Safety is an integral part of Quality Care in Medicine. As such it intersects with and is interdependent on other parts of efficiency, efficacy and most critically equity. measures among others. Patient centeredness and integration of the parts being a foundation for the enhancement..
The consequential chasm between the "What is" and "What is possible" (ie improvement?) is crossed through a recognition of (a) the existing chasm and (b) equitable awareness of the different parts as a whole.
My reference to "agency" of patients engages this direction for a paradigm shift, in Patient Safety, from the traditional "bench to bedside" to "bench to bedside to communities" model as succinctly explained in the recent Lancet Lecture by Victor J Dzau, president of the National Academies of Sciences, Engineering and Medicine, the Academy of Medicine being formerly known as the IOM.*
Richard's reference to the "new" rules of engagement and related dimensions of Clinical Governance - I believe - are focused on enrichment of the traditional model while the reference to recognition of patients; agency suggests a roadmap for equity for enhancing the disciplinary field.
Esha Ray Chaudhuri
Calgary,Canada
*The Lancet. Lecture.| VOLUME 400, ISSUE 10361 P1481-1486.October
22,2022 -"Has Traditional Medicine had its day ? The need to redefine academic medicine"
HIFA profile: Esha Ray Chaudhuri is an Equity Analyst, in Canada. Professional interests: Equity Issues in Health and Health Care with particular focus on interface of Local and Global contexts. She is a member of two HIFA working groups: HIFA SUPPORT-SYSTEMS - How can decision-making processes for health systems strengthening and universal health coverage be made more inclusive, responsive and accountable? and the WHO-HIFA Catalyst Group on Learning for quality health services.
https://www.hifa.org/support/members/esha-ray
https://www.hifa.org/projects/new-support-systems-how-can-decision-makin...
https://www.hifa.org/projects/learning-quality-health-services
Email address: ed.consult3 AT gmail.com
[*Note from HIFA moderator (NPW): The paper by Dzau et al is available here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01603-8/fulltext
In the second paragraph they say: 'The practice of traditional medicine is rooted in the bench-to-bedside model of academic medicine that is responsible for today's education, research, and approach to medical care. To meet current needs of health and health care, medicine will require more health workers who are community and population health oriented and digitally competent; whose work integrates social, behavioural, data, and other sciences; and who are socially responsible.']
