Patient safety – A necessary challenge for healthcare organizations
- Part 2 -

Anisha Khundongbam *

Mission Myamar Phase III for Smile Train and Key Hole Surgery at Monywa General Hospital, Sagaing :: Pix - Shija Hospitals

B. Patient Identification: Use of uniform methodology for identification of patients while at the hospital using patient tags and writing the patient details including Unique Hospital Identification number of the patient legibly in all patient documents. Recent advancement includes electronic medical records and Radio-frequency Identification (RFID) tags for patients.

C. Reduce the risk of Health Care Associated Infection (HCAI): Also known as nosocomial infection is an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission.

This includes infections acquired in the hospital but appearing after admission or discharge, and also occupational infections among staff of the facility. The key to avoiding HCAI is improved Hand Hygiene by healthcare providers and patient relatives at the hospital, restricting visitors to the hospital, following a hospital- wide Antibiotic policy, adequate use of Personal Protective Equipment etc.

D. Minimize Medication Errors: Medication errors are one of the most common cause of avoidable harm to the patients.Medications that have the highest risk of causing injury when misused are high risk medications which must be stored separately and labelled. These include Look-alike, Sound-Alike medicines, antiarrhythmics, narcotics etc.

Hospitals must build clinical protocols, strategies and documentation systems to ensure correct and timely dosage of medicines to the patient. Medication error can occur at multiple levels starting from prescription errors, transcribing errors, procuring errors, administration errors etc. Avoiding error prone abbreviations in all clinical documents has been advised by various experts to mitigate medication errors in HCOs.

E. Correct Site, Correct Procedure and Correct Patient: Healthcare facility must engage frontline practitioners and other healthcare workers actively in verification at pre-procedure stage: correct patient, procedure, site, implant or prosthesis. Unambiguous marking of site must be done by individual performing procedure, particularly surgeons (with patient’s involvement). WHO has also encouraged healthcare institutes to use their prescribed format of Surgical Safety Checklist in order to minimize such error.

F. Effective Communication: The use of effective communication between the hospital workers as well as between the patient and health care providers is an essential component of providing safe care to the patient. Poor communication, unclear lines of authority of physicians, nurses, and other care providers also leads to miscommunication regarding the care provided to the patient.

Practice of effective communication and the right choice of communication channel is crucial to ensuring safe care to patients. Counselling of patients and obtaining proper informed consents from patients and relatives is the responsibility of the healthcare provider and right of the patients. During a patient’s stay at the hospital there are multiple hand-overs among the care providers. Utmost attention must be given to constitute proper methods of hand over including documentation, read-back policy etc.

G. Patient Falls: Prevention of patient falls is also a considerable challenge for health care facilities. Unintentional falls are the most common causes of non-fatal injuries in United States for people older than 65 years. Proper initial assessment of the patient is important in providing adequate ambulatory service to the patient during their stay at the health care facility. Mandatory usage of bed rails, trolley rails, wheelchairs etc. are also adopted to avoid patient falls.

H. Proper disposal of bio-medical waste: Central Pollution Control Board of India has prescribed guidelines which must be followed by healthcare providers in disposal of bio-medical waste. This ensures safe disposal of waste reducing the risk of spread of diseases and threats to healthcare providers and patients in particular and general public and environment at large.

As per Supreme Court orders dated March 1996, it is the primary responsibility of the government to enforce proper handling and disposal of hospital waste and an act was passed in July 1996 and a bio-medical waste (handling and management) rule was introduced in 1998 in the general interest of public as well as the environment.

I. Regular Calibration of equipment: Medical facility now depends largely on equipment for diagnosis and treatment. As much as doctors are required for proper treatment of patients, equipment plays a major role in accurate and early diagnosis of diseases and treatment thereof. Regular calibration, controls and maintenance of equipment is vital in providing safe care to the patients.

Estimates show that at-least 50% of medical equipment in developing countries are unusable or only partly usable. Often the equipment is not used due to lack of skills or commodities. As a result, diagnostic procedures or treatments cannot be performed. Training of end users for optimal usage of equipment is an area in which HCOs need to pay constant attention.

The hospitals or Health care organizations that put a priority on safety and use the universally accepted techniques to reduce, if not eliminate, adverse healthcare events will show improved results in the form of better outcomes and their patients will be safer. These initiatives by healthcare institutes also helps in building trust and entering the ever growing Medical Tourism arena by ensuring safest care.

Manipur stands at an advantage when it comes to developing tourism of the state especially in war (Battle of Imphal-Biggest in 2nd World War), ecology, sports, cultural arenas and Medical tourism.

With India’s Look East/ Act East Policy, Manipur’s favorable location bordering with Myanmar, surface and air connectivity with ASEAN nations, meeting point of two superpower nations -China and India, Manipur being an amalgamation of lakes, hills and valley, the tourism potential of the state is tremendous.

The state can work further on developing safe healthcare services with collective effort of private and government entities with support and encouragement from the public.

Concluded