Patient Safety Paramount: A new approach can take patient safety to the next level-Dr. Mradul Kaushik, Director, Operations & Planning, BLK Super Speciality Hospital
The Indian Healthcare is at the cusp of transformation. While it is competing with the best in the world to provide quality medicare, it also has to address the realities that are unique to India.
Nothing is more fundamental to healthcare than the safety of patients. It is a matter that deserves no compromise and therefore it must remain uppermost on the minds of hospital management as well as doctors across the country. The patient safety day is an occasion to reinforce this.
Patient safety is defined as freedom for a patient from unnecessary harm or potential harm associated with the provision of healthcare. Ensuring the safety of patients is a high visibility issue for health institutions. Services that are unsafe and of low quality lead to compromised health outcomes and may even be harmful. As far as harm is concerned, our ancient ancestors accorded the highest priority to patient safety. That is why, while becoming a doctor, we take the Oath and one of the promises within that oath is “first, do no harm” (or “primum non nocere,” the Latin translation from the original Greek.)
“I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”
So right from the ancient period to present day, patient safety should be a prime concern for every healthcare institution. Patient safety includes safety at each step in the hospital including but not limited to Patient Identification, Surgical Safety, medication and blood safety, medical device safety, safe organ tissue transplantation and donation. It is also about bio-medical waste management, prevention of healthcare associated infections and much more.
Healthcare systems aim at providing Safer, Better, Faster and Affordable services to the patients. These objectives would not be achieved if health institutions fail to deliver safe care due to unsafe clinical practices, systems, tools and processes.
Safety of medication needs adequate attention. This would be possible by developing safer drugs. Advancement in pharmacology has also added new dimensions to the patient safety. The use of pharmacokinetic and pharmacodynamic data in the assessment of drug safety in early drug development has transformed the way we look at drug therapy. According to British Journal of Clinical Pharmacology, in order to reduce the cost of overall drug development it is essential that resources be focused on those compounds most likely to succeed. The utility of pharmacokinetic predictions (or at least estimations) in the drug discovery phase has resulted in fewer compounds failing as a result of inappropriate clinical pharmacokinetics. This application of pharmacokinetic prediction is now being extended to the pharmacodynamics of novel compounds in order to gain better understanding of their efficacy and safety profiles.
With availability of safe and affordable drugs, we also need to prioritize safe administration of drugs. For this all health institutions should maintain right documentation, research and highly trained healthcare personnel.
Health institutions need to follow standardized measures for procedural safety by putting and adhering to checklists like aviation industry. Such measures, certainly enhances procedural safety. Further, hospital acquired infections and healthcare infused infections are major safety concerns. Every healthcare organization should have protocols and policies need in place for prevention from these infections. Hand washing, use of sterilized devices play a critical role here. Identifying vulnerable patients for precaution is yet another challenge which needs to be addressed with proper care and attention.
Technology is making healthcare safer, better, faster and affordable and has come as a big support in achieving the goals of healthcare. From Quantum computing, Internet of Things (IoT) to 3D imaging, a transformation is taking place rapidly which would lead us to a higher stage of advancement in patient safety.
For example, advancements in diagnostic imaging – digital detectors and softwares – has completely replaced investigative surgery and reduced radiation dose for various procedures by up to 75 percent. Earlier clinicians used to do surgery, just to have a look at the insides of the body, and to ascertain the cause of the problem. In preceding years, such practice has been replaced with new age 3 D Imaging for Cardio tests and advanced imaging for MRIs, Ultrasounds and CT Scans. In contemporary times, with the help of digitization and new age post processing techniques the images taken from the scans look exactly the same as the insides of the body during operation. Apart from accuracy in surgeries, technology also helps in monitoring progression of a condition of the patient post-surgery.
The World Health Organization’s objectives in the area of patient safety are to provide global leadership for patient safety and to harness knowledge, expertise and innovation to improve patient safety in health care settings. Health institutions need to adopt best practices in quality. Appropriate documentations, facility safety, policies and SOPs as per the standards need implementation on ground. Patient safety goals can be achieved by identifying the patient correctly, improving effective communication, improving safety of high alert medication, ensuring safe surgery, reducing the risk of healthcare associated infections and reducing the risk of patient harm resulting from falls.
While the Central government has come up with a draft framework aimed at ensuring patient safety while undergoing any medical intervention, much would depend upon initiatives and innovations being introduced by health institutions in the country. Healthcare institutions should aim to create patient centric set ups where quality and technology should play a critical role for effective patient safety.