Let us work together to make health care safer for patients

On the first day of the ongoing week, September 17, World Patient Safety Day 2023 was observed across the globe under the theme “Engaging patients for patient safety”, in recognition of the crucial role patients, families, and caregivers play in the safety of health care and to uplift the voice of patients.

It is one of the WHO’s global public health days. The main objectives of the day are to increase public awareness and engagement, enhance global understanding, and work towards global solidarity and action by Member States to enhance patient safety and reduce patient harm.

World Patient Safety Day 2023 was established in 2019 by the 72nd World Health Assembly through the adoption of resolution WHA72.6, “Global Action on Patient Safety”.

The most fundamental principle of any health care service is “First, do no harm”. No one should be harmed in health care; however, there is compelling evidence of a huge burden of avoidable patient harm globally across the developed and developing healthcare systems, which has major human, moral, ethical, and financial implications.

If we look at the global overview, estimates show that in high-income countries, as many as one in 10 patients is harmed while receiving hospital care, and more than 3 million deaths occur annually due to unsafe care.

The harm can be caused by a range of adverse events, with nearly 50% of them considered preventable. Half of this harm is attributed to medications. A study on the frequency and preventability of adverse events across 26 hospitals in eight low- and middle-income countries showed the adverse event rate to be around 8%. Of these events, 83% were preventable, while about 30% were associated with the death of the patient.

In low-to-middle-income countries, as many as 4 in 100 people die from unsafe care. Common adverse events that may result in avoidable patient harm are medication errors, unsafe surgical procedures, healthcare-associated infections, diagnostic errors, patient falls, pressure ulcers, patient misidentification, unsafe blood transfusions, and venous thromboembolism.

Some estimates suggest that as many as 4 in 10 patients are harmed in primary and ambulatory settings, while up to 80% of this harm can be avoided.

Investments in reducing patient harm can lead to significant financial savings and, more importantly, better patient outcomes. An example of a good return on investment is patient engagement.

The critical role of patient and family involvement in ensuring patient safety can lead to a 15% reduction in damages and a decrease in medical costs. Patient harm potentially reduces global economic growth by 0.7% a year. On a global scale, the indirect cost of harm amounts to trillions of dollars each year.

Patient safety is defined as the absence of preventable harm to a patient and the reduction of the risk of unnecessary harm associated with health care to an acceptable minimum. Within the broader context of the health system, it is a framework of organized activities that creates cultures, processes, procedures, behaviors, technologies, and environments in health care that consistently and sustainably lower risks, reduce the occurrence of avoidable harm, make errors less likely, and reduce the impact of harm when it does occur.

Evidence shows that when patients are treated as partners in their care, significant gains are made in safety, patient satisfaction, and health outcomes. By becoming active members of the health care team, patients can contribute to the safety of their care and that of the health care system.

With the slogan “Elevate the voice of patients!”, this year, WHO calls on all stakeholders to take necessary action to ensure that patients are involved in policy formulation, are represented in governance structures, are engaged in co-designing safety strategies, and are active partners in their own care.

This can only be achieved by providing platforms and opportunities for diverse patients, families, and communities to raise their voices, concerns, expectations, and preferences to advance safety, patient-centeredness, trustworthiness, and equity.

Patient and family engagement were embedded in Resolution WHA72.6, “Global action on patient safety,” and the Global Patient Safety Action Plan 2021–2030 as main strategies for moving towards eliminating avoidable harm in health care.

Back to this year’s objectives, WHO highlighted four major terms: raise, engage, empower, and advocate. It is important to raise global awareness of the need for active engagement of patients, their families, and caregivers in all settings and at all levels of health care to improve patient safety.

In terms of engagement, it emphasized the efforts of policymakers, healthcare leaders, health and care workers, patients’ organizations, civil society, and other stakeholders to engage patients and families in the policies and practices for safe health care. On empowerment, patients and families need to be actively involved in their own health care and in the improvement of the safety of health care.

To make health care safer for patients, urgent action on patient and family engagement, aligned with the Global Patient Safety Action Plan 2021–2030, is needed by all partners.

We need to be mindful that safe health care is a fundamental right for all patients everywhere and every time. Yet patient harm due to unsafe care is one of the leading causes of death and disability worldwide, with millions of patients harmed every year. Patient and family engagement can be a key strategy for developing safer health systems in any society.

Safe health care depends on the full involvement of patients and their families as the users of the health care system, and it requires a shift from care designed for patients to care designed for patients.

At every level of health care, patients and families should be involved, from fully informed consent and shared decision-making at the point of care to policy-making and planning. And no one should be harmed by health care. We must elevate the voice of patients, and we must listen and learn.

Inappropriate or unskilled health care can lead to health hazards, both for patients and staff. Greater patient involvement is the key to safer care, and engaging patients is not expensive and represents a good value.

Everybody has a role to play: policymakers, health care leaders, health and care workers, patients and their families, patient advocates, and civil society. So, it is time to work together to make health care safer for patients.

The author is employed as a communication professional.

 

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