Even though erring is human, no patient should be harmed when visiting a hospital or a clinic to seek medical treatment.
Available global data shows that one in ten patients is harmed in healthcare and more than 3 million deaths occur annually due to unsafe care, with low- and middle-income countries accounting for two-thirds of these adverse events, largely due to a lack of safety culture.
Research by the Health Foundation of the UK shows that a positive safety culture is associated with better health outcomes, and is paramount, especially in today’s complex healthcare environment.
This complexity is manifested in the diversity of tasks involved in the delivery of patient care, inter-dependency of healthcare providers, diversity of patients, clinicians and other staff, the vulnerability of patients, implementation of new diagnostic technologies, and increased specialisation of healthcare professionals among others.
In today’s health delivery environment, patients typically depend on many individuals doing the right thing at the right time.
A robust patient safety culture that promotes collaboration and open communication among healthcare teams is necessary for this to happen in sync.
It starts with the leadership recognising that healthcare is inherently hazardous and ensuring that care processes in their institutions are designed with harm-reduction strategies.
Fortunately, deliberate moves are being made to instill patient safety, guided by global best practices from the World Health Organisation (WHO).
During the recent African Consortium for Quality Improvement in Frontline Healthcare Research (ACQUIRE) Quality Improvement Leadership Conference, held in Nairobi, Kenya delegates unpacked the WHO Global Patient Safety Action Plan (GPSAP) 2021-2030 to develop tangible initiatives towards achieving zero harm during care.
Most African countries were a long way from meeting the minimum patient safety standards.
Let us prioritise patient safety, from the boardroom to the bedside by securing leadership commitment, opening communication channels, thorough safety training, regular safety audits, and recognition of safety-conscious behaviour.
The importance of reporting safety incidents during care was a heated discussion point with delegates emphasizing the need to report events. Reporting near misses and harmful events enables the system to learn and improve.
The participants identified leadership as crucial in creating a non-punitive environment that encourages reporting, allowing for mitigation and prevention of future incidents.
There was also a call for laws to protect healthcare workers, recognizing that while no one intentionally harms patients, processes must be in place to address intentional harm.
To get to this point, healthcare stakeholders will draw from the GPSAP for guidance regarding implementing patient safety by developing policy guidance to support institutional leaders.
They should allow concerns from patients, staff, and leadership to be heard, reducing all barriers to communication regarding patient safety.
Patients are at the center of healthcare. Engaging them during care empowers them to raise concerns when necessary. Each care process should identify opportunities to educate patients and families on danger signs and side effects.
For example, postnatal wards should educate new mothers on newborn care and the identification of danger signs.
Patients' concerns should be closely followed up, ensuring clarity at transition points. Clear communication during clinic appointments, along with opportunities for redress when there is a lack of clarity, helps reduce patient harm events.
Ultimately, creating a culture of safety requires a long-term commitment. One of the model organizations that we can learn from is the International Atomic Energy Agency (IAEA), which outlines three stages for establishing a safety culture.
In Stage 1, safety management is based on strict rules and regulations. In Stage 2, good safety performance becomes an organizational goal. In Stage 3, safety performance is dynamic and continuously improving, emphasizing communication, training, management style, and efficiency.
Organizations should strive to get and maintain stage 3 status. Everyone in the organization contributes to maintaining high awareness of behaviors and attitudes that impact safety and fostering a culture where people are not afraid to report issues.
