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Making a Difference in Health Care

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Presentation on theme: "Making a Difference in Health Care"— Presentation transcript:

1 Making a Difference in Health Care
4/9/2017 Making a Difference in Health Care Patient Safety Today NNLM

2 Legislation Issues Malpractice regulations
4/9/2017 Legislation Issues Malpractice regulations Mandatory and/or voluntary reporting Adverse events, hospital acquired infections, etc. Patients Patient notification / Disclosure of events Apologies permitted Staffing issues Pharmaceutical laws Electronic prescription/health records Reporting, Mandatory/Voluntary Patients want disclosure, to know what happened, how consequences will be mitigated, how reoccurrences will be prevented {Gallagher} Apology Six states [since 2003] ... have enacted laws excluding expressions of sympathy (e.g., “I’m sorry that you are hurt”) after accidents as proof of liability. {Cohen} - Note: some states protect both apologies and acknowledgement of fault; others may only protect the apology. NNLM

3 National Legislation National Laws UK Medical Act 1858
4/9/2017 National Legislation National Laws UK Medical Act 1858 National Patient Safety Agency Regulations, 2001 China Regulation on the Handling of Medical Accidents, 2002 Act on Patient Safety in the Danish Health Care System, 2003 US Federal Patient Safety and Quality Improvement Act of 2005 Patientsäkerhetslag 2010 Patient Safety Act NNLM

4 Legislation: USA Electronic Prescription and Health Records Programs
4/9/2017 Legislation: USA Electronic Prescription and Health Records Programs Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003 American Recovery & Reinvestment Act of 2009 The Patient Protection & Affordable Care Act of and Health Care & Education Reconciliation Act of 2010 (Affordable Care Act) Health Information Technology for Economic and Clinical Health Act (HITECH Act) Other laws addressing patient safety issues Medicare – provides for the development of an Electronic Prescription Program leading to Electronic Health Records NNLM

5 International Commitments
4/9/2017 International Commitments Resolutions and Declarations World Health Organization (WHO): Quality of care: patient safety; WHA55.18, 2002 European Commission: Patient safety - making it happen!; Luxembourg Declaration on Patient Safety, 2005 Helsinki Declaration on Patient Safety in Anaesthesiology, 2010 NNLM

6 International Organizations
4/9/2017 International Organizations Agencies, Councils, Institutes The Australian Commission on Safety and Quality in Health Care (ACSQHC), 2000 Danish Society for Patient Safety (DSFP), 2001 UK National Patient Safety Agency (NPSA), 2002 Canadian Patient Safety Institute (CPSI), 2003 WHO World Alliance for Patient Safety, 2004 European Network for Patient Safety (EUNetPaS), 2008 Middle East Regional Network for Patient Safety Culture (PSCMEN), 2010 Centre for Patient Safety, Saudi Arabia, 2013 NCC MERP: independent body comprised of 27 national organizations. NNLM

7 Campaigns National International – World Health Organization
4/9/2017 Campaigns National 1000 Lives plus. National Health Service (NHS) Health/Gesundheit/Santé/Sanità/Sanadad 2020 Norwegian patient safety campaign Sorry Works! Campaign to Educate Patients and Families International – World Health Organization Global Patient Safety Challenges: Clean care is safer care, Safe surgery saves lives High 5s: Standardized Operating Protocols (SOPs), Assuring medication accuracy at transitions in care, Managing concentrated injectable medicines, performance of correct procedure at correct body site Campaigns WHO: NNLM

8 Conferences International
4/9/2017 Conferences International Patient Safety and Quality Congress Middle East, March 2013, Abu Dhabi, UAE Patient Safety Forum 2013, 9-11 April 2013, Saudi Arabia International Forum for Quality and Patient Safety, April 2013, London, UK Patient Safety Congress, May 8-10, 2013, New Orleans, LA, USA International Congress on Patient Safety: Best Practices for Asia, 6-7 September 2013, London, UK Patient Safety Congress, October 2013, Abu Dhabi, UAE 6th Medication Safety Conference, November 2013, Abu Dhabi, UAE NNLM

9 Ongoing Studies Multiple types of studies
4/9/2017 Ongoing Studies Multiple types of studies Medication safety; Nosocomial infection; Patient satisfaction AHRQ Patient Safety Indicators, 2002 AHRQ Patient Safety Culture surveys (Hospital, 2004, Nursing homes, medical offices, retail pharmacies) 41 countries: Spain-2008, Turkey-2009, Saudi Arabia-2009, Lebanon-2010, Iran-2012, Taiwan-2012, Egypt-2012 22 languages University of Texas: Safety Attitudes and Safety Climate Questionnaire, 2006 Dates are of adverse events studies are publication dates; dates of other are introduction dates Patient Safety Culture surveys: Hospital, nursing home, medical office, pharmacy {Sorra} {Sexton} {UTHealth} Indicators: {Drösler} Culture Survey: Spain {Aranaz-Andres}, Turkey {Bodur} , Saudi Arabia {Aboshaiqah 2010}, Lebanon {El-Jardali}, Iran {Tabrischi}, Taiwan {Chen}, Egypt {Aboul-Fotouh} NNLM

10 Our Journey towards Patient Safety
Affra S. Al Shamsi, MScIM

11 The Story of Patient Safety in the Region
Patient Safety in the Eastern Mediterranean Region initiatives by EMRO/WHO The first Regional Meeting on Patient Safety The first intercountry consultation for ‘Developing a Regional Strategy for Patient Safety in EMR countries’ was held from 27 to 30 November 2004 in Kuwait. Patient Safety Friendly Hospital Initiative (PSFHI) PSFHI is a program that aims to instigate and encourage safe health practices in hospitals in the Eastern Mediterranean region (EMR). It represents a collaboration with the World Alliance for Patient Safety (WAPS), the International Islamic Relief Organization (IIRO) and Member States.

12 Strategic Directions for Health Systems in the Gulf Region
Developing health services according to the priorities of each country Setting unified quality systems at the level of the Gulf Region Sustaining and integrating health care at all levels Setting and developing rules and regulations of medical practice Setting and developing the accreditation system for improving medical practice in the Gulf health establishments

13 The Royal Hospital, Department of Quality Management1
The Story of Patient Safety in Oman Our definition of quality Quality is a care that is accessible, safe, effective, patient-centred, timely, equitable, appropriate and efficient. and as main aspect of our Goals to Maximize patient safety and minimize patient and organization risk of adverse events

14 The Royal Hospital, Department of Quality Management2
Strategic Goals Establish and enhance a culture of excellence and patient safety Continuously and incrementally improve the quality of healthcare provided to patients of the Royal Hospital Enhance patient’s experience by exceeding their expectations Improve efficiency by optimizing the usage of facilities and resources Patient safety Quality Culture Data Customer service

15 Patient Centered Care/Culture
Medication error initiative Involve all employees Patient safety work Surgical safety checklist initiative System thinking Surgical site infection initiative Patient Centered Care/Culture Team building Training in risk management

16 Safety Culture Involves Paradigm Shift
OLD Who did it? Focus on bad event -Root Cause Analysis Top down Punish bad behavior NEW What happened? Focus on Near Miss -Failure Modes and Effects Analysis (FMEA) Bottom up Fix broken processes

17 The Royal Hospital, Department of Quality Management 5
The Story of Patient Safety in Oman One of the Critical Success Factors Availability of required resources to effectively maximize the quality improvement initiatives at the Royal Hospital Establish specialized staff including Patient Safety Officer, Medication Safety Officer, Risk Manger and quality specialists.

18 The Royal Hospital, Infection Control Department 2
The Story of Patient Safety in Oman Active prevention of infectious diseases outbreaks Education and training of healthcare workers about infection prevention principles and implementation Development and implementation of strategies and policies on infection, prevention and control Environmental hygiene auditing of clinical areas including kitchen and laundry and following improvements actions Monitoring compliance of Health Care Worker with hand hygiene

19 Ministry of Health, Quality Assurance & Patient Safety Department
Phase III ( ) Developing & launching national patient safety indicators Developing national patient safety standards Phase II ( ) Develop patient safety training schedule Draft patient safety standard Phase I ( ) Situational analysis Assessment of patient safety culture Milestones of the Project The Story of Patient Safety in Oman

20 Project Recommendations 1
Institutional Level: Standardize & computerize incident reporting system for all healthcare institutions Develop & standardize patient safety indicators Establish patient safety auditing system, identifying indicators, making annual plan for the audit Develop patient safety policies & procedures

21 Project Recommendations 2
Governorate Level: Establish patient’s safety structure, including patient safety departments & committees Improve patient safety practice by ensuring adequate resources (personnel) & training Strengthen patient safety environment (e.g. waste disposal & appropriate ventilation)

22 Project Recommendations 3
National Level: Re-activate the National Patient Safety Committee Develop capacity building for patient safety Develop appropriate channel of communicating safety issues to staff as feedback Develop Quality & Patient Safety Websites as networking for all healthcare quality professionals

23 Project Conclusion Improvement in patient safety demands a complex system-wide effort Significant commitment & leadership support is required Establish Prioritization Strategy: including activities that support Mission, Vision, & Value of institutions Prepare the workforce (i.e. Capacity Building)

24 Summary We need: Librarians to be advocates in this field
4/9/2017 Summary We need: Librarians to be advocates in this field To take part in designing health care systems that put safety first To apply the knowledge we already have in patient safety and share it To remember it’s a long, on going process To coordinate between those who are doing patient safety NNLM

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