by a patient safety culture and patient safety system. The National Patient Safety Team supports the NHS in achieving these objectives through a range of programs and initiatives linked to these core principles. On 26 September, NHS-England published its Primary Care Patient Safety Strategy. This document highlights national and local commitments to improving patient safety in primary care, informed by research, including from the National Institute for Health and Care Research, a key part of the Greater Manchester Patient Safety Research Collaboration. 2020 study, which aims to improve patient safety. This research examined the incidence, nature and causes of avoidable major harm in primary care in England, providing key insights and recommendations to reduce risk and prevent patient safety incidents. The five key points of the strategy are: enhancing drug safety; Integrating digital systems that alert healthcare providers of potential risks or adverse events. Proactively approach risk management to inform support staff and address safety concerns; actively involving patients and the public in safeguarding initiatives to ensure that care reflects their needs and preferences; and focusing on reducing disparities in access and safety outcomes among different population groups, including implementing community-based models of care.

Considering these reports, how can we contribute to upgrading our healthcare system locally? First and foremost, medication errors are preventable events that can harm a patient or lead to the inappropriate use of a medication. They can relate to many things, including: prescribing, communication between health care personnel, product labeling, packaging, especially in settings where drugs are brand-name, dispensing, distribution, administration, education. , are recommended through monitoring and usage. These failures are often caused by poor medicine systems and human factors such as fatigue, poor environmental conditions, or staff shortages, which lead to severe harm, disability, and death. The global cost associated with these errors has been estimated at $42 billion annually. A number of interventions are needed to reduce the frequency and impact of medication errors. Second, effective protocols include comprehensive medication reconciliation, use of electronic prescribing systems and regular staff training on safe medication practices. Finally, creating a safety culture that encourages reporting and analyzing errors without punitive measures is critical to continuous improvement.

Ensuring that patients feel empowered to discuss their concerns about safety and quality of care is critical to enhancing patient safety outcomes. An effective strategy is to foster an environment where speaking up is encouraged and normalized. Health care professionals such as nurses and physicians can lead by example by regularly advocating for patient safety and encouraging colleagues to do the same. Creating a supportive environment where concerns are heard, and acted upon, can help reduce the reluctance that patients and healthcare workers often feel. Healthcare organizations can implement digital technologies and training programs that focus on communication skills and the importance of expressing concerns for new and experienced healthcare professionals. . Additionally, patient education initiatives that inform patients of their rights and the importance of speaking up are essential for patient empowerment. Healthcare facilities can also use patient feedback mechanisms, such as surveys and suggestion boxes, to continuously collect and address patient concerns. Integrating evidence-based practices addresses challenges, supports innovation, and improves the quality of patient care for a better health care system, focused on harm prevention.

Dr. Subia Javed is a family physician at Evercare Hospital, Lahore.

Dr. Hina Javed is Associate Professor of Family Medicine at Health Services Academy, Islamabad.