Dear HIFA colleagues, Thank you for all your contributions to date. Please keep them coming. Please send by email to: hifa@hifaforums.org
You can review previous messages here: www.hifa.org/read
An overview is here: www.hifa.org/patientsafety
Below I have selected verbatim quotes related to Question 1: What is unsafe care and what is its local and global impact?
“Unsafe care occurs when patients are exposed to preventable harm through errors, delays, misdiagnosis, inappropriate treatment, poor communication, medication errors, infection risks, inadequate referral, or failures in follow-up.”
“Patient safety is about so much more than correcting errors. Poor quality care is unsafe care.”
“Around 1 in every 10 patients is harmed in health care and more than 3 million deaths occur annually due to unsafe care.”
"[What does 1 in 10 actually mean?] 1 in every 10 patients per treatment episode? per year? over a lifetime? I have been unable to find a denominator which would make this statistic meaningful.
"If we accept that poor quality care that leads to death must by definition be unsafe, then the actual deaths due to unsafe care are likely to be at least 5 million rather than 3 million."
“People living with NCDs are particularly vulnerable to harm due to the long-term nature of their conditions, ongoing treatment needs and frequent interactions with health systems. This repeated exposure increases the likelihood of harm over time.”
“For people living with NCDs such as hypertension, diabetes, cardiovascular disease, cancer and chronic respiratory diseases, unsafe care can result in avoidable complications, disability, premature death, catastrophic household expenditure and loss of confidence in health services.”
“With some conditions, such as cancer, up to 1 in 3 patients experience adverse events during care. [What is the denominator?]”
"Globally, patient harm is a major public-health problem, particularly in low- and middle-income countries. In West Africa, the consequences are amplified by weak health infrastructure, shortages of skilled personnel, fragmented services and financial barriers. For people living with NCDs — such as hypertension, diabetes, cardiovascular disease, > cancer and chronic respiratory diseases — unsafe care can result in avoidable complications, disability, premature death, catastrophic household expenditure and loss of confidence in health services."
"I hope that by sharing my experience [of a missed diagnosis of epiglottitis] it may help us understand the impact of unsafe care and that it will encourage you to share your experience."
"WHO defines patient safety as 'the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum'. By extension, unsafe care involves the presence of avoidable, preventable harm or the failure to reduce the risk of unnecessary harm during healthcare delivery."
"I asked Copilot 'how many patient safety incidents occur in a doctor's career?' and it answered 'a typical doctor will be involved in hundreds to thousands of patient-safety incidents over a full career. Only a minority of these are due primarily to an error by the doctor."
"In which countries are patients most likely to receive unsafe care? What countries provide the most and least safe care and what are their commonalities?"
"At which level of the health system is unsafe care most likely: in the home or community? among outpatients and the family doctor's clinic? in the emergency room? among inpatients in district or referral hospitals?"
As you can see there are some unanswered questions. Can you help? Further comments are very welcome.
Best wishes, Neil
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org