Health worker safety deserves a second look

Health worker safety deserves a second look

World Patient Safety Day (September 17th):

• The World Health Organization observes World Patient Safety Day on September 17th every year.
• The day is celebrated to highlight the issue of harm in health-care settings.
• The theme for 2020 was ‘Health Worker Safety: A Priority for Patient Safety’ with a call to action to ‘Speak up for health worker safety’

Harm in health-care settings:

The world over, one in 10 patients experiences or is subject to harm in health-care settings.

Indian situation:

• More than 2/3rd of injections are given in an unsafe manner.
• Over 2/3rd of injections in primary care are unnecessary in the first place.
• Much harm done to patients is because of unsafe health-care practice and unsafe health-care communication.

Unsafe health-care practice

• Unsafe health-care practice refers to unsafe or unnecessary procedures, wrong medications, medications given in a wrong dosage, etc.

Unsafe health-care communication

• Unsafe health-care communication refers to mistakes made in health-care settings due to miscommunication between health professionals.

Why is health worker safety important for patient safety?

• The quality of both practice and communication is dependent on the safety and well-being of health workers.
• For example, health workers who have been on duty for more than 24 hours at a stretch, have a higher risk of making mistakes.
• During the current pandemic situation, health workers’ physical and mental health are being affected due to long work hours under increasingly difficult circumstances.
• The mental health of health workers is linked to workplace culture.

Impacts of COVID-19:

• At instances of patient harm, whether health workers report them or not depend on the organisation’s culture and leadership.
• Reporting helps prevent similar future occurrences.
• Power differences can further prevent reporting and cooperative organisational learning and may increase chances of verbal, physical, emotional and sexual abuse.
• In India, many health-care organisations observe strict hierarchies between specialties, between designations.

Issues:

• India simply does not have enough health facilities to cater to all its population, even without a pandemic.
• Additionally, there is a lack of adequate social care, such as care homes, community health services and community-based rehabilitative and palliative services.
• Lack of health facilities and overcrowding unduly increase the burden on health-care facilities.
• Numerous persons find healing and restoration in health care, but some are harmed as well. In crises such as COVID-19, quality of care can be compromised further.

Way ahead:

• Organisational learning is more important than individual learning because instances of patient harm are often an end result of a chain of organisational failures.
• Moreover, good systems can mitigate the effects of individual mistakes.
• Creating sustainability would involve taking a systems approach to make sure all parts of the system, both of health care and of supportive social care are well functioning.
• There is a need for a systems approach with the involvement of all stakeholders.
• Patients themselves need to be aware of patient safety and be empowered to demand safe health care, resist unnecessary medications and procedures.
• Systems of reporting, monitoring and organisational learning need to be created.
• Policymakers must prioritise staffing, co-designing functional and safe workplaces, and ethics in health care.
• There is a need for the promotion of a culture of health worker safety and well-being to ensure patient safety.