Cahocon 2019 highlights need for patient safetyJune 9, 2019
The quality of service provided by healthcare providers and the related issue of patient safety is a major concern of hospital managements around the country. Mistakes in the treatment and healthcare services can not only affect the well-being of individual patients and their families but also create a trust deficit between the healthcare provider and the service consumers.
To discuss these questions and to seek ways and means to minimize errors at various levels, senior management executives of leading Indian hospitals got together in Mumbai at the 5th national conference of CAHO (Consortium of Accredited Healthcare Organizations). These are hospitals and healthcare organisations that have obtained an accreditation from the NABH (National Board of Accreditation of Hospitals), a quasi-official certification body functioning under the aegis of the Quality Council of India (QCI).
The NABH, which was established in 2005-06, offers accreditation at two levels: An entry-level certificate and full-accreditation. The entry level certification was instituted along the way when NABH leaders realised that many hospitals were unable to meet the criteria for full-accreditation at the start.
Discussing the healthcare scenario before the accreditation system was set up in India, Air Marshal (Dr) Pawan Kapoor, vice chairman, RUS Education and vice chancellor, Lincoln American University stated that awareness of quality issues in healthcare arose when Consumer Protection Act 1986 was made applicable to doctors and hospitals. Till then, mistakes and mishaps involving clinicians were carefully hidden with the express purpose of protecting healthcare practitioners from being blamed for patient death or injury.
At present, about 600 large and medium healthcare institutions, along with about 218 small hospitals, have been able to obtain the entry-level certification from NABH, Air Marshal Kapoor said. He also provided extensive statistical data on improvements recorded in accredited hospitals in terms of fewer mistakes, better patient outcomes and so on.
A highlight of the recent CAHO conference was the launch of entry level certification by the National Accreditation Board for Laboratories (NABL), which is a sister organization of NABH. Currently, about 1,100 pathology labs have obtained the full accreditation from NABL, which is a really small number compared with the total of about 50,000 to 80,000 laboratories present inall over the country.
The NABL has not only launched a number of schemes to enable small laboratories to join the accreditation system, but is also getting ready to include the hundreds of radiology and imaging laboratories under its ambit.
Dwelling on the impact of errors in patient care, Dr Krishnan Sankaranayaranan, Patient Safety Officer, with Tawam Hospital in Abu Dhabi, pointed out that the healthcare workers responsible for a serious error wasare often impacted almost as severely as the patient concerned. In international literature, this is being described as “becoming the second victim”, the first victim of the mistake being the affected patient.
Dr Krishnan emphasized that the second victim could suffer severe depression and even denial of the responsibility, and later self-doubt and a loss of self-confidence. There have been many instances where such a healthcare professional might move to a less stressful department in the hospital, or in extreme cases move away from the healthcare profession completely, he said.
Dr Sanjay Oak, who has held a number of top positions in public health and education, including that of vice chancellor of D Y Patil University, Navi Mumbai, pointed out that there were several gaps in the way medical education was imparted in most medical colleges. He said there was an urgent need for modern teaching methods, including simulation modules, that could allow the students to appreciate both the structure and the functioning of the human body without endangering an actual human being.