MOST IMPORTANT ASPECT OF HEALTHCARE SERVICES OFFERED AT HOSPITALS: PATIENT SAFETY
The title frightened you, isn't it? You may never actually know the severity of threat, if patient safety is not duly monitored and managed by the administration of the hospital where you let save your life. Presentation of healthcare services and hospital processes is really complex. How safe is healthcare service period, ranging from the moment you step in the hospital to the moment you leave, for you? Or, what are factors threatening you even after you leave?
One should consider three components in order to maximize service processes of hospitals;
- Are all phases of service or processes standardized?
- Are employees duly qualified?
- Physical conditions of the hospital
Are all phases of service or processes standardized?
Healthcare service delivery is associated with particular risks which shall not be overcome solely by skills, knowledge and desire of employees. Therefore, it is necessary to standardize what will be done by who and how? In simplest term, standard implies agreed and repeatable way of doing something. We may give following example to adapt the term to hospital services,
Procedure: measuring blood pressure. It sounds very simple, isn't it? However, even this simple procedure should be standardized in order to ensure safety. Healthcare professionals, pre-procedural preparation stages and pre- and post-procedural processes should have been standardized and authorized personnel should be trained.
Does doctor, nurse, healthcare technician or other personnel authorized by administration wash hands before starting measurement or does measurement follow time requirements (resting for minimum 30 minutes before measurement, avoiding smoking within last half an hour etc.)? Is size of cuff appropriate? Are results duly evaluated? Are physiological ranges determined? Is physician informed about results which are outside safe ranges?
If healthcare professional only writes the result, 200/140 mmHg, to the medical chart, it is possible facing adverse effects ranging from cerebral hemorrhage to stroke and heart crisis.
As it is clearly understood, there are many qualifications of blood pressure measurement which is among simplest healthcare procedures.
Are employees duly qualified?
Yes, diploma is a requirement for healthcare professionals and we are all graduates of schools which offer education and training in relevant field. It is not possible to think about a doctor and nurse without diploma. Some occupations do not require diploma; if you have a good voice, you may be a singer after you have brief training. Or, you can be actor or actress, if you are talented? However, this is not possible for occupations requiring qualification
Diploma is only the first step to the occupation. A physician, for example a Gynecologist & Obstetrician, should have extra training for in vitro fertilization procedures. Or, a nurse should have many extra training for being critical care nurse, including but not limited to resuscitation training.
How are physical conditions of the hospital?
Considering safety of patient, physical structure of hospital is as important as standardized healthcare service and qualified personnel. Usually, patient has minimum knowledge on this aspect of hospital services. How safe is hospital building?
It is obvious that relaxing and peaceful environment has healing effect on human. When do we visit hospitals? Excluding routine visits, we usually visit hospitals when we have a health problem. Recently, the term "healing hospital" is introduced into the healthcare sector. This concept implies buildings which make contributions to healing process based on architectural and environmental features beyond treatment and care of the patient.
Well heated, well illuminated, peaceful, and calm environment, landscape arrangements or even a calming music and comfortable waiting units have positive effects on recovery intent and process, as demonstrated by many scientific studies. Remember what Claude Monnet said: "beauty has healing effect
In addition to architectural characteristics of hospital building, it is necessary to manage actual threats to patients and employees. We have many hazardous gases at hospital, including our Oxygen, our Nitrogen protoxide, our carbon dioxide or Nitrogen and even, we have our Helium.
Are we totally sure that they are safely stored, they are duly manufactured and they flow in pipes at appropriate pressure? Is fire risk managed? Is the building equipped with fire safety systems? Are wastes sorted? Is infection control sufficient? Are treatment and transfer stretches safe? We can many more questions.
Those three components, namely defined and standardized service and operation processes, qualified personnel and safe building, form principal structure of pat safety. If service delivery is not defined or employees are not duly trained, it may lead to medical error in the simplest term. If physicians handwrites drugs rather than using digital entry, nurse misread orders and administer wrong dose.
If high-risk drugs are not identified and if they are checked by single nurse rather than jointly checked by two nurses, the procedure will be prone to error. If verbal communication is preferred by healthcare professionals and if patient is not safely and duly identified before doing a procedure, a medical error can be seen.
A report, issued by Institute of Medicine (IOM) in 1999, demonstrated how serious the extent of medical errors is. According to the report, approx 44000 to 98000 people die due to medical errors in the U.S. Moreover, it is reported that number of deaths secondary to medical errors is four times higher than that of traffic accidents in the U.S.
Various managerial processes are developed worldwide in order to eliminate threats originating from hospitals. The most commonly recognized one is JCI (Joint Commission International) accreditation. Representing one of most creditable instruments in terms of patient safety, JCI accreditation of TOBB ETU Hospital is renewed for three times. Among all aspects of healthcare service delivery, patient safety is duly prioritized by TOBB ETU Hospital.
I congratulate all my colleagues for their contributions to renewal of our accreditation.
DO YOU KNOW THAT
- Medical error is the fifth leading cause of death,
- Medical error is highly prevalent in the U.S., Canada and U.K.,
- Approximately 250.000 people die due to medical errors in every year in the U.S.,
- Number of medical error lawsuits increases in our country