WHO flag.

WHO and Global Patient Safety: A View from Across the Pond

By John Tingle

After months of heavy criticism of the World Health Organization, President Donald Trump announced on Friday that the United States would end its relationship with the WHO.

As the organization shoulders sustained disparagement from President Trump, it is worth highlighting the critical work the WHO has done over the years. This post will focus on the role the WHO has played in promoting patient safety around the world and in the United Kingdom National Health Service (NHS) through useful materials and key initiatives.

The Patient Safety Work of WHO

WHO global activity on patient safety has included the Multi-Professional Patient Safety Curriculum Guide (2011), Safe Childbirth Checklist (2015), Surgical Safety Checklist (2009), and The Third WHO Global Patient Safety Challenge: Medication Without Harm (2017). WHO patient safety initiatives have made a valid and valued contribution to the development of an instrinsic patient safety culture in the NHS.

WHO Patient Safety Initiatives and the NHS

A good case study on how WHO patient safety work has positively influenced NHS clinical practice is the WHO Surgical Safety Checklist.

In the introduction to the NHS’s National Safety Standards for Invasive Procedures (NatSSIPs), there is a discussion of the WHO checklist.

“The introduction of the WHO Safer Surgery Checklist was a great step forward in the delivery of safer care for patients undergoing operations. Experience with its use has suggested that the benefits of a checklist approach can be extended beyond surgery towards all invasive procedures performed in hospitals. Experience with it has also made it evident that checklists in themselves cannot be fully effective in protecting patients from adverse incidents.”

While the checklist was a step forward for patient safety, in the NHS clinical context it is not enough, by itself, to change NHS patient safety culture and to make health care safer. Also, when the totality of policies, tools., and products used are examined for improvement effect, patient safety problems such as wrong site surgery may stubbornly persist. A recent report found 218 wrong site surgeries detailed between April 1, 2019 and February, 29 2020 in the NHS.

Global Patient Safety Collaborative (GPSC)

WHO and the UK Government have also entered into a new strategic collaboration towards establishment of the Global Patient Safety Collaborative (GPSC) (2019).

In the GPSC’s own words, the effort “will enable countries to collaborate at global, regional and national levels to focus on patient safety as one of the most important components of health care delivery, essential to achieving U[niversal Health Care] and moving towards U[nited Nations Sustainable Development Goal]s.”

World Patient Safety Day

September 17th, 2019 marked the first-ever World Patient Safety Day. Activities to commemorate the event took place in countries across the globe. This now-annual event is designed to create awareness of patient safety, and creates an opportunity for expressions of commitment to the ideal of patient safety in health care. Planning is now taking place for the second World Patient Safety Day on 17th September 2020.

Conclusion

The patient safety work of WHO has made a positive contribution to developing a safer NHS and safer health care systems around the world. Patient safety tools and checklists by themselves, however, are not enough to deal with persistent patient safety problems such as ‘Never Events’ in surgery. The complex nature of the problems and issues involved in developing an ingrained patient safety culture demonstrate just how critical the continued efforts of the WHO are.

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 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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