BlessWorld Foundation International

Affecting the World Through Health
A Global Health Initiative




Hospitals and health care facilities are generally seen as one stop solutions to most health problems. However, these places have the potential to increase or add to our health problems when we visit them while seeking treatment. There is always a small risk of something going wrong during health visits or interventions and this; unfortunately, happens quite a number of times as patients often suffer one complication or the other when they go to the hospital or healthcare facility.  Examples of such complications include:

  • Developing a VVF from an obstetric surgery
  • Developing a nosocomial infection
  • Losing a child due to injection of a wrong drug
  • Overdosing

Patient safety is a serious and common situation- The World health Organization reports that 4 in 10 patients (40%) are harmed in primary and ambulatory care settings. This is of course worse in low and middle income countries which have substandard health care facilities with 134 million adverse events (over 2/3 of the world burden) occurring annually. A patient in the United States has a 1 in 4 chance of experiencing injury, harm or death when admitted to the hospital, and this situation is quite similar in Canada as well as many developed countries. This bothersome statistics begs the question: Are health facilities doing more harm than good? I mean, should we decline doctors’ appointments and develop cold feet towards hospitals visits- the very place we need to go to get help? Well, the answer remains YES. However, we need to recognize the importance of patient safety and endeavour to make it a top priority. WHO defines Patient safety as the absence of preventable harm to a patient during the process of health care, and reduction of unnecessary harm associated with health care to an acceptable minimum. This harm can come in form of infections, injuries, errors and poor care.

Hospital infections, also known as nosocomial infections are caused mostly by antibiotic resistant bacteria which can affect any part of the body like the skin, lungs and can lead to sepsis and can quickly progress to organ damage and ultimately, death. Invasive procedures like surgeries have increased risk of complications and contaminations due to additional problems with anaesthesia while higher risk procedures like pancreatic surgeries are even worse. This risk is further increased by poor training and expertise. Errors in drug prescriptions also account for many hospital problems which errors cost about 42 billion dollars annually and can easily result in death especially in children. Poor patient management cause problems like bed sores and thromboembolism due to prolonged hospital stay. Patient safety is a serious issue, a matter of life and death actually. Health providers must endeavour to do no harm consciously and unconsciously because it violates the ethics of healthcare. Furthermore, lawsuits to health workers for making a mistake may be cultivating unsafe blame culture which focuses on the ‘WHO’ (who made the mistake), instead of the ‘WHY’ (why the mistake was made in the first place). Focussing on the person that made the error also prevents identification of errors within the system itself.

Errors arise as a result of poor system organisation and usually result from workers being extremely tired, probably experiencing fatigue or burnout. Since human errors are inevitable, a good system- which develops only when there is good safety culture of transparency and no blame games should sufficiently reduce errors. For example, if a nurse gives propranolol to a patient with heart failure that is coincidentally asthmatic (this would sadly cause an asthmatic attack), a good safety culture should seek to find out how the error moved past the entire system, and not just focus on the nurse. Additionally, effective communication, which involves active listening, showing empathy and patient involvement in care, is important and necessary to reduce errors. It would help for patients to be more involved in their care and clarified if need be as this emphasizes the importance of individual care as well as the gradual shift from patient to client. Patients who have questions about their care or feel uncomfortable about a procedure should be able to:

  • Talk to someone immediately- preferably someone involved in their care
  • Discuss the issue in a polite way and let the person know they want feedback if the issue warrants investigation  OR
  • Report to the hospital through the customer service, suggestion box, hotline, patient advocacy or patient and family relations department.

Finally, it is important to have a national hospital rating system like the leapfrog hospital grade system in the US for the public to make choices about which hospital to visit depending on the safety and quality of care; this should also help foster better safety culture for health facilities.

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