I am glad that Armand agrees that medical error should be viewed from the system aspect even though the individual practitioner's responsibility needs to be taken into account.
The 'to err is human' paper says the same just like other recent seminal papers on quality and safety in health, like the 'crossing the quality chasm' paper (2001, IOM) and 'clinical governance' (1998, NHS UK).
In the 12-Pillars Clinical Governance version in Nigeria since 2004, we emphasise that a strong health system (fulfilling SEISMIC [*see note below]) helps practitioners to reduce avoidable error. The additional 5-Pillars are added to remind policy makers that a strong system ensures that facilities are ready at every level of care (primary, secondary, tertiary).
Africa Center for Clin Gov Research & Patient Safety
@ HRI West Africa Group - HRI WA
Consultants in Clinical Governance Implementation
Publisher: Health and Medical Journals
8 Amaku Street Housing Estate, Calabar
Cross River State, Nigeria
HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: www.hriwestafrica.com Joseph is a member of the HIFA Steering Group: http://www.hifa.org/people/steering-group
jneana AT yahoo.co.uk
[*Note from HIFA moderator (Neil PW): Joseph refers to the seven SEISMIC Needs of healthcare providers, as described on the HIFA website:
Healthcare providers can only function effectively if their own basic professional needs are met. These needs may be summarised as:
- Structural support
- Communication facilities.
This spells the acronym SEISMIC - a seismic shift is needed to address the needs of front-line healthcare providers in low-income countries. For too long their needs have been ignored.