Patient safety – A necessary challenge for healthcare organizations
- Part 1 -

Anisha Khundongbam *

Shija Hospitals and Research Institute, Langol

The 9th of December is marked as World Patient Safety Day to raise awareness regarding patient safety. The World Health Organization (WHO) launched this Alliance day in 2005 to increase the awareness of unsafe healthcare.

The purpose of Patient Safety Day is to revolutionize high level support and commitment to tackle patient safety issues in all parts of the world.Patient safety is a new healthcare discipline that emphasizes on reporting, analysis and prevention of medical error that often lead to adverse healthcare events. Patient safety is a global public health concern and is a fundamental principle of health care.

As per WHO reports, estimates show that in developed countries as many as 1 in 10 patients are harmed while receiving hospital care. The harm can be caused by a range of errors or adverse events.In developing countries, the risk of health care-associated infection is as much as 20 times higher than in developed countries.

The consequences of unsafe care can be as large as economic loss of the region besides the individual loss of the patient and the healthcare organization. When we talk of patient safety, it encompasses not only the safety of patient but also the healthcare providers.

What can Health Care Organizations (HCO) do to ensure Patient Safety?

The recent trends in healthcare industry is towards improving quality of service through which Patient Safety is ensured by clinical protocols, documentations, continuous monitoring, root cause analysis, and providing corrective measures to mitigate errors.

Joint Commission International (JCI) is an international body which works to improve patient safety and quality of care and is considered as gold standard in global healthcare. There are currently 21 hospitals in India which are accredited by JCI.

National Accreditation Board for Hospitals & Healthcare Providers (NABH) is a constituent body of Quality Council India. It is an accreditation body which defines standards for hospitals and healthcare institutes which are to be complied with.

There are currently 578 organizations accredited by NABH in India including Blood Banks, AYUSH hospitals, Multispecialty hospitals and allopathic clinics. National Accreditation Board for Testing and Calibration Laboratories (NABL), similar to NABH, is also an autonomous body which provides third-party assessment of the quality and technical competence of testing and calibration laboratories.

Currently, two organizations in Manipur are accredited by NABL, they are, Babina Diagnostics and Laboratory of Shija Hospitals & Research Institute Pvt. Ltd. Shija Blood Bank and Transfusion Services (SBBTS) is the first NABH accredited blood bank in North East India. SBBTS services includes Nucleic Acid Test facility which screens HIV, Hepatitis B &C Virus, and significantly reducing window period as compared to conventional methods for early detection before infected blood is transfused to another patient.

It is the first installation in the entire Eastern India and it ensures patient safety through avoiding transmission of diseases through unsafe blood transfusion. It may be mentioned that NAT testing is mandatory for blood transfusion in many developed countries such as US, UK, Germany, Singapore etc. and many states in India are also working towards becoming NAT mandatory states. Manipur can set an example in the country by adopting NAT testing as a state health policy for the single purpose of Patient Safety.

The best way for healthcare providers to ensure patient safety is by embracing these standard practices with regular monitoring and put in continuous efforts for quality improvement. Since it is a voluntary accreditation and not a mandatory certification, not all healthcare institutes are actively working on it.

The basis for these accreditation depends on a set standard practices to be followed throughout the organization with documented evidence of practice of the same. It is essential for the management of healthcare organizations to encourage disclosure of adverse events that happen in an institute which will be important learnings for the fraternity to avoid the same in future.

Non-punitive policy of an institute reassures employees that they will not be blamed for a particular error and in turn increases reporting of adverse events, sentinel events or near miss events which have not caused harm to the patient and has been mitigated at the correct time. There are various measures which can be taken up by HCOs. Some of which are as follows:

A. Effective committees: Create committees and assign specific responsibilities for quality assurance activities in an institute. Infection Control Committee, Pharmaceutical and Therapeutic Committee, Patient Safety & Quality Committee, Mortality & Morbidity Review Committee etc. are few of the listed committees as advised by accreditation bodies.

For instance, the Infection control committee of a hospital will regularly review and monitor infection control indicators such as Urinary Tract Infection Rate, Ventilator Associated Pneumonia Rate, Surgical Site Infection Rate, Hand Hygiene practices etc.

To be continued...