patient Safety

Patient Safety

Health, defined to be the condition of a person’s mental and physical condition has always been on the priority list of individuals and governments. With increasing competition and economic factors, health has become a billion dollar industry. According to United Nations International Standard Industrial Classification (ISIC), the medical industry consists of hospital activities, patients’ problems and medical and dental practice activities. The hospital should be registered with the locality’s health authorities to operate as part of the industry. Moreover, the healthcare organization should have authorized doctors, nurses, and equipment.

Healthcare industry is growing at a high rate in the United States and has hit about $3 trillion lately. It explains the increasing importance world and individuals are giving to their health and safety issues. While entering the list of top 10 markets, it is important for the stakeholders of this industry to improve the systems and provide the best to its customers to keep them satisfied. As a matter of fact, hospitals can never feel the need to market them as whatever is the situation; people will get sick and will come to hospitals and clinics. However, with growing competition, it has become important for the stakeholders to improve customer satisfaction and the systems to retain customers.

GOALS AND KEY PERFORMANCE INDICATORS

Because of immense competition in the healthcare industry with many hospitals operating in the same area, and health centers and clinics opening in every neighborhood, it has become necessary for the management to set goals for their organization, make proper SOPs and put forward key performance indicators for their staff. We have always heard KPIs and SOPs for businesses to enhance their profits but due to competition, it has also become necessary for service industries to bring in KPIs and proper execution of their systems to achieve their KPIs. Once the KPIs are achieved, the patients will be happy and retaining them will be easy. Moreover, for an industry like healthcare, it is mandatory to have proper systems and goals which have to be aligned with providing the best service to their clients, the patients of the organization. Some relevant KPIs for healthcare industry are improving operational and clinical effectiveness, quality of services, reducing medication errors, enhancing member/patient satisfaction, improving financial and administrative aspects and use business intelligence and data analytics to measure the effectiveness of KPIs towards the organization.

Achievement of these KPIs is also important a huge part of the government’s budget is being provided to the healthcare sector, the inefficiency of which can lead to severe consequences. If in any way, key performance indicators are not achieved by any hospitals, this can result in many lives wasted. KPIs are the easiest way to measure the success of the goals, how effective is the organization with their healthcare services, and how satisfied are the customers of the organization.

Out of many aims and KPIs for a health organization, the most important is the safety of its patients. The security of the patient during and after their course of service is a vital concern of the organization and all other KPIs are associated with this particular indicator.

WHAT IS SAFETY? 

In unprofessional terms, safety means to be in a state of comfort and away from danger. It is about staying protected from any harm whether it be physical, social, emotional, financial, occupational or psychological. Safety has different meanings for different people. People tend to stay away from issues, which can hurt them in one way or the other. Staying safe is the reaction to the fear of danger or harm and this fear can get people to take some precautions to ‘stay safe’. People have their safety plans for everything, and these plans are necessary for their living. 

Security is part of everyone’s lives, every moment of their lives. No one can stay away from safety rules neither should one. It is necessary that people follow security procedures in every activity they do. As much is your own safety is important, the security of people around you is also important. An individual should be careful about his safety plus everyone around them, and then only can one live a peaceful life. Taking a simple example of traffic rules, which are made for the security of people on the road, driving or walking. If one individual does not care about these safety rules, his life is in danger along with many others. 

Like this example, there are many safety regulations, plans, and procedures, which we are bound to follow in our daily lives that keep us safe from the unwanted hazards.

SAFETY IN HOSPITALS

Like the importance of safety explained above, hospitals are the areas where they are most prone to happen. A place with an objective to provide the best service and healthy environment to its patients, safety can be the primary concern. On average, most of the safety issues happen in a hospital setting. Medical errors can occur most of the times, and these errors can have some serious consequences to the patient and image of the organization. Hospitals with a high rate of safety concerns and medical errors lose their authorization from the health care authority of the state as well.

Hospital and healthcare organizations are places where people come to get into a good healthy state, and if these areas are the reason to get you into hazardous situations and make you unhealthy, the hospital will lose the credibility and its customers. 

Keeping in concern the strategic importance of safety in hospitals, many researchers, and strategic planners are working on the ways to improve the safety plans in hospitals and healthcare institutions. Creating and maintaining an environment where patients and employees can feel safe and healthy should be the core to a hospital’s strategy rather than making profits out of everyone. All profits will take the lead once the employees and customers are happy, and this can be achieved by providing them with an environment with compassion and without any hazards. Hospitals have started using their safety stats for their marketing as well which shows the importance of safety for the patients and employees.

Safety in hospitals can be divided into three main areas where the safety is most needed. Those three sectors include safety of people, the security of places and property. If these areas are protected and preserved, the organization is following its KPIs.

SAFETY OF PLACE 

While making safety plans for a zone, hospitals should consider the safety of the areas associated with their surrounding and internal location safety. Location security is divided into the safety of electrical and fire. Hospitals are prone to fire and electrical hazards due to machines, high voltage connections, heavy equipment and electrical gadgets around the place. Fire and electrical appliances have the tendency to catch fire and be hazardous to people in the building and therefore, fire extinguishers are essential for any location, and so is the planning of the safety procedures. 

The hospital should have the training provided to all the staff as part of safety programs. Precaution planning is essential but so is the training in case anything goes wrong. Precaution planning ensures that the chances to hazards are minimized and training ensure that in the event of some natural calamity, the staff knows how to handle the situation and help people around them by saving their lives.

SAFETY OF PROPERTY

Hospitals’ building and equipment make 95% of the capital investment of the hospital. (Joshi, 2011). Safety of goods means providing safety to the capital of the organization and saving capital is foremost for business. If the building or equipment gets any damage due to a natural disaster or any artificial issues, the consequence for the hospital will be drastic. To keep buildings and equipment sustainable and in a good condition, it is necessary for the hospital management to maintain the best out of its assets and equipment. Equipment for the hospitals is very expensive depending on the technology they are using, and so are the property for the hospitals.

To safeguard hospital property, equipment, and the other assets, hospitals need a property plan. Proper maintenance of the asset needs to be done in prior and while in use. The equipment needs maintenance every quarter to keep them in working condition and increase the life of the assets. Moreover, the insurance of the property and equipment should also be a priority of the hospital. Safety management committee should ensure proper usage and functioning of the ownership and building.

SAFETY OF PEOPLE

Safety of people is mostly considered as the security of patients while talking in the context of hospital’s safety. People in hospitals can be divided into three groups: the staff of the hospital which is working for the patients, visitors which are either coming with the patients or visiting the hospital for educational purposes and the most influential group, the patients.

Customers are always thought to be the Gods for any organization as they are the ones providing you money. Therefore, protecting them is a big responsibility. While providing safety to patients is important, protecting everyone around the patients and hospital is also necessary and interlinked. Safety of employees is as important as the security of the patients as your employees and staff will be the one taking care of the patients. If an institution is providing safety to its customers, they are bound to give safety to their visitors and their staff. Employee retention is as important as customer retention and therefore, hospitals should be open to ways where they can safeguard all the people on their premises. Organizations all around the world have started giving equal importance to their employees and customers, and this has resulted in increased customer satisfaction. Work Health and Safety Day celebrated on April 28th is one perfect example of this.

HOW ALL SAFETY AREAS CONTRIBUTES TO PATIENT SAFETY

Patient safety is the foremost responsibility of hospital management and staff, and we have discussed the reasons in quite a detail. Why are the other safety areas important and why should management focus on all other safety areas? One reason is that live of every human is important whether it is the patient or the employees. The second reason which could be of interest to businesses and management is the relation between these three areas and how they all contribute to their goal of customer satisfaction and retention.

Starting with the safety of the place, the contribution of this area to patient safety is quite simple. If the hospital gets into any fire, electric or infrastructure-related problem, the patients in the hospital will suffer from the disaster with everyone else. Secondly, the hospital or the insurance companies would have to bear the expenses.

Furthermore, if the assets and equipment of the hospital are not in a good condition, this would lead to diseases in the customers again. We all know that worldwide, people die in hospitals because of the inadequate sanitization or conditions of the equipment used in the treatment. Therefore, the safety of material, in turn, is the safety of the patients and their well-being.

Coming to the most important area, the security of people. The security of individuals includes safety of patients in itself along with some other important people in the premises of hospitals. When the employees and staff are told about providing safety to their patients, how can we forget that they are also human beings and deserve the same protection from hazards as the other stakeholders of the hospitals? Working to provide a safe environment to employees means that they are cared for, and they will only work for the hospital’s goals if they feel that the hospital and top management cares about them. They will never care for the patients with an open heart if they think their lives and well-being are not valuable to their employers. This is the only reason human resource around the world is getting attention and working to provide a safe environment not just to their customers but their staff and employees as well. As it is stated, a happy employee will turn a client happy.

PATIENT SAFETY

Providing safety to the patients has taken buzz since quite a few decades, however, the oath adopted by the medical staff at the beginning of their career with their caps on, states that safety of patients is their foremost priority and should always be one. In the context of Greek mythology, the physicians take an oath from healing Gods to work under the ethical standards of the world. A small extract from the oath is given below which deals with harm and safety of patients.

“I will use treatment to help the sick according to my ability and judgment, but never to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free.”

While speaking these words, a physician takes an oath to himself to protect the patients who consider them the hand of God. This oath is the origin of the concept of protection of patients, the concept which is given importance now as the medical industry grows into a business.

We have discussed some major areas where safety should be provided to the people in the premises of the hospital. Let’s look on to the area where most errors are made, being the medical errors.

MEDICAL ERRORS

Medical errors are the third largest cause of death in the USA, state a recent report. (VOA news, n.d.) With all the buzz of patient safety and their importance increasing, still a major chunk of deaths are coming due to medical inefficiency and errors by the staff.

Medical errors are broadly defined as a preventive condition which can or cannot leads to adverse consequences. It can result in inefficiency in treatment or decision making in case of injury, disease, surgery or any other medical related issues. Medical errors are human errors that could have been prevented with little care to the topic and thinking.

TYPES OF ERRORS

Medical errors are divided into two categories being the intended actions of the medical staff or the intended actions of staff which lead to adverse situations. Intentional actions can either be violations or lack of knowledge. Violation of the medical terms and oath can be due to corruption or any other sources in favor of intended unethical behavior. Mistakes are due to lack of knowledge in the particular area of study and still treating the patient for the sake of their income or fame.

Unintended medical errors can be due to lapses or slips which are due to the skill the medical staff never had. It can be due to failing to remember about a particular disease or medicine where you prescribe some other one or mixing one disease with another due to memory error. On the other hand, slips can happen due to attention loss while in conversation with patient understanding the symptoms or lost during surgery which resulted in an adverse reaction.

Some of these errors are those which could have been prevented if given a little attention and care while some of them are purely crimes when you play with someone’s life for your well-being. 

WHY DO THEY OCCUR?

Let’s dig into more detail on why does these simple yet huge errors occur from medical staff who has taken a vow to protect their patients.

HUMAN FACTORS

We have heard it many times that man is made to make mistakes, but medical facilities take this quite seriously while making mistakes with people’s lives. 

The errors occur due to less of attention being given to the patient, the disease, and the situation. This can be caused by many reasons be it family pressure, work pressure or sleep deprivation due to long hours. It is said that work is affected after you work 8 hours and therefore, the timings for work in the corporate environment does not exceed, but the same hospital faculty is required to work for up to 23 hours and still expected be efficient. That’s not humanly possible. Management should understand that over-worked employees can lead to some serious accidents which can be avoided. Time pressures or family pressures can also be reasons behind less of attention given by the physician.

COMPLEX HEALTHCARE

Healthcare and its studies are the most difficult job as it requires one to learn and remember the excess of names, diseases, conditions, symptoms, medicines and what not? Alongside, the doctor and physician do not have time to go online while the patient is sitting in front of him to check whether he remembers the right formula and the medicine to it. The decision of doctors are quite instant, and chances for unintended errors do occur.

POOR SYSTEM AND COMMUNICATION

Institute of Medicine says the problem with the medical error is not with the people, but the core problem is the bad system. (Medicine, 2000) One of the biggest issues with medical errors is the communication between the different levels of organization and people associated with a case. The authority to take decisions is not divided nor is it clear to individuals and this leads to errors being made or instant decisions delayed. A report from Joint Commission says that communication issues between the medical staff or communication between staff and the patient lead to errors which result in unwanted situations for both the parties (Improving America’s Hospitals, 2007).

EDUCATION AND TRAINING 

Some of the physicians lack knowledge of particular areas while some of them are not good with decision making while the patient is on the surgery table. Colleges treat them about what diseases are and what they should do in particular situations, but they fail to train them in real life situations. Authority to work should come with years of experience not a bunch of money in the management’s pocket. 

WHAT SHOULD BE DONE AFTER AN ERROR Occurs? 

Errors are part of the procedure and can be made by anyone intentionally and unintentionally. We can always try to control the errors as much as possible, but there is always minimal of possibility left. What we normally see is staff tries to avoid consequences by hiding the error behind other diseases, call the error as the cause of side effects and avoid talking about it. After an error occurs in the medical facility, it is important to accept the reality and truthfully move forward with it rather than trying to hide it in fear of bad mouth about them or their hospital.

Some major steps to that can be taken after an error occurs are following:

Inform the patient and family: the issue has been quite a debate in many organizations about whether to inform the patients the error done by the medical staff. At times, disclosing the issue can lead to the consequence which could have been avoided if it was not disclosed. That is because the patient gets tensed and tension can result in psychological stress which can make them feel in danger and to believe that. It is better to inform the family or relatives of the patient about the error. It is important to disclose the information and dissolve the issues from the core before the error leads to serious problems. Moreover, it is important to let them know about the consequences of the mistake, so they are aware of it the symptoms and stay careful and cautious.

Inform the medical staff associated with the patient: medical error and all the details are to be told to all the medical staff who are associated with the patient and their medical history. It is important so they are aware of what can go wrong and have planned the outcome of the issue.

Document the error in patient’s history files: The medical error should be included in patients’ file so anyone who deals with the patient in future for the same disease or any other disease can keep the error in mind before providing any medicines and treatment to the patient. It will be a step towards future safety where the patient will be provided with analysis and treatment based on the information and history intact. Keeping history in mind before providing any treatment is one of the measures in the context of patient’s safety.

Document the error with hospital’s safety committee: the safety committee is bound to know if anything bad happens to the patients or employees. The documentation of this error will lead to finding the causes of the error, and they will work in improving it in the future and providing a fair judgment for the staff involved with the medical error. 

WHO AND ITS INITIATIVE

World Health Organization is the specialized agency of United States which works on the development of the international health scenario. WHO started with a constitution in 61 countries and now had alliance all over the world. Since its beginning, it has been thriving to make countries believe in the importance of health and is fighting for health related problems all over. They have worked on eradication of many diseases from the world, provide measures in all cases of health and collaborate with the government to improve the health situations in their respective countries.

World Health Organization takes the issue of patient safety very seriously and has worked in many different areas to improve the safety measures in hospitals, provide safety plans to medical staff and training to them to work in best favor of patients and people in their premises. They have encouraged the staff and management to consider the issue of its paramount importance.

WHO Patient Safety Program was the first step towards the safety issues. Since then the program has launched Safer Primary Care project which provides understanding and knowledge to medical staff and management about safety. They have recently partnered with Africa to work on their Patient safety programs after working in the US, Europe, and Asia. WHO even provides complete checklists to the hospital which can minimize the risks of errors if managed properly. The safety guide is a book launched by WHO to provide complete guidelines on how to implement security in the organization.

WHO awards for safety encourages management by providing appreciation in case of any initiative in the road to safety. Recently, WHO has taken a step forward in this field by working on the core of the issue. It operates on the security of patients when it enters the premises of the hospital, but the real training should be provided to students registered in the graduate/undergraduate programs. Patient safety is not an individual area but an overall part of medicine and therefore, providing it importance on the base level will lead to consequences reduced. WHO, along with its researchers and professors have designed a complete curriculum guide for medical schools around the world to introduce this important area as a whole subject to enhance and strengthen the importance of this issue. World Health Organization and its partnership with many NGOs, government organizations and medical hospitals have established the importance of patient safety.

THE JOINT COMMISSION AND SAFETY INITIATIVES

The Joint Commission is a non-profit organization in the United States which has 501 organizations and has 21,000 healthcare centers and organizations accredited with them. The objective of the organization is to keep a strong check on the hospitals and ensure fair working in the hospital’s management and medical staff. The organization provides reports which provide one with different stars and awards which increase the hospital’s brand image and worth. Moreover, The Joint Commission also provides guidelines and support in making the hospital a place where the patient feel safe and healthy. To provide the patients with a protected and clean environment is the core concern of the joint commission and they’re working along with all the stakeholders to achieve this objective. 

Efforts of The Joint Commission and its accredited hospitals has led to improving the healthcare system in regards to quality and value for money. Being accredited by The Joint Commission also brings thrive and fear in hospitals to improve their safety and quality systems and stay intact with it throughout the year. 

Last year, a program was introduced by The Joint Commission Center for Transforming Healthcare called NEW Preventing Falls Targeted Solutions Tool, which was an online application. This application helped the organization keep track of their patients and thus reduced patient falls rates by an estimate of 35% and injury by 62%.

The Joint Commission also launched ORO, which is Organizational Assessment and Resource Library, which helps the medical organizations to learn about leadership regarding safety culture, how to implement it and measure the execution and results with assessments. 

The organization works on a magazine which is made bi-monthly and features interviews and plans from the patient safety officers and executives from around the world. After providing techniques, information and guidance, The Joint Commission takes tests to know who achieved what throughout and which organization is fair with their safety and quality procedure. 

TYPES OF SAFETY

BUILDING SAFE ENVIRONMENT

The area where a patient will reside has to be clean and should have no hazards to the patient. The work environment in which the medical staff is working will have an impact on how they feel about cleanliness and health and how they will consult the patient. Moreover, if the environment in which the patient is treated is not healthy, the patient does not feel good internally, and the can lead to damage. The environment should have a proper sanitation system, proper electrical appliances, available fire extinguishers in case of any emergency, away from noise and air pollution and appropriate ventilation.

ENSURING SAFE MEDICAL ACTIVITIES

Medical safety includes safe decisions related to medicines and patients. Documentation of patients’ history reports, easy availability of these reports to all the physicians, proper identification of the patients in system for any duplication error, checking the history and body conditions before giving any medicine or recommending any treatment, providing the correct dose and timings of the drug and being sure of the consequences of the drug or treatment comes in the genre of medical safety to the patients.

ENSURING SAFE SURGERIES

Before moving forward with any surgery, the medical staff is supposed to inform the patient and family with any outcome that can occur. They are also expected to take written content from them and then attempt the surgery. Moreover, pre-anesthesia requirements and the amount of anesthesia provided to the patient should be measured carefully. The medical team operating the surgery should make sure no outside element is left inside the body, and all the surgical instruments are clean and sanitized. The medical team should also follow the checklist provided before the surgery and make sure no step is missed during the surgery which can cause harm to the patient.

PROVIDING SAFE ELECTRICAL AND FIRE SETUP

It includes providing the building with proper electrical and fire evacuation plans. Management should plan emergency evacuation training sessions which help the staff understand how to react in case of any emergency. Always have an electrical backup as the surgery or treatment can get affected in the event of power breakage. No use of loose wires and proper electrical setup. For fire safety, the management is supposed to have fire extinguishers and smoke detectors on every floor which can easily help detecting and informing the patients and staff.

PROVIDING SAFE BLOOD

There should be a good blood bank with a proper setup and systems to group the blood properly, check whether the patient is healthy enough to donate the blood, use proper equipment while transferring blood, make sure the blood being provided to the patient is of the same blood group and there is no mismatch which can result in some reaction. These are some of the activities which are very general but if not done with care, can lead to severe outcomes.

PRINCIPLES AND METHODS OF PATIENT SAFETY

Talking in detail about how the types of error medical staff can come across, what to do when a medical error is concerned and types of safety we can provide to our patients, let move to some broad methods actually to improve the safety conditions in a medical organization. While considering the reasons for the error, it is important to work on the methods to avoid the mistakes by solving the core issue through it.

CONVINCE THE STAKEHOLDERS

The first step towards the safety culture formation is to convince the management and staff of the importance of the patient safety regarding human behavior, their oath, for customer satisfaction and retention and fro the long term benefits of the hospital. If the stakeholders understand the importance of the culture, they will be willing to bring the change with you in a positive manner. These things cannot be forced upon anyone with a negative behavior and therefore, convincing the staff is as importance as the management because management will provide the budget but the doers of the activity are always the medical staff.

TRAINING TOWARDS HEALTHY CULTURE

The second step towards a healthy organization is to provide extensive training to the staff explaining them the areas where there is a possibility of slightest error, different types of mistakes and reasons identified for the occurrence of those errors. The best way to train the medical staff would be to provide them with the opportunity to determine the errors themselves and the everyday situations which lead to those mistakes. If they can identify it themselves, they will remember to improve them as well when they come across them the next day.

ENCOURAGE TO ACCEPT MISTAKES

The third step towards providing safety measures is to provide them with the confidence that speaking the truth about their mistake would not lead to an adverse consequence for them. Tie some incentive with safety management to give them a boost and encourage them to work more on the safety culture ground and encourage others to do so.

STRESS MANAGEMENT

Moreover, the division of labor and stress is an important element that needs to be done to increase the quality of work the medical staff does. A doctor or nurse working since 20 hours is bound to make mistakes. It can only be controlled if the resources are provided with the amount of work they can handle and stress they can take. Distributing the workload is essential when creating a safety culture.

SANITIZED EQUIPMENT

The usage of clean and sanitized equipment while clearly dividing it among patient is the next step. Inform the medical staff of more sanitization methods and how a wrong equipment being provided to the patient can also lead to severe consequences, though sounds a small thing to staff.

IMPROVED COMMUNICATION

The communication between staff, nurses, doctors, different teams, patient, and relatives is mandatory while treating a patient. All one to one and team communications leads to the discussion of some issues which are handled on the spot which cannot have been possible in isolation. The team discussion and frequent communication also result in the debate on the history of patients which could be missed out while reading the history reports. 

CHECKLISTS

The most important step of all is to make a checklist for different departments, surgeries, and treatments. These checklists provide the medical staff with clear guidance on which path to follow and which path not to follow. The checklists remind the staff about the things that needs to be done and inform them if they’re missing out on anything. The checklist is a form of check on themselves and a check for the management as well to know who the culprit is if anything goes wrong. Clear SOPs needs to be trained, and checklists should be attached to the SOPs which needs to be documented after treatment or surgery is completed.

PRINCIPLE OF 5 RIGHTS

Federico wrote in his article in Institute for Healthcare Improvement about the five rights of the patient safety being the right patient, the right drug, the right dose, the right route and the right time. Most of the medical errors revolve around these grounds where they either provide a wrong dose of a real drug or a wrong drug to a right patient or vice versa. At times, the proper time to provide the drug is not what has been told by the doctor. All these five rights need to be taken care of in smallest of surgery, disease or treatment. According to them, if these five rights are taken care while treating a patient, the chances for the error decreases from the side of the medical staff. It can them be due to the irresponsibility of the patient himself and not the medical staff. Therefore, while creating a culture of health and safety, the medical staff should also be trained in the five rights and their uses.

TRAINING TO PATIENTS

There can be many instances when the lack of knowledge, confusion or irresponsibility of the patient leads to error and severe consequences. It is essential that organization arrange sessions to train the patients as well. Once something goes wrong with the patient, it is hard to track whose mistake lead to the consequence which can result in a bad image of the brand of the hospital. Therefore, for a hospital that either patient are provided formal training or are provided small training when they are given the treatment.

RESPONSIBILITY OF ALL STAKEHOLDERS

Creating a healthy and safe environment in the medical organization is not the responsibility of only management or patient safety officer. It is an overall approach, and all the stakeholders need to take step forward in this conversion. Converting the organization to people friendly and protected environment is not a small activity neither it can be done from a single individual. This activity needs time to settle up and efforts of everyone involved. People ranging from nurses to doctors to management and safety officer, all of the stakeholders need to put individual efforts and be sincere towards the cause. Along with the individual efforts, all of them needs to work as a team to create this transformational shift in the organization. Individual efforts teamed up with the team efforts will lead to an organization which keeps the safety of patients at the core of their strategy.

This activity also involves the active participation of your patient as he is responsible for his behavior and the image of the organization will be affected by what the patient does as well. Therefore, the team of the culture development also as patient as the central element as well.

When all these elements combine to bring a positive change in the strategy of the medical organization, the implementation of the strategy gets easier and will be executed in a proper way.

BARRIERS TO IMPLEMENTATION

Patient safety is taking a hype and priority in hospitals but not with the speed it should be. Institutions like World Health Organization or The Joint Commission have forced the medical organizations to accelerate their activities related to providing a safe environment to patients and increase the quality of their services. Even though the field is important, it’s not provided much importance in many areas of the world. The major barriers to implementation are following:

Organizations in developing or underdeveloped countries work in a cost-cutting manner with a small number of resources working on behalf of a vast number of people. It lets them save their HR cost and take more work from a single individual. This particular reason affects the quality of work and can also lead to the safety issues for employees and patients. If the management would have to work on patient safety systems, they will need more resources in each department alongside a safety manager or officer to control the system and activities. It can add to their costs more which stop them from working on the safety culture.

The concept of patient safety is not considered a top priority in many medical organizations. The management and doctors believe that whatever they do is of the best quality and would provide the patient with the best. They do not understand that small mistakes lead to many significant errors with enormous consequences. They consider that patient safety is always there and doesn’t need to spare an extra amount of money to working on a traditional concept which is in place already.

To provide safety regarding proper equipment management, sanitization and providing each patient their equipment can be of the enormous cost to the hospital. Alongside, more the technology is advanced, more it is hard to understand by the medical staff and will be expensive as well. If the technology is not easily understandable, the medical staff requires training sessions for the technology which adds to the costs and takes away time of the staff as well. 

Doctors do not accept their mistakes, and that is the major issue with this generation. To compete in the world, it is believed that truth is the enemy. The blame game is played which leads everyone to put the error or mistake on the colleague and not take the responsibility to proceed with the improvement and change. It results in not knowing the real culprit and no signs of improvement for the present case and cases in future.

The health community never agrees on their mistake and puts the gross mistake on the patient or their family. They try to cover up the situation and save their brand name which is at stake if the patient is in a dangerous condition due to the medical error and can sue the hospital. To stay safe from these situations, the medical organizations do not take ownership of the situations. 

There is a lack of leadership or someone who understands the concepts of creating a healthy culture and a safe environment for patients. Old school management believes that the safety management is already present in the organization and that no concept can work forward, or there is no change to be done. The world needs leaders who have studied safety management in detail who can work to convince the management. 

HOW HAS PATIENT SAFETY MADE PROGRESS?

The hard work and efforts put forward by the trainers have improved patient safety and the field. The students and medical staff have been trained before their entry in hospitals and during their tenure repeatedly; NGOs are working in collaboration with medical organizations to improve the conditions and governments are putting in more focus toward a healthy plus safe environment for the patients and employees in medical organizations. The joint commission and WHO’s collaboration and guidelines are a significant step forward which is changing the situations in not only the developed countries but developing and underdeveloped countries as well. Until last decade, there were issues with cleanliness in the hospitals which has now improved to providing a safer environment as well. US centers of disease control share their statistics that in the US, there was noted a decrease of 58% in intensive care units which is an achievement in itself. Another report published by Department of Health and Human Services stated that 50,000 fewer patient death was found in hospitals by the little cause of medical errors. Moreover, $12 billion in health care cost were saved in the reduction in hospital-acquired conditions. Same research further says that due to extensive working on the systems, and plans being made on a large scale with proper implementation, the results has been drastic. In 2013 alone, almost 35,000 fewer patients died in hospitals, and approximately 800,000 fewer incidents of harm occurred, saving approximately $8 billion. 

WHAT IT MEANS FOR MANAGEMENT 

Patient safety and its increasing numbers are of paramount importance to management and can be a gain in long-term. Patient safety is considered a cost which is forced to management and has the enormous amount of money involved which makes the hospital management angry and frustrated. A management focusing on a long-term strategy considers patient safety and quality management as a bonus to satisfy customers and retain them in the long run.

The hospitals which have worked on satisfying customers and bringing new ideas to this field have realized that this strategy has given the management and hospital and edge and has saved them an immense amount of money which was formerly wasted on the errors, fire and electrical issues, the life of equipment decreasing because of no proper maintenance. These are some factors which are of major concern in patient safety management and all the hospitals following safety plans satisfy customers easily and get them to come back in future. Retaining customers are difficult in this competitive world, and level of patient safety a medical organization can provide is the edge to the client and their marketing strategy. 

The hospital management is bound to understand the fact that to stay in the market; it is important to take patient safety as an essential element of hospital management.

PATIENT SAFETY AS PROFESSION

With increasing importance to patient safety and quality control system, patient safety has led to a whole new era of medical studies. Patient safety has emerged as a study and profession by many. To be a patient safety certified professional, there is a course which needs to be completed. A patient safety professional or officer is bound to provide a safe and healthy environment to the patients, in a nutshell. But it is not as simple as it sounds. The professional is supposed to plan all the safety procedures starting from place, property and people and work on to minimize all the errors. He also has to be put in proper structures on what and how should safety work in the organization. The officer is also supposed to be prepared towards any emergency occurrence in the premises of the organization. Providing training to the medical staff from a custodian to a doctor or management, everyone should be clear on safety rules and plans and how to avoid hazards. Every individual should have their safety checklist which they’re bound to follow every day and that the safety officer should provide the list. The officer should also make sure proper documentation is maintained in case of any medical error or hazard.

In some hospitals and organizations, the patient safety officer is also supposed to plan the curriculum and training for the medical graduates who are trained during their health tenure.

The job is a difficult one as it is not easy to force a doctor to fill their checklist or follow the procedures nor can a check be kept on all the activities done by medical staff. The only way is to provide training, explain the importance of the proceedings and plans and tie some reward with the performance as this will keep the lower staff motivated towards the goal. 

References

John, S. 2014. Retrieved from HHS: http://www.hhs.gov/about/news/2014/12/02/efforts-improve-patient-safety-result-1-3-million-fewer-patient-harms-50000-lives-saved-and-12-billion-in-health-spending-avoided.html

Akins RB, C. B. (2005). Barriers to implementation of patient safety systems in healthcare institutions: leadership and policy implications. .

Federico, F. (n.d.). The Five Rights of Medication Administration. Retrieved from Institute for Healthcare Improvement: http://www.ihi.org/resources/pages/improvementstories/fiverightsofmedicationadministration.aspx

(2007). Improving America’s Hospitals. Joint Commission’s Annual Report on Quality and Safety.

Joshi, S. (2011). Safety Management in Hospitals.

Medicine, I. o. (2000). To Err is Human.

Organization, W. H. (2010). The WHO patient safety curriculum guide.

Patient Safety. (n.d.). Retrieved from The Joint Commission: https://www.jointcommission.org/topics/patient_safety.aspx

Q Delanor Manson, R. B. (2003). The Role of the The Role of the. Smith Seckmen Reid Inc.

VOA news. (n.d.). Retrieved from http://learningenglish.voanews.com/a/medical-mistake-cause-third-of-deaths/3326271.html

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