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773 Indian experience with patient safety in public health
  1. RK Srivastava1,
  2. Anil Kumar2
  1. 1Former Director General Director General of Health Services, Ministry of Health and Family Welfare, Govt. of India
  2. 2Chief Medical Officer, DGHS, GoI

Abstract

Background Safety of patients in tertiary care hospitals in India was found to be a big problem. 62.9% of unsafe injections are administered every year1 in India. Estimated risk of HCAI is up to 20 times higher than industrialised countries and is approx 10% and 15–30% in acute care. 77% of all reported cases of counterfeit and substandard drugs are from developing countries.

Methods A longitudinal study on patient safety practice in 12 (6 public+6 private) multi-specialty hospitals* was conducted by DGHS from 2005–2011 with objective of identifying, analysing and improving the gaps in hospital patient safety system, so that it is compliant to WHO guidelines on patient safety 2005.The study took up safety practice for hand hygiene, surgery, injection, medication, blood transfusion, infection control and hospital waste management as core areas of hospital patient safety system. Data were collected & analysed annually and at the end of study. It provided for annual gap identification and introduction of corrective measure in each core area and also for system development at end of study in areas of advocacy, infrastructure, capacity building and funding for practice of patient safety in hospitals.

Results This study created a patient safety unit in DGHS, a patient safety committee in the hospitals, a targeted advocacy programme, guidelines for survey and root cause analysis, protocols for safety practice in hospitals, training manuals, standard reporting format for adverse events, supportive monitoring system , and annual and study- end evaluation of outcome in terms of mortality and adverse events . Policy and practice changes like introduction of auto-disable syringe in public health (2009), revision of guidelines for disposal and syringe/needle under bio-medical disposal rules (2010), introduction of antibiotic policy in tertiary hospitals, strengthening of pharmaco-vigilance programme took place during this period. Success stories, reports of hospital, study report and technical report were documented.

Conclusions The study was able to showcase relevance of patient safety system in tertiary hospitals for better quality outcome.

*Safdarjang Hospital, Ram Manohar Lal Hospital, AIIMS, Kalawati Saran Hospital, G. B. Pant Hospital, and GTB Hospital in public Health Sector – 6 National Accreditation Board for Hospital and Healthcare Providers approved private hospitals of Max group

MoHFW – Ministry of Health & Family Welfare

HCAI – Hospital Care Associated Infections

  • (CLEN Program Evaluation Network (IPEN) for Department of Family Welfare, MoHFW)

  • Patient Safety System – The patient safety system involves development of central administrative unit in DGHS
  • control and command unit (patient safety committee) in hospitals
  • advocacy
  • guideline development
  • training
  • practice of hand hygiene
  • surgical safety
  • injection safety
  • infection control
  • blood safety
  • bio-medical waste management and medication safety
  • monitoring and evaluation and documentation

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