A conceptual presentation of a abstract published in Health line- The journal of Indian association of preventive and social medicine ,Gujurat chapter,vol-3,March-2012 and also presented at PRISIM-2012, National conference on Hospital management-2012,Organised by ARVIND eye hospital,Madurai. THIS PRESENTATION MAINLY FOCUS ON HOW TO CREATE A CULTURE OF PATIENT SAFETY IN INDIA'S PUBLIC HEALTH CARE INSTITUTIONS BASED ON A NON INTER VENATION EXPLOITATIVE STUDY DESIGN.
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Patient safety .by dr.gyanaranjan
1. Patient Safety In Public Health Care
Institutions
A Conceptual Postmortem
&
Critical Analysis
Clean Care is Safer Care
By.
Dr.Gyanaranjan Pradhan(PGDHM*)
drgyanaranjan@gmail.com
Dr. S.Yasobant (MPH *)
dryasobant@gmail.com
* Pursuing
2. Content To Be Covered
Patient Safety In Public Health Care institutions
Objectives of presentation.
What is patient safety?
Public Heath Care Institutions in India.
Patient Safety and India.
drgyanaranajan@gmail.com dryasobant@gmail.com
3. Content to be covered
Patient Safety In Public Health Care institutions
Conceptual Postmortem of the issue :Factors
Responsible.
Result of Postmortem: Explore Various Dimensions Of Patient
safety.
Critical analysis :Frame Work To Increase Patient Safety
Conclusion.
drgyanaranajan@gmail.com dryasobant@gmail.com
4. Objectives of presentation
Patient Safety In Public Health Care institutions
To know how unsafe our patients are.
Explore the hidden factors of patient safety along
with most common factors
How to create a culture of patient safety
Managerial suggestions to overcome
drgyanaranajan@gmail.com dryasobant@gmail.com
5. How much unsafe our patients are?
Doctors Are More Dangerous than Guns In USA…..
Patient Safety In Public Health Care Institutions
Number of doctor: Number of gun owners:
70,0000 80,000,000
Accidental death due to gun
Accidental death caused :1500
by doctors per year:
120,000
Hence Accident Per Year
Hence Accident Per
Per Gun:0.001875*
Year/Doctor:17.14 *
*Curtsey USA dept. Of Family
Welfare. *Curtsey FBI
Conclusion: Doctors are 9000 times dangerous than Gun
6. How much unsafe our patients are?
Health Care Industry is one of the Risk Industry….
Patient Safety In Public Health Care institutions
Fatal Iatrogenic Blood transfusion
adverse event
Cardiac Surgery
Charted flight
Himalaya
Medical Risk
mountaineering Total Commercial large
jet aviation
Micro light aircraft Road Safety
Railways
Chemical Industry Nuclear Industry
Very un safe ..... Risk ….. Ultra safe
7. What is patient safety?
Do no harm 1st corner stone of medicine…
Patient Safety In Public Health Care institutions
The prevention of errors and consequence
adverse effects to patients associated with health
care . (WHO)
Health care error : At various level ;At various
aspects
From managerial………...To Clinical
Human Cause…………….To Instrumental
Policy Failure ……………...To System failure
drgyanaranajan@gmail.com dryasobant@gmail.com
8. What is patient safety: Various dimensions
Freedom from accidental injury……
Patient Safety In Public Health Care institutions
Medicine error Surgical error
Treatment
Physical enviourment Transfusion (blood
accidents & fluid)
HAI
Diagnostic
Health
care error
Communication Equipment
9. Three tier health Delivery model in India
A great challenge for patient safety
Patient Safety In Public Health Care institutions
242 Medical colleges
205 Dental colleges
3,346 CHC
4,400 DHC
23,236 PHC
1,46,026 Sub centre
Ref.k.Park20th ed.
10. India‘s health care paradox
For why patient safety is a ”?”
Patient Safety In Public Health Care institutions
11. Patient Safety and India: legal aspects
Health to all or safe care to all?
Patient Safety In Public Health Care institutions
No direct legal frame work: Constitution not
provide special right to patients.
Sec-304 0f Indian penal code 1860: Space to complain
against physician for negligence.
IMC professional etiquette and ethics regulation :
Address the issue
Consumer act :Use some time
12. Patient Safety and India : Current scenario
Time to think and progress
Patient Safety In Public Health Care institutions
At corporate /private hospitals: Quite promising but still
need more attention to create patient safety as a culture
Our focus public health care institutions: Not only
disappointing but also a headache for all stake holders
Over burden the system: By increase visit to hospitals, burden
of disease, out pocket and public spending , longer bed occupancy&
queue in OPD.
Reduce faith on public health care system and growth of parallel
market.
Vision gradually turned in to rhetoric or a utopian appeal-because
something lack to
Vision Reality
13. Back ground of study : Just give a overview
Thanks to all who cooperate us
Patient Safety In Public Health Care institutions
Non-interventional-explorative study
design
Total number of public health care
institutions cover:
1.Sub-cetre and Anganwadi: 6
2.PHC:6
3.CHC:4
4:DH:3
drgyanaranajan@gmail.com & dryasobant@gmail.com
14. Postmortem of Patient safety
Funny but a necessary
Patient Safety In Public Health Care institutions
Public health care Institutions
Overburden
Collapsed
Patient safety venerable
Death of patient safety in these organizations
15. Why postmortem: Explore the cause
Not a natural death
Patient Safety In Public Health Care institutions
The death is suspected due to
Individual causes :Health care professionals and other
supportive enviourment
System causes : The health care delivery system and
work process
So there is need to find the exact cause
By
Conceptual postmortem
16. The Procedure of postmortem
should not be biased
– Patient Safety In Public Health Care institutions
Open eye observation:
Silent data collection
Interactingwith various
stake holders of system
Secondary data Sources
drgyanaranajan@gmail.com & dryasobant@gmail.com
17. Findings of Postmortem
You may not belief but true
Patient Safety In Public Health Care institutions
Number of issues :Represents interlinking factors
Various dimensions of factors: Multi facet interaction
Most common highlighted causes : Mask the root
causes, So difficult to Addressed
Already well focused :But seems to be a nightmare.
drgyanaranajan@gmail.com dryasobant@gmail.com
18. Current Scenario :We all know
Valuable clues towards solution
Patient Safety In Public Health Care institutions
19. Critical analysis of Findings
Not criticism but finding
Patient Safety In Public Health Care institutions
Issue-1:Human Resource: It’s dimensions
Beehavioural
Lack
Inadequacy and change and
Competency
Inequitable poor attitude
related to
distribution towards patient
patient safety
safety
Required some special strategy to address
20. Critical analysis of Findings
Only findings are not enough
Patient Safety In Public Health Care institutions
Issue-2.Work Culture: Various dimensions
Lack of team
Un-supportive work Not people
Work Centered
&
enviourment work culture
Leadership
Required some special strategy to address
21. Frame work to increase patient safety
some hopeful suggestion
Patient Safety In Public Health Care institutions
Create a culture of patient safety in public
healthcare institutions: focus on system issues and
individual issues.
De-centralization of organizational structure and streamline
the management process.
The administrative power shifted from medicos to medicos
specialized in healthcare management.
Allotment of resources and its proper distribution
22. Conclusion
Not possible to conclude still we are not achieve the Goal
Patient Safety In Public Health Care institutions
From Too Much Zeal For The New
And Contempt For The Old;
From Putting Knowledge Before Wisdom
Science Before Art
Cleverness Before Commonsense
From Treating Patient As a Case
And
For Making Cure of Disease More Grievous
Than The Endurance Thereof ;
Good lord Deliver Us
By: Robert hutichison
23. Thanks to all
Join Hands Creating a culture of patient safety
Patient Safety In Public Health Care institutions
Special Thanks
To
Prisim-2012
&
You!!!!
drgyanaranjan@gmail.com & dryasobant@gmail.com