The World Health Organization (“WHO”) has declared today, September 17, to be “World Patient Safety Day.” The WHO’s slogan is “Safe health workers, Safe patients.” Clearly, the idea is: safer health workers results in safer patients. Pascal Metrics affirms this truth.

The WHO accompanying “Policy Brief” reminds us that, “Poor well-being and occupational burnout among health workers is associated with poor patient safety outcomes such as medical errors.”1. Further, the Policy Brief clarifies that the stakes are high: “Medical professions are also at higher risk of suicide in all parts of the world.”2. Indeed, healthcare workers consistently see patient harm but often feel powerless to fix these events being overwhelmed and ill-equipped — now exacerbated by COVID-19.

Medical errors and patient harm cause psychological and even physical harm to the caregivers who care for us and our families. The natural question is: why do we expect healthcare workers to find and manually report errors and harm when (i) the evidence shows that this only results in 5% of patient harm being identified and (ii) our healthcare workers were overwhelmed even before the worldwide pandemic?

Policies, committees, educational campaigns, and checklists are needed. But patient harm will remain pervasive — continuing to cause emotional exhaustion and harm to our healthcare workers — until the field moves beyond the “See something, Say something” approach to identifying and reducing safety problems…proactively, consistently, and without the human bias inherent in the event reporting method.

Happily, the WHO, beyond recommending the use of “incident reporting”3 also recommends in Building Block #10 to “Utilize appropriate information systems to assist in the collection, tracking, analysing, reporting and acting upon data to promote health and safety of the health-care workplace and health workforce.”4 [Emphasis added] Unfortunately, too much activity in global patient safety today is neither actionable nor driven by accurate, timely patient-specific safety data.

Indeed, information without the foundation and application of science and medicine in daily patient safety operations is powerless to drive valid change. What is needed states Pascal’s Chief Medical Officer, Dr. David Stockwell, is the practical use of both epidemiology (i.e. “What harm is happening?”) and etiology (i.e. “Why is this happening?”). Without using accurate, timely, and validated adverse event outcomes data to drive an understanding in daily operations of what harm is happening everywhere across all patients, understanding why harm is happening will remain elusive — as will its measurable and material reduction.

Health workers and patients worldwide will be safer in 2021 if healthcare leaders everywhere demanded in 2020 that their organizations measure & manage all-cause harm all the time for all patients in order to know what really is going wrong and why. Only then can we do something about it to keep both patients and their caregivers healthy worldwide.


Footnotes
  1. Policy Brief, page 5.
  2. Ibid.
  3. Ibid, page 8.
  4. Ibid.

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