Looking Towards 2030 in Patient Safety

By John Tingle

There is a clear need for those charged with patient safety policy making to prepare for the future and to take account of emerging trends. This would be so in any commercial or professional organisation. These issues were addressed in the context of patient safety at the recent,Patient Safety Global Action Summit held in March 2016 in London. The conference was designed to mirror the discussions contained in the report  by NIHR (National Institute for Health Research), Patient Safety Translational Research Centre at Imperial College London and The Imperial College NHS Trust on the priorities and direction that the patient safety movement should follow going towards 2030.

There is a lot that is excellent in this report  which is very rich in analysis and detail. Lots of deep thinking about patient safety issues with interesting and novel ideas expressed on nearly every page.

Emerging threats to patient safety

In the report, in chapter one, it is acknowledged that there are many existing issues at the root of patient harm that have yet to be solved. Also that unfortunately trends in healthcare are likely to increase the risks to safety. The report focuses on four emerging trends:

Increasingly complex cases,

Increasingly complex care,

Budget constraints,

Antimicrobial resistance.

In chapter two there is a discussion on what can be done to thwart or minimise these threats and others .The concept of an Integrated Approach to patient safety is key. The report calls for much more coordinated and joined up thinking and responses to policy actions on patient safety:

“Too often responses have been piecemeal, focusing on one issue and deploying an isolated solution. Health systems need to avoid repeating this mistake and instead employ an approach that is systems-based, focused on culture, patient- and staff-centred and evidence-based.”(p.18)

The first approach considered is the systems approach which today can be seen to underpin NHS patient safety thinking and policy development.

This approach of viewing a health service as a system depending for its proper operation on component parts is very helpful and instructive. The focus is a broad one, rather than focussing on the individual, we focus on the system and this helps good patient safety thinking:

“In patient safety, these sub-parts include provider organisations across different care settings, regulators, policy-makers, and patients.” (p18).

Other ways of dealing with the likely future threats to patient safety are a focus on transforming the culture of an organisation .Organisation should also become more patient and staff-centered. Evidenced based practice should also be paramount.

In chapter three there is a patient safety tool box presented for the next 15 years. The chapter highlights six areas that show great potential to reduce patient harm.

Regulation and governance, leadership, education and training, data and information, digital health and behavioural insights and design.

In chapter four there is a discussion of the importance of global collaboration in patient safety, viewing patient safety from a world stage perspective and the advantages of doing this.

Short term and long term recommendations are made at the end of the report.

Altogether a first class report which will become a focus for patient safety policy development and practice in the future.

John Tingle, Reader in Health Law, Nottingham Law School, Nottingham Trent University, UK

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 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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