Dear HIFA colleagues,
Officially our discussion ends today. Meanwhile I have received a request to extend the discussion and propose we extend to Wednesday 23 September inclusive. This will give an opportunity for those who have not yet contributed to do so, and will further enhance the WHO learning brief that we are preparing for publication on the WHO Health Services Learning Hub (HLH).
An extension will also give us an opportunity to answer some of the many unanswered questions that have arisen during the discussion.
For example, in relation to Q1:
1. It is said that “Around 1 in every 10 patients is harmed in health care and more than 3 million deaths occur annually due to unsafe care.” We do not know the denominator for '1 in 10'. Is this annually? The average global lifespan is 74 years (76 for women and 71 for men). If the denominator is annually then almost all of us can expect to be harmed by healthcare, multiple times.
2. But what do we mean by 'harm'? This can range from an unpleasant but transient side effect to an avoidable death caused by a catastrophic error.
3. Also, do we accept that poor-quality care that leads to death is unsafe care? If so then we should be talking about at least 5 million people dying per year and not 3 million.
4. We have noted that “People living with NCDs are particularly vulnerable to harm due to the long-term nature of their conditions, ongoing treatment needs and frequent interactions with health systems. This repeated exposure increases the likelihood of harm over time.” However, I feel that we have only scratched the surface of patient safety specifically in relation to NCDs. Can anyone help? Email: hifa@hifaforums.org
5. We also have a suggestion that 'a typical doctor will be involved in hundreds to thousands of patient-safety incidents over a full career. Only a minority of these are due primarily to an error by the doctor.'
6. We do not have a sense of which countries provide the most and least safe care, other than the broad brush of increased risk in LMICs.
7. We do not know at which level of the health system unsafe care is most likely to occur. Most research on patient safety has been done in hospitals, but what about the home, community, and primary care clinics?
If you would like to comment on any of the above, or any aspect of patient safety and NCDs, email: hifa@hifaforums.org
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org