Making a Difference in Health Care

1. Making a Difference in Health Care Patient Safety Today http://nnlm.gov/training/patientsafety/global.html

2. LegislationIssues • 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

3. 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

4. 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 2010 and Health Care & Education Reconciliation Act of 2010 (Affordable Care Act) • Health Information Technology for Economic and Clinical Health Act (HITECH Act)

5. 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

6. 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

7. Campaigns • National • 1000 Lives plus. National Health Service (NHS) • Health/Gesundheit/Santé/Sanità/Sanadad2020 • 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

8. Conferences International • Patient Safety and Quality Congress Middle East, 24-27 March 2013, Abu Dhabi, UAE • Patient Safety Forum 2013, 9-11 April 2013, Saudi Arabia • International Forum for Quality and Patient Safety, 16-19 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, 27-29 October 2013, Abu Dhabi, UAE • 6th Medication Safety Conference, 22-24 November 2013, Abu Dhabi, UAE

9. 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

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

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

15. Patient safety work

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

17. The Royal Hospital,Department of Quality Management5 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 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 • 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 http://nnlm.gov/training/patientsafety/global.html