Patient Safety: The Urgent Need for Global Information Sharing and Learning

Patient harm is the 14th leading contributor to the global disease burden, according to a new report by WHO, OECD, and the World Bank.

In resource-constrained health care environments, it is important not to reinvent the wheel and waste money when existing, proven patient safety solutions already exist in other countries. Global patient safety knowledge sharing, and learning helps all countries, regardless of income level and this needs to be encouraged.

Global learning and sharing

WHO highlight the need for global sharing and learning at all country levels:

“Ensuring the safety of patients is a high visibility issue for those delivering health care – not just in any single country, but worldwide. The safety of health care is now a major global concern. Services that are unsafe and of low quality lead to diminished health outcomes and even to harm. The experience of countries that are heavily engaged in national efforts clearly demonstrates that, although health systems differ from country to country, many threats to patient safety have similar causes and often similar solutions.”

Some patient safety reports to share globally              

USA

The ECRI Institute in the USA have recently produced a report, listing the top ten patient safety concerns. By identifying these concerns from various patient safety organization data bases and other sources, this information helps organizations meet safety challenges.

The top 10 patient safety concerns in 2019 are:

  1. Diagnostic Stewardship and Test Result Management Using EHRs
  2. Antimicrobial Stewardship in Physician Practices and Aging Services
  3. Burnout and Its Impact on Patient Safety
  4. Patient Safety Concerns Involving Mobile Health
  5. Reducing Discomfort with Behavioral Health
  6. Detecting Changes in a Patient’s Condition
  7. Developing and Maintaining Skills
  8. Early Recognition of Sepsis across the Continuum
  9. Infections from Peripherally Inserted IV Lines
  10. Standardizing Safety Efforts across Large Health Systems.

Canada

The CPSI (Canadian Patient Safety Institute) produce some excellent patient safety resources for the public, providers and leaders which have relevance globally and can be usefully shared.

Public awareness of the patient safety crisis

A recent CPSI report discusses public awareness of the patient safety crisis in Canada and there are several useful findings which have global relevance. Public awareness of patient safety issues was explored to provide a baseline read of understanding. Information was sought to see how Canadians prioritize, experience, understand patient safety. An objective was also to determine how Canadians would like to receive information about patient safety, if at all.

The report states: “In our healthcare system, there is a death from patient harm every 13 minutes and 14 seconds. It is the third leading cause of death in Canada. One out of 18 hospital visits result in preventable harm. These incidents generate an additional $2.75 billion in healthcare treatment costs every year. This level of harm is simply unacceptable.”

Limited public knowledge of the patient safety crisis

The report states that Canadians show limited knowledge of patient harm. One third of Canadians rank patient safety in their top three healthcare priorities, with just under one in ten ranking it first. Six in ten say the $2.75 billion cost of patient safety incidents in Canada is higher than they expected.

The report states that despite the limited knowledge of the patient safety crisis in Canada one in three Canadians have experienced a patient safety incident.

Scotland

Healthcare Improvement Scotland also has lots of useful patient safety reports and information which can be shared globally. They have produced a report on falls and falls with harm in acute hospitals identifying improvement strategies and themes.

The report states that Falls remain a common cause of harm to patients in acute hospitals with as many as 27,000 falls (6.7 per 1,000 occupied bed days) recorded in Scotland every year.

Sharing global patient safety learning should be encouraged. Different global perspectives on patient safety issues can refresh policy making which may become stale and ossified over time.

John Tingle

John Tingle

John Tingle is a regular contributor to the Bill of Health blog. I am a Lecturer in Law, Birmingham Law School, University of Birmingham, UK; and a Visiting Professor of Law, Loyola University Chicago, School of Law. I am also a Patient Safety Specialist at ECRI Institute. I was a Visiting Scholar at Harvard Law School in November 2018 and formerly Associate Professor at Nottingham Law School, Nottingham Trent University in the UK. I have a fortnightly magazine column in the British Journal of Nursing where I focus on patient safety and the legal aspects of nursing and medicine. I have published over 500 articles and a number of leading texts in patient safety and nursing law. My current research interests are in global patient safety, policy and practice, particularly in African health care systems. My most recent publication is: "Global Patient-Safety Law Policy and Practice," edited by John Tingle, Clayton O'Neill, and Morgan Shimwell, Routledge 2018.

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