National Task Force (NTF)

The recent spotlight on healthcare professional safety stems from the first meeting of the National Task Force (NTF) constituted by the Supreme Court of India, after the tragic murder of a postgraduate doctor at RG Kar Medical College Hospital in Kolkata. The NTF is tasked with developing strategies to improve safety, working conditions, and overall well-being of medical professionals across India.

Key Points on the NTF:

• Mandate: To recommend measures on safety, infrastructure, working conditions, and legal frameworks.
• Sub-groups: The NTF formed four thematic sub-groups to address:
• Strengthening infrastructure in medical institutions.
• Enhancing security systems.
• Improving working conditions.
• Evaluating the legal framework for protection.

Current Issues Faced by Healthcare Professionals:

• Global Risks: According to the WHO, violence against healthcare professionals is widespread, with 8% to 38% suffering physical or verbal violence, mostly by patients or visitors.
• Workplace Hazards: Long working hours, inadequate facilities, and easy access to restricted areas pose risks to doctors, especially during night shifts.
• Inadequate Infrastructure: Many medical institutions lack basic security measures such as CCTV surveillance, secure entrances, and safe transportation for staff working late hours.
• Health Hazards: Doctors are also exposed to health risks, as seen during the COVID-19 pandemic where many healthcare workers succumbed to the virus.

Initiatives in India:

• Legislation: Various laws have been enacted to protect healthcare workers, such as:
• Epidemic Diseases (Amendment) Act, 2020, which criminalizes violence against healthcare professionals during epidemics.
• Prevention of Violence Against Healthcare Professionals and Clinical Establishments Bill, 2022.
• State-Level Acts in Karnataka and Kerala to address violence in healthcare settings.
• Workplace Protections: The Sexual Harassment of Women at Workplace Act, 2013 applies to hospitals and nursing homes, ensuring gender-based safety at work.

Global Best Practices:

• ILO-WHO Framework: Guidelines for addressing workplace violence, emphasizing the need for protective infrastructure and policies.
• UK & Australia: The NHS in the UK enforces a zero-tolerance policy towards violence, and Australia has introduced security measures like panic buttons and de-escalation training for hospital staff.

Challenges:

• Security Gaps: Inadequate security provisions in public hospitals leave healthcare workers vulnerable, especially during night shifts.
• Poor Infrastructure: Insufficient CCTV, biometric controls, and lack of transportation for healthcare workers, especially during late hours.
• Excessive Working Hours: Doctors, especially interns and residents, often face long and exhausting shifts with insufficient breaks or facilities.

Recommendations:

• State Responsibility: State governments need to prioritize violence prevention by enforcing strict penalties and setting up dedicated helplines.
• Infrastructure Development: Hospitals should install CCTV, secure entrances, and ensure safe transportation for staff.
• Safety Audits: Establish Employee Safety Committees to conduct safety audits in healthcare facilities.
• WHO Recommendations: Advocate for national occupational health programs, promote zero-tolerance policies on violence, and establish a “blame-free” work culture.

These steps aim to create a safer, more supportive working environment for healthcare professionals, acknowledging the vital role they play in society while ensuring their protection from violence and health hazards.

Patience saftey

Patient Safety refers to preventing harm to individuals during healthcare provision. It emphasizes safeguarding patients from unintended or unexpected harm due to various errors and system inefficiencies.

Common Causes of Harm in Healthcare:

As identified by the WHO, common causes include:

• Medication errors (e.g., incorrect dosage or drug mix-ups).
• Surgical errors (e.g., wrong-site surgery or anesthesia complications).
• Infections acquired during hospital stays.
• Sepsis and its complications.
• Diagnostic errors, leading to delayed or wrong treatments.
• Patient falls within healthcare settings.

Factors Leading to Harm:

Harm in healthcare can be traced to a combination of:

• Systemic/organizational failures (e.g., poor coordination, lack of safety protocols).
• Technological aspects (e.g., malfunctioning equipment, complex systems).
• Human behavior (e.g., fatigue, miscommunication).
• Patient-related factors (e.g., pre-existing conditions, non-compliance).

Importantly, most errors are caused by system or process breakdowns rather than individual negligence.

Major Objectives of the Patient Safety Rights:

• Right to Information: Patients should receive clear and understandable information about their health, treatment options, and potential risks.
• Right to Informed Consent: Before undergoing any medical procedure, patients must provide informed consent after being fully informed about the risks and benefits.
• Right to Privacy: Confidentiality of patient records and personal information must be respected, only shared with authorized personnel.
• Right to Quality Care: Every patient deserves high-quality, safe, and effective healthcare services, regardless of socio-economic background.
• Right to Safe Medication Management: Patients should have their medications administered correctly and safely to avoid errors.
• Right to Involvement in Care: Patients should be active participants in decisions regarding their treatment and care plans.
• Right to Cultural Competency: Healthcare providers should respect and understand cultural differences and provide culturally competent care.

Patient Safety Rights Charter:

The Patient Safety Rights Charter serves as a foundational document that outlines the fundamental entitlements patients should expect in any healthcare setting. The key goals include:

• Informed Decision-Making: Ensuring patients have access to clear and detailed information about their condition, treatments, and risks, empowering them to make informed choices.
• Consent and Privacy: Ensuring that patients' informed consent is sought for all treatments and that their privacy, particularly concerning medical records, is protected.
• Quality Care: Guaranteeing access to safe, timely, and equitable healthcare without discrimination, supported by effective grievance mechanisms.

Why the Charter is Urgently Needed:

The statistics from the Organization for Economic Co-operation and Development (OECD) underscore the gravity of patient safety concerns:

• Around 1 in 10 patients suffer harm while receiving healthcare.
• Over 3 million deaths annually are linked to unsafe healthcare practices.
• In low- to middle-income countries, as many as 4 in 100 deaths are caused by unsafe healthcare practices.

These alarming figures highlight the need for a Patient Safety Rights Charter that focuses on shifting the healthcare approach from a blame-centric to a systemic model. This new approach recognizes the role of organizational systems in patient safety, aiming to prevent errors by improving processes, training, and infrastructure.

Benefits of Investing in Patient Safety:

Investing in patient safety:

• Improves health outcomes.
• Reduces healthcare costs associated with preventable harm.
• Increases efficiency in healthcare systems.
• Rebuilds trust between patients and healthcare providers.
• Engages patients and caregivers in minimizing harm, making healthcare safer for all.

Conclusion:

The Patient Safety Rights Charter, championed by the World Health Organization (WHO), marks a crucial step toward enhancing patient safety worldwide. Addressing the widespread harm faced by patients, this charter calls for systemic improvements, urging global adoption to protect every patient’s fundamental right to safe and quality healthcare. It is essential to shift focus from blaming individuals to improving healthcare systems, transforming patient safety on a global scale.