IASbhai Daily Editorial Hunt | 25th Sep 2020
Someone else’s success does not equal a failure for you.– Joe Rogan
EDITORIAL HUNT #156 :“World Patient Safety Day Analysis | UPSC“
Dr. Harikeerthan Raghuram | Dr. Anant Bhan
World Patient Safety Day Analysis | UPSC
Dr. Harikeerthan Raghuram is a public health researcher and consultant. Dr. Anant Bhan is a researcher in global health, bioethics and health policy
Health worker safety deserves a second look
The key is to adopt a systems approach and lay emphasis on a culture of health worker well-being
SYLLABUS COVERED: GS 3 : Health : UN Observances
In the view of World Patient Safety day , Elucidate how is Patient Safety is important for Health worker Safety and vice versa. -(GS 3)
- World Patient Safety Day
- COVID-19 and Patients reporting cases
- Case Study : Overcrowding
- HEALTH CARE : Health facilities are a place of healing and restoration.
- CARELESSNESS : These range from operations done on the wrong patient, to injections being administered in an unsafe manner.
- LIFE THREATENING INJECTIONS : Studies in India have shown that more than two-thirds of injections are given in an unsafe manner.
- NEEDLESS MEDICATION : Equally worrying is the fact that over two-thirds of injections in primary care are unnecessary in the first place.
- OBSERVANCES : To highlight this important issue, the World Health Organization observes World Patient Safety Day every year (September 17).
- HEALTH CARE SETTINGS : Much harm done to patients in health-care settings is because of unsafe health-care practice and unsafe health-care communication.
- FAULT LINES : Unsafe health-care practice refers to unsafe or unnecessary procedures, wrong medications, medications given in a wrong dosage, etc.
- MISCOMMUNICATIONS : Unsafe health-care communication refers to mistakes made in health-care settings due to miscommunication between health professionals.
- QUALITY PRACTISES : The quality of both practice and communication is dependent on the safety and well-being of health workers.
COVID-19 AND REPORTING CASES
- MENTAL STRESS : In COVID-19 crisis, health workers are not only putting in longer hours but also working under increasingly difficult circumstances, which affect both their physical and mental health.
- WORKSPACE CULTURE : The mental health of health workers is linked to the workplace culture.
- STAFF SUPPORT : Some organisations have a culture of supporting staff, responding to their needs and encouraging learning from mistakes; while others have a culture of fault-finding, blame, guilt and abuse.
- HIERARCHIES BETWEEN SPECIALTIES : In India, it is not uncommon to find health-care organisations observe strict hierarchies between specialties, between designations etc.
- POWERFUL DIFFERENCES : Such power differences can increase chances of abuse: verbal, physical, emotional and sexual, putting the safety of health workers and patients at risk.
LOOKING AT THE ORGANISATION
- INSTITUTIONAL LEARNING : Organisational learning is more important than individual learning.
- REASON : This is because instances of patient harm, even when they occur at the individual level, are often an end result of a chain of organisational failures.
- Systemic under staffing
- Lack of reporting mechanisms
- Lack of dedicated time for hand overs
- Training and team building
- Poorly maintained equipment and corruption in purchases.
CASE STUDY : OVERCROWDING IN HOSPITALS
To take a systems approach in this situation would mean looking at it holistically .
- THE INPUT : Looking at whether patients who come to the emergency department need to be there in the first place or could be managed somewhere else such as in the community itself.
- THE THROUGHPUT : Looking at whether there are inefficiencies such as shortage of doctors, nurses, equipment or space that is increasing the time taken for patients to be treated.
- THE OUTPUT : Looking at whether the patients are staying longer in the emergency department than required because of lack of non-emergency department inpatient beds, delays at the pharmacy or delays in transportation of patients out of the emergency department.
- EFFORTS IN PANDEMIC : Many health workers have demonstrated excellence despite the limitations in the Indian health system. This is laudable but may not be sustainable.
- SUSTAINABLE APPROACH : Creating sustainability would ensure both of health care and of supportive social care are well functioning.
- UNDERSTAFFING : Many health workers are overworked not by choice, but rather the lack of it since understaffing and shortages are a common feature of the Indian public health-care system.
- RESPONSIBLE STAKEHOLDERS : Finally, a systems approach involves all stakeholders.
- AWARENESS : Patients themselves need to be aware of patient safety as well as be empowered to demand safe health care and resist unnecessary medications and procedures.
- HOSPITAL MANAGEMENT : Hospital managers must understand the need for and be empowered to create systems of reporting, monitoring and organisational learning.
- QUALITY OF HEALTHCARE : Numerous persons find healing and restoration in health care. But some are harmed as well. In crises such as COVID-19, quality of care can be compromised further.
- LET US PROMOTE : We can help improve patient safety by taking a systems approach and promoting a culture of health worker safety and well-being.
Good systems can mitigate the effects of individual mistakes.
SOURCES: THE HINDU EDITORIAL HUNT | World Patient Safety Day Analysis | UPSC