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Global Challenges in Patient Safety

Reshma Ramachandran

November 17, 2020

+Hospitals and Doctors = DANGER?

Patient safety is the most basic of patient rights, "bringing significant benefits to patients in countries rich and poor, developed and developing, in all corners of the globe.

Adverse Drug Events alone: 8 -10% of hospitalized patients Tens of billions USD to healthcare systems, 140 000 death in US alone 28 –56% of ADE are preventable

Medical devices (manufacturer-, user-, design-related errors) Over 1 million adverse device events / year in US (6.3 events per 1000

patient days) LMIC: e.g. 34.2 device related infections per 1000 patient days

Surgery & anaesthesia adverse events US: 48% of all events (54 –74% preventable) LMIC: surgical adverse events rates 5 -10 times higher

Nosocomial infections (pneumonia, catheter-related BSI, surgical wound infections) 5 –10% of hospitalized patients (high income) 25 –40% (LMIC)

Unsafe blood products (blood transfusion) –HIV, Hepatitis, Chagas, West Nile Sub Saharan Africa: 88.5% of blood products not screened for HIV

+OUR patients affected...

+WHO Second Global Patient Safety Challenge: Safe Surgery Saves Lives Improving safety in the

OR through promoting evidence based standards Technical guidelines,

Surgical Safety Checklist and implementation tool

Global campaign, endorsements by professional societies

4000 participating hospitals, 25 countries dedicate funds to checklist implementation

+It works! Survey of staff at pilot sites

79% thought it easy to use

79% thought it improved care

84% thought it improved communication

78% thought it reduced errors

93% would want the checklist used if they were having surgery

+Trauma Care Checklist (TCC) Injury - leading cause of death and disability

estimated 5.8 million people each year

10% of preventable deaths among trauma patients by human and system errors that occur in the hospital

International Consultation Meeting – Rio de Janeiro (October 2009) Preliminary Rough Draft

Usability Feedback Cycle 6 hospital sites Data collected

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+Save the Date! February 5th at Rhode Island Hospital!

Northeast Regional Patient Safety and Quality Improvement Conference

Future Projects Safe Surgery Checklist – Academic Tool for

MSIII on Surgery Clerkship