World Patient Safety Day 2019

Message from Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region on the occasion of World Patient Safety Day, 17 September 2019

Today is the first ever World Patient Safety Day. As the theme of this inaugural event underscores, and as the World Health Assembly resolution that created it emphasizes, securing patient safety is a global health priority, and is key to achieving universal health coverage.

The need to act is clear. Unsafe and poor quality care remains common, especially in low and middle-income countries. Evidence shows that disadvantaged groups are most affected. An estimated 134 million adverse events occur each year due to unsafe care in hospitals in low- and middle-income countries, while four out of every ten patients in primary and ambulatory settings are harmed. Both outcomes contribute to around 2.6 million deaths from inadequate patient safety annually, the majority of which are avoidable. With nearly 40% of health care facilities in low- and middle-income countries lacking water from an improved source, and nearly 20% lacking sanitation, the scope for immediate progress – especially on the basics – is clear.

Since 2015, improving patient safety has been an important part of the WHO South-East Asia Region’s Flagship Priority on achieving universal health coverage. In line with the Region’s strategy on patient safety, which came into effect in 2016, Member States have implemented a series of interventions aimed at reducing avoidable harm, and which reflect the conviction – highlighted by today’s commemoration – that ‘no one should be harmed in health care’.

Progress has been made on each of the regional strategy’s six objectives, as outlined at the recently concluded Seventy-second Session of the Regional Committee in New Delhi, India. For example, almost all Member States now have policies, strategies or frameworks to improve patient safety and quality of care. Several have active health facility accreditation or quality assurance programmes. Most Member States now have mechanisms to report adverse events, while all are carrying out trainings for health workers on patient safety and quality of care. Infection prevention and control and water, sanitation and hygiene (WASH) are key features of most national policies, strategies and guidelines, and form important entry points for this work.

More progress is needed. As the Region strives to achieve its Flagship Priorities, in addition to WHO’s ‘triple billion’ targets and the Sustainable Development Agenda, enhancing patient safety must remain a core priority. Action in several areas should be prioritised to ensure progress is sustained and accelerated, and that new innovations are harnessed to maximum effect.

First, health authorities Region-wide should ensure the basics of quality and safety are addressed, especially in primary care facilities. Clean water, adequate sanitation, essential equipment, safe medicines and competent health workers are all crucial to providing care that is safe and of acceptable quality. In addition, greater synergy must be established between programme-specific activities, while continued emphasis must be given to increasing the volume of health workers – including nurses and cleaners – and ensuring they are trained on patient safety and quality improvement. To this end, team learning approaches and supportive environments that create a culture of safety (as opposed to blame) should be pursued as a matter of priority.

Second, better data are needed to track whether patient safety is really improving. To help do this, WHO is working with Member States across the Region, as well as key partners, to develop a data dashboard that brings together and tracks indicators on clean and safe health facilities, including WASH services, with a focus on the primary care level. Importantly, indicators on safe and good quality care should be integrated into routine health information systems, while adverse event reporting systems should be strengthened. Evidence and experiences should meanwhile be more effectively shared between Member States, alongside greater efforts to convert data into knowledge to drive improvement and impact.

Finally, health authorities should engage all stakeholders, including patients and their families, to promote awareness, create a sense of urgency and strengthen demand for improved patient safety and health care quality. Parliamentarians in particular should be better engaged to increase the prominence of patient safety within national discourses and across sectors, while harnessing buy-in among facility administrators should be a top priority. Among the public more generally, it is crucial that access to safe health care is considered a right, with targeted messaging needed to secure that outcome.

As today’s commemoration emphasizes, we must all ‘speak up for patient safety’, and do so with full voice. Accelerating progress towards UHC depends not only on our ability to ensure that the coverage of services increases, but that their safety and quality does too. WHO is committed to supporting Member States achieve that outcome, and to ensuring they go from strength to strength in its pursuit. The present and future health of all people in the South-East Asia Region demands as much.

Dr Poonam Khetrapal Singh
Regional Director