Geneva’s “Le Jet d’Eau,” the city’s historic fountain, illuminated with a dazzling orange, casting a bright light against the dark Genevan skyline. The 140-meter water display was not just for show; it was in solidarity with the hundreds of millions of patients who have experienced unsafe hospital care, and to commemorate the World Health Organization’s first World Patient Safety Day on Sept. 17, 2019. The WHO, along with 194 countries, will recognize this day every year to promote awareness of patient safety and to urge hospitals worldwide to affirm their commitment to safe health care.
Every year, 134 million adverse events such as unsafe surgical procedures, radiation errors and simple mix-ups with medications occur in hospitals in low and middle-income countries (LMICs), a rate far higher than that observed in higher-income countries (HICs) – even so, one in every 10 patients is harmed while receiving care in these HICs. This unsafe patient care leads to 2.6 million deaths annually, making it one of the 10 leading causes of death and disability in the world. Patient safety-related deaths “lead to losses of trillions of US dollars every year,” even though “most of these deaths are avoidable” (1). According to the WHO Director-General Dr. Tedros Adhanom Ghebreyesu, the world needs “a patient safety culture that promotes partnership with patients, encourages reporting and learning from errors, and creates a blame-free environment where health workers are empowered and trained to reduce errors” (1).
The WHO’s primary goals are clear policies, organizational leadership, research in safety improvements, education of health care professionals and engagement of patients in care (2). To promote global solidarity and worldwide improvements in patient safety, the WHO has encouraged international networking and cooperation through initiatives like the Global Patient Safety Network and the Global Patient Safety Collaborative. The GPSC, which is spearheaded by the WHO and the UK Government, will serve as a learning resource for all WHO Member States (MSs), drawing on input from MSs, WHO regional and country offices, academic and research institutions, professional and civil society organizations, and WHO collaborative centers (3). Current GPSC initiatives include literature and policy reviews, educational electronic resources, international workshops and conferences, and platforms for sharing approaches to improving patient safety (4). The ultimate goal of the GPSC is to provide national governments, particularly those in LMICs, with the knowledge and resources necessary to improve the safety of their health care systems. Medical anthropologist Stephen McIsaac, Ph.D., who teaches Introduction to Global Health and Medicine & Social Justice, praised the patient safety movement’s “acute awareness” of the importance of collaboration with local governments. According to McIsaac, forcibly imposed “top-down” health interventions have proven to be unsustainable throughout the history of global health, and it is essential for countries to eventually make lasting improvements to patient safety practices in health care systems.
Despite the enthusiasm for World Patient Safety Day, it is important to recognize that this movement is still in its early stages. Given the intended goal of creating sustainable, long-lasting solutions, McIsaac stresses the importance of focusing on details and asking questions like “where the money comes from, what money is being spent on, who is making decisions, and what exactly the metrics of patient safety are.” He believes being critically skeptical is key to implementing successful global health initiatives.
“In my research and writing practice, I lean much more towards skepticism of these things, because a lot of the times, when organizations say they’re going to do something to address these big problems, sometimes it feels more surface-level than it should,” McIsaac said. “Since World Patient Day is so new, we don’t really know what’s going to happen with it.”
Furthermore, many still differ in thoughts about what would make patient safety programs most effective, despite the global consensus that the issue is important to address. According to McIsaac, this is why asking critical questions is especially important in addressing the varied, multidisciplinary issues regarding patient safety. This global issue can be seen in local patient safety problems: Missouri’s only abortion clinic, located in St. Louis, was criticized by Governor Mike Parson for having “at least one incident in which patient safety was gravely compromised,” as reported by the Missouri Department of Health and Senior Services (4). In response, Planned Parenthood Federation of America President and CEO Dr. Leana Wen criticized Parson for statements that “are simply not based on medicine, facts, or reality” (5). These conflicting perspectives highlight the importance of discussing the facts on both sides of patient safety, especially because, while patients can suffer unsafe care in abortion clinics, abortion clinics also experience harassment, stalking and death threats. These acts of violence also pose a threat to the safety of patients and care providers, further demonstrating the need to analyze every facet of the issue to promote a safer patient care environment. McIsaac extends this concern to the global patient safety movement, citing a need to be “thorough, rigorous and detailed” when critically examining different patient safety cases.
“Real powerful global health happens when we really pay attention to the details,” McIsaac said. “I feel excited about the possibility that this movement will localize interventions and ask more intimate, critical questions about what’s going on and what can be done to make long-lasting improvements in patient safety.”
Edited by: Heather Chung
Illustrated by: Noor Ghanam