A Patient Safety Day Special!

September 17 is World Patient Safety Day. We were fortunate to get a chance to speak to DR AMIT DIAS, MD, from the Department of Preventive & Social Medicine at the Goa Medical College, to enlighten us on the need to consider patient safety. “Ensuring patient safety I of utmost importance for any health care provider and getting the patient involved in developing better and safer services is an effective strategy,” he explains, detailing how patients and doctors can unite to care and ensure that no one is harmed while being healed….

GOAN OBSERVER: Doctor, what is the focus of Patient Safety Day this year?
DR AMIT DIAS: We need to acknowledge the fact that while receiving health care, patients could be subjected to risks. This year’s theme, for World Patient Safety Day — “Engaging Patients for Patient Safety” — underscores the critical role that patients play in their healthcare. It highlights the importance of involving patients in decisions about their treatment, medication, and overall well-being. Good patient engagement can reduce the harm by up to 15%.

Q: It seems ironic! How can health care cause harm to a patient?
A: It is not intentional, but it can happen. We need to acknowledge it and take measures to prevent it. In an attempt to provide preventive, curative and rehabilitative services to a patient, there is a risk of inadvertently harming a patient. The WHO suggests that engaging patients in the process not only empowers them but also contributes significantly to preventing medical errors and improving the overall safety of the healthcare processes. “First, do no harm” has always been the principle of health care.

Q: How serious is this threat? Is there an estimate on the amount of harm caused to people while availing health care?
A: Collectively the WHO estimates that one in every 10 patients experiences an adverse event while receiving health care and around three million deaths occur annually due to unsafe care.
Unsafe injections can also cause diseases such as Hepatitis B, Hepatitis C and HIV. The unsafe injections can lead to a silent epidemic that could be detected several years after being administered the unsafe injection. It can also cause abscesses, septicemia and nerve damage. The prescriber, provider and patient should be aware and ensure that proper disposable syringes are used for treatment. The WHO defines a safe injection as one that does not harm the recipient, does not expose the provider to any avoidable risks, and does not result in waste that is dangerous for the community. The exclusive use of safety-engineered syringes called auto-disable (AD) is advised to prevent harm. Unnecessary injections should be avoided and the sharps should be properly disposed of. There are an estimated 16 billion injections administered every year.
Similarly every year there are 117 million blood donations. Infections can spread through blood and the sample is tested for common infections such as Hepatitis B, C, Syphilis, HIV and Malaria. However, it may contain other microorganisms and the judicious use of blood is necessary to ensure blood safety.

Q: That is indeed worth considering. Are there any other threats to patient’s safety?
A: Yes, there can be a lot more threats to patients while receiving health care. Common adverse events that may result in avoidable harm are medication errors, unsafe surgical procedures, and leaving a swab inside the operated patient for example, which can cause life-threatening infection. There are 300 million surgical procedures done every year, surgical errors continue to occur despite all the precautions. It is estimated that 10% of all preventable patient harm in health care is from a surgical setting. Maternal infections and deaths during pregnancy could also be prevented if we take care and precautions — both from the patient’s side as well as from the doctor’s side.
Healthcare-associated infections, diagnostic errors, patient misidentification and venous thromboembolism are some other threats.

Q: What about the improper disposal of bio-medical waste? Can it harm people and patients?
A: Yes, it can most certainly harm them. Moreover, it can also harm health care providers and those handling bio-medical waste, if precautions are not taken. It is, for this reason, that we strictly follow the 2016 regulations for the safe disposal of Bio-Medical Waste Guidelines for segregation of waste, transport and safe disposal. All healthcare institutions must be registered and follow the guidelines.

Q: How can patients collaborate with healthcare providers to contribute to patient safety?
A: It is a joint partnership between the patient and the healthcare provider.
Here are some suggestions:

1. Communicate: Patients should feel comfortable asking questions, seeking clarification about their treatment, and providing their healthcare team with accurate information about their medical history.
2. Engage the Patient: Patients should actively participate in shared decision-making regarding their care and be informed partners in their treatment plans.
   3.Medication Management: Patients should understand their medications, including their purpose, dosage and potential side effects. This can help prevent medication errors.
3. Infection Control: Both patients and healthcare providers should practice good hygiene, hand washing, follow infection control protocols to reduce the risk of healthcare-associated infections.
4. Safety Culture: Fostering a culture of safety within healthcare organizations, where staff feel comfortable reporting errors without fear of retribution.
   6.Promote Best Practices: Encourage the implementation of evidence-based best practices in healthcare settings to ensure the safety of patients. Disposal of biomedical waste, prevention of hospital-acquired infections and the spread of resistant bugs.
5. Review Protocols: Review and update healthcare protocols and guidelines to align with the latest recommendations and best practices. Continuous training of health care staff on protocols to be observed.
6. Technology: The adoption of electronic health records and other technologies can help streamline and improve patient safety processes.
   9.Reporting Errors: Encourage patients and healthcare providers to report any incidents, near misses, or errors in a non-punitive manner to facilitate learning and improvement.
7. Health Literacy: Efforts should be made to improve patient health literacy, ensuring that patients understand their medical conditions and treatment options.

Q: This was very informative and we appreciate all that the health care workers do to ensure patient safety. What is your final message to our readers on safety?
A: Patient safety is a joint partnership. Together we need to unite to care, to achieve the best outcome. In Goa, we are fortunate to have a good network of safe health care services which are reflected in excellent outcomes. However, there is always a scope for improvement and we should leave no stone unturned to ensure patient safety.