PATIENT SAFETY : The WHO International Conceptual Patient Safety (ICPS) framework

PATIENT SAFETY : The WHO International Conceptual Patient Safety (ICPS) framework

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Patients can be harmed from health care, resulting in permanent injury, increased lengths of stay in hospital and even death. Adverse events can occur not because people intentionally hurt patients, but rather due to the complexity of health-care systems where treatment and care depend on many factors, in addition to the competence of health-care providers. When so many and varied types of health-care providers, such as dentists, dieticians, doctors, midwives, nurses, surgeons, pharmacists, social workers, and others are involved, it can be difficult to ensure safe care, unless the system is designed to facilitate the delivery of quality and safe services.

What is Patient Safety?

"A discipline in the health-care sector that applies safety science methods towards the goal of achieving a trust worthy system of health-care delivery Patient safety is also an attribute of health-care systems, it minimizes the incidence and impact of, and maximizes recovery from adverse events." "Adverse events include missed and delayed diagnoses, mistakes during treatment, medication mistakes, delayed reporting of results, miscommunications during transfers and transitions in care, inadequate postoperative care, mistaken identity and others. Patient safety is an issue in all countries that deliver health services, whether these services are privately commissioned or funded by the government.

In developing countries, the poor state of infrastructure and equipment, unreliable supply and quality of drugs, shortcomings in infection control and waste management, poor performance of personnel, low motivation or insufficient skills and severe under-financing of the health services makes the probability of adverse events much higher.

• Many of the features of patient safety programs do not require financial resources, but rather the commitment of individuals to practise  safely procedures, learning from errors and communicating effectively within the health-care team.

• Such simple activities can help minimize costs, while minimizing the harm caused to patients too.

• Reporting and analysis of errors can help identify the contributing factors.

Understanding the factors that lead to errors is essential in order to develop changes that will prevent future errors.

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Challenges related to unsafe care can be categorized into:

Unsafe medical care, eg unsafe medication, injection practices, unsafe blood practices, health care associated infection, unsafe care related to mothers and neonates or the elderly patient falls Structural factors contributing to unsafe care, such as no regulation or accreditation, no culture of safety, poor training and education of health-care workers (HCW), environment pressures . Poor processes contributing to unsafe care, such as misdiagnosis, poor test • follow-up, counterfeit drugs, poor involvement of patients in their care.

Blame culture :

"Blaming" in health care is common for resolving problems, referred to as the blame culture"

It is human nature to blame someone . It is a human belief that punitive action sends a message to others that errors are unacceptable and that those who make them will be punished. This assumption is based on a belief that the offender somehow chose to make the error instead of adopting the correct procedure.

• Health-care providers accept responsibility for their actions as part of their training and code of practice. It is easier to attribute legal responsibility for an accident to the mistakes or misconduct of those in direct control of the treatment than to those at managerial level. Errors have multiple causes.

• These are: personal, task-related, situational and organizational. Within a skilled, experienced and well-intentioned workforce, situations are more amenable to improvement than people.

Organizations that place a premium on safety, examine all aspects of their system in the event of an accident, including equipment design, procedures, training and organizational features.

• Almost 80% of errors or adverse events are system derived. conceptual model of patient safety: It divides health care systems into the

following four main domains:

1. those who work in health care.

2. those who receive health care or have a stake in its availability;

3. the infrastructure of systems for therapeutic interventions (health-care delivery processes).

4. methods for feedback and continuous improvement.

The WHO International Conceptual Patient Safety (ICPS) framework

 The ICPS conceptual framework addresses 48 key concepts and preferred terms. All their the and the the factors rather when an evidence-based many parts that interrelate produce journey that patients make through this system is necessary in understanding how failures arise. Important information incorrect, leading to inadequate care or errors.

 Be aware of the importance of self-care: Health-care providers should be responsible for their own well-being and that of their Act ethically every day: Health-care providers should be aware of their legal and ethical obligations to put the interests of their patients first.

The delivery of safe health care The success of patient's care depends on understanding the entire health system available to that particular patient. An of systems  will help the health-care providers appreciate how different parts of the health system are connected and how continuity of care for the patient is dependent on all parts of the system communicating in an effective and timely manner.