Health workers’ safety comes first while ensuring patient safety

While experts termed safety for health care providers (HCPs) as a major requirement for ensuring patient safety, the Covid-19 pandemic has unveiled the huge challenges and risks the professionals in the country are facing including healthcare associated infections, violence, stigma, psychological and emotional disturbances, illness, and even death.

The sad part is although a national plan has already been formulated, that remains in paper and speech not in reality. This has demotivated the HCPs and affected safety of patients as well, experts have opined.

Bangladesh will observe World Patient Safety Day on Thursday.

The National Strategic Plan for Patient Safety in Bangladesh was developed in 2018 by the Quality Improvement Secretariat of Health Economics Unit under the Health Services Division. 

The national plan was formulated following the World Health Organization urging its member countries to ensure patient safety on a priority basis.

The pandemic unveiling lackings

However, health authorities primarily failed to ensure safety for the HCPs which caused a huge number of them to be infected in the primary stage causing mistrust among patients and doctors, said Bangladesh Medical Association (BMA) Secretary General Dr Ehteshamul Haque Chowdhury.

According to Bangladesh Medical Association (BMA), around 7,963 healthcare professionals including physicians, nurses, technologists, technicians and other staff members got infected by the novel coronavirus.

When a pandemic emerges, a temporary but effective system has to be formed to protect the doctors and to provide quality services at their highest capacity. However, the authorities were not able to provide PPEs on time and many measures like triage could not be taken timely.

With the interference of the head of the government the system somewhat came to a tolerable situation but still the safety of the healthcare professionals is still at risk. None of the ICUs (except in CMH) have ensured negative pressure (necessary to reroute infected air) which puts the HCPs into risks.

“This means we failed to bring effective technological upgradation as well,” Dr Ehteshamul added. 

The medical professional leader said besides medical, personal, and technical safety there is another matter that is never to be forgotten – the physical safety. 

“We often see that without understanding medical issues, the relatives of the patients physically abuse the doctors and others. However, the issue is mostly related to the healthcare managers not the doctors,” he said.

Bangladesh Medical Association (BMA) former president, also Bangladesh Health Rights Movement Chairman Dr Rashid E Mahbub said if HCPs safety can be ensured, the errors at the facilities happening while providing services will decrease.

His observation matched what BMA Secretary General Dr Ehteshamul Haque Chowdhury mentioned, and added that it is not the Health Ministry who is solely responsible for ensuring their safety.

The patients who are coming for the services should be honest about their medical history so that the HCPs can also assess the risk as well, he said.

Recognizing the problems Virologist Prof Nazrul Islam, a member of the National Technical Advisory Committee (NTAC), said the Health Ministry failed to ensure safety for the healthcare professionals primarily during the Covid-19 pandemic.

The situation improved later on and now the number of HCPs being infected is very low, he added.

The pandemic has exposed the issues in ensuring safety for the doctors that is happening over the years and causing a serious problem in ensuring patient safety, he said, adding that the national plan needs to be implemented, specially the provisions of the committees – Medicines Management Governance Committees, Infection Control Committees and so on.

WHO celebrating World Patient Safety Day 

WHO and its member countries are observing the day throughout the world to send the message to the health care professionals, its managers, patients and all others to act responsibly to ensure patient safety.

In the 55th World Health Assembly on 18 May, 2002, they adopted a resolution - Quality of care: patient safety - where WHO urged all countries to ensure it in their countries. 

Recognizing patient safety as a global health priority, WHO in May 2019 decided to observe World Patient Safety Day on 17 September.

The theme for this year is “Health Worker Safety: A Priority for Patient Safety.”

Directorate General of Health Services (DGHS) will also observe the day and will arrange discussion meetings and send messages to its units to observe the day without making any gatherings during the pandemic. 

Key facts on Patient safety (Source WHO)

• The occurrence of adverse events due to unsafe care is likely one of the 10 leading causes of death and disability in the world.

• In high-income countries, it is estimated that one in every 10 patients is harmed while receiving hospital care. 

• Each year, 134 million adverse events occur in hospitals in low- and middle-income countries (LMICs), due to unsafe care, resulting in 2.6 million deaths.

• Another study has estimated that around two-thirds of all adverse events resulting from unsafe care, and the years lost to disability and death (known as disability adjusted life years, or DALYs) occur in LMICs.

• Globally, as many as four in 10 patients are harmed in primary and outpatient health care. Up to 80% of harm is preventable. The most detrimental errors are related to diagnosis, prescription, and the use of medicines.

• In OECD (Organization for Economic Co-operation and Development) countries, 15% of total hospital activity and expenditure is a direct result of adverse events.

• Investments in reducing patient harm can lead to significant financial savings, and more importantly better patient outcomes.