"Some good news is that in 2019 the World Health Organization (WHO) recognized patient safety as a global health priority and the 72nd World Health Assembly adopted a resolution on “Global action on patient safety” so there are now realistic steps that we can all take to improve patient safety." ~ Ariana Longley, MPH
World Patient Safety Day brings together patients, families, caregivers, communities, health workers, healthcare leaders, and policy-makers to show their commitment to #PatientSafety. We're excited to share our conversation with global patient safety leader Ariana Longley, MPH ,and the 🧠 & expertise of Beth Wangigi, MPH from our medical partner African Mission Healthcare as we move toward building real, lasting solutions that will save millions of lives each year. ⤵️
Q: Unsafe and poor-quality healthcare affects far too many people in the world with staggering economic and human cost. Yet, this is almost entirely preventable. What steps can we take to make patient safety more of a priority among the broader global health community and in hospitals around the world?
First, connect with the issue on a human level
One of my favorite ways of understanding the gravity of the issue is hearing it directly from patients. There are hundreds of patient stories that have been shared about lapses in patient safety. In my previous role at the Patient Safety Movement Foundation, I had the opportunity to meet dozens of families who experienced preventable adverse events that resulted in temporary injury, long-term harm, and in many cases the loss of a loved one’s life. We worked to capture their stories - from preventable infections and medication errors to maternal and mental health issues. I’d encourage you to read and watch some of the stories to humanize this issue. Here is one YouTube playlist with stories directly from patients that you can watch to help you connect real faces to the issue and help you see this is a very real problem, with oftentimes very clear solutions to prevent them from happening again.
Second, understand the current landscape of patient safety
The statistics are staggering. It is estimated that as many as four in 10 patients are harmed in primary and outpatient care and 80% of those harms are preventable. Even in high-income countries, one in 10 patients is harmed while seeking care in a hospital and 50% of those events are preventable. It’s a problem that affects all patients but those that are marginalized are often affected at higher rates.
Some good news is that in 2019 the World Health Organization (WHO) recognized patient safety as a global health priority and the 72nd World Health Assembly adopted a resolution on “Global action on patient safety” so there are now realistic steps that we can all take to improve patient safety. World Patient Safety Day was also designated as one of the WHO’s 12 official global health days celebrated each year, taking place the 17th of September each year.
Third, take part in global campaigns
The WHO encourages individuals and institutions to take an online pledge as well as organize World Patient Safety Day events and share their plans. I encourage anyone who is reading this blog post and made it this far to get involved in the WHO’s World Patient Safety Day campaign. It is a great way to raise awareness, get engaged, and feel empowered as a current or future patient. I encourage you to check out the 2022 World Patient Safety Day webpage and take the pledge based on your role here!
Lastly, identify your role in the Global Patient Safety Action Plan
Following the 2019 WHO resolution, the Global Patient Safety Action Plan 2021-2030 was released. It calls on all stakeholder groups - governments, healthcare facilities, and services, nongovernmental organizations, patients and patient organizations, professional bodies, scientific associations, academic and research institutions, and civil society organizations - to take specific actions to help prioritize patient safety. Understandably, in the past few years the focus shifted to the global pandemic so World Patient Safety Day is an excellent opportunity to remind the global health community - administrators and front-line workers to patients and family members - that there is a plan and they can be part of the solution. The 2021-2030 plan provides a strategic direction for concrete actions to be taken by all stakeholder groups so if you haven’t explored it yet I would recommend diving in. The next thing you can do is look up what stakeholder group you belong to and identify the actions you can take personally and what opportunities exist if you represent an organization that plays a role in keeping patients safe. Don’t forget that patients are stakeholders so I truly believe everyone reading this has a step they can take! You can download it and read more about the background here.
Q: As anyone who has gone through treatment in a hospital for themselves or a family member has likely experienced, healthcare systems are notoriously difficult to navigate. In all corners of the world, this results in essential healthcare that is delayed or skipped altogether by people in need. And when patients do go forward with care, the complexity of accessing it creates risks of insufficient, incomplete, or even harmful treatment. How can our healthcare systems of the future simplify access and support patients comprehensively through the entire care process?
According to a 2015 Lancet publication, over 4.8 billion people of the world's population, do not have access to safe surgery. And, there has not been a significant change in that statistic since that study was published 7 years ago so accessibility to care remains a major challenge that our healthcare leaders need to address eminently. (Interested to learn how Watsi is solving this major challenge? Learn more here.)
We have to radically rethink the healthcare system in order to chip away at the accessibility and support issues we see. Our healthcare leaders, alongside patients and family members, should rethink where care is delivered, who delivers the care, and how that care is delivered. No country has perfected care delivery - certainly, some do it better than others. But when it comes to safe, accessible, and supportive care, we have a long way to go!
So many systems are so broken that they may be beyond repair, yet the optimist in me sees an opportunity to re-envision a vastly safer healthcare system - no matter whether you’re in downtown L.A. or Bangkok. I manage the Patient Safety Technology Challenge funded by the Jewish Healthcare Foundation and hosted by the Pittsburgh Regional Health Initiative which is challenging students - our future healthcare leaders - to think about how to re-imagine accessibility and support through the lens of patient safety. You can learn more here.
Think about how aviation has made it so easy to get from point A to point B, even if you’re not a frequent flier. I would encourage our healthcare leaders to reflect on the ways that other industries - like aviation - engage their customers and translate those learnings into more supportive care.
If you took your first commercial flight ✈️ in 2022, you’d receive communications from your airline in advance with resources to provide you with the support you needed to get onto the plane you purchased a ticket for. And, if you had questions there’d be someone you could call to answer all your questions, for free. Those resources would likely include educating you on when to check in, where to check in, what to expect when you arrive at the airport, how to check your bags, what to expect at the security checkpoint, and what time the gate closes so you don’t arrive after the door has closed but before the time the plane departs. The airlines also ensure that once you’re on the plane en route to your destination that you are made aware of the safety features of the plane, such as: where the exits are, where to find the oxygen masks and your life preservers. They give you additional information if you’re in an exit row to make sure you can help in case of emergency. All of this to say, the airline industry has made it as easy as possible to get on your plane and arrive at your destination safely. The same is far less frequently true in healthcare and I’d love for our current and future healthcare leaders to think about how we can provide more communication and support so that patients and their family members or advocates are well prepared for their visit, treatment, and follow-up care.
My last reflection on this topic is that the future healthcare systems across the world will begin to solve some of these major challenges - like accessibility and support - when they begin to treat patients as partners and important members of the care team.
We do a pretty poor job in healthcare listening to patients and family members and viewing them as active members of the care team. The power dynamic is so strong that it is difficult for patients and family members to feel like they have the right to be able to speak up.
Patients and family members have grown up in the “Trust me, I’m a doctor” culture. Until we grow out of this notion, with the help of medical professionals who value patient and family engagement, I believe we’ll make little progress.
Patients and family members play so much more of a role than passively receiving care. In order to do that we have to value the voices of patients, their family members, and frontline health workers who are desperate to deliver safe, high-quality care but are too overworked and burned out to do so. There is hope and we need our amazing doctors who know the value of the patient and family voice to help.
Q: At Watsi we've seen C-sections and maternal & newborn care as one of our medical partners' fastest-growing needs, especially since the onset of the pandemic. It is clear that this critical healthcare for moms and babies cannot wait and is truly life-saving. How can we accelerate progress toward ensuring safe maternal and newborn care for those most in need, particularly around moments of childbirth?
Education, education, and education.
Expectant mothers are an amazing and unique set of patients who traditionally try to learn as much as they can about how they can prepare for the arrival of their precious baby and are often more engaged in education around their care so they can bring the healthiest baby into the world. One way to accelerate progress toward greater safety among this patient population is to educate and empower mothers and their support networks about some of the leading causes of maternal mortality that can be prevented and provide tools for what they can do to prevent or mitigate them if they have symptoms.
The leading causes of preventable patient harm and death among this population include postpartum hemorrhage, pre-eclampsia, and unnecessary C-sections. Postpartum hemorrhage can occur in the first 24 hours of labor and up to 12 weeks after delivery so educating patients about the risks can make a huge difference and help them seek care earlier. Hypertension is associated with pre-eclampsia so there is specific education that can be delivered to mothers and their support networks to help identify hypertension between 20 weeks of pregnancy and less than 4 weeks after delivery. Lastly, C-sections in many scenarios can be a life-saving procedure - for both mother and baby - and are underutilized in many countries due to a lack of adequate facilities to perform the surgery as well as a lack of trained professionals to perform the surgery. However, in other countries, C-sections are being overperformed and create downstream problems, like placenta accreta, for mothers who go on to have another pregnancy. So these three topics, in particular, can be great targets for the education of expectant mothers and the people who will support them perinatally.
Q: It is encouraging to see that targeted investments in reducing patient harm can improve patient outcomes and lead to significant financial savings. What innovation(s) or initiative(s) have you been impressed with that are positively contributing to improved patient safety?
My favorite example of a patient safety innovation that has made a measurable impact has been hospital-acquired pneumonia prevention by engaging nurses' initiative, also known as HAPPEN.
A group of nurses in 2016 at the Salem VA Medical Center noticed that with increased oral hygiene the rate of hospital-acquired pneumonia went down significantly in their patient population. The nurses worked together and assembled oral care kits that cost between $3-5 per patient and only added two minutes of direct care by a nurse or nursing assistant when the kit was deployed.
When they implemented this they were able to decrease their pneumonia rates by up to 60% and for each infection avoided they saved $40,000. They saw such a significant impact for the small time and financial investment that this gained attention and the VA rolled this out to every VA hospital in the nation. The VA now estimates that over $200 million will be saved every year, as well as countless lives. This is such a beautiful example of front-line nurses identifying a simple solution to a costly problem that was able to impact an entire health system and is being applied across other healthcare systems with success. You can learn more about the HAPPEN initiative here.
What ideas do you have for making healthcare safer for all? Join the conversation on our social channels today & spread the word.
The Watsi Team
Everyone deserves healthcare.