Safety of care
Collaboration for the future of healthcare safety
Originally published May 2015
The expression, “many hands lighten the load,” rings true for the future of healthcare safety in Canada. Medical associations, regulatory authorities (Colleges), federal and provincial health associations, hospitals, and others involved in healthcare generally understand the importance of safe care, and are actively working to raise awareness about safety and reduce harm to patients.
While there are many organizations in Canada that play a strong role in the healthcare safety domain, several stand out.
The Canadian Patient Safety Institute1 (CPSI) provides leadership for patient safety in Canada, and seeks to build and influence safety knowledge and skills at team, organizational, and system levels. The organization offers education, training, and resources, and supports research on specific patient safety topics. CPSI also leads the Safer Healthcare Now!2 program, which gives front-line providers and healthcare organizations clinical interventions that are known to reduce avoidable harm. The CMPA has been involved in a number of the institute’s priority areas and summits, including surgical care safety, medication safety, and infection prevention and control.
Patients for Patient Safety Canada3 is a patient-led program of CPSI. The group represents the voice of the patient in the healthcare safety discussion. Patients and their families are a valuable resource for healthcare providers in efforts to reduce harm to patients. They possess unique knowledge about the patient experience, which providers can use when making decisions about care. Patients can also help create safety tools and resources, plan and implement safety improvements, and motivate health providers to reach new levels of safety.4
Canada’s provincial quality health councils work closely with ministries of health, health authorities and health regions, and providers to make care safer. Most councils measure and provide insight into health system performance, and many also survey patients about their healthcare experiences. For example, the Saskatchewan Health Quality Council has quality improvement consultants and web applications to assist physicians and office managers to identify areas for improvement in primary healthcare, use measurement in daily work, and survey patients.5 The B.C. Patient Safety and Quality Council supports clinical improvement and offers programs to build capacity among the province’s healthcare providers to improve quality and safety.6 In Québec, Le Groupe Vigilance pour la sécurité des soins was established by the province’s health ministry to oversee the safety of care delivery and propose risk management solutions.7
Accreditation Canada helps healthcare organizations improve the quality of care, reduce risk, and strengthen accountability. The organization’s program includes evidence-informed Required Organizational Practices (ROPs) that address areas central to quality and safety.8 Some ROPs, for example, touch all physicians, such as the disclosure of patient safety incidents, effective information transfer among service providers at transition points, and hand hygiene compliance.
The Institute for Safe Medication Practices Canada (ISMP Canada) is committed to advancing medication safety and promoting safe medication practices.9 The organization analyzes medication incidents and makes recommendations to prevent harmful medication incidents. ISMP Canada also encourages confidential reporting by individual practitioners and providers, and offers free electronic medication safety bulletins to healthcare professionals.
Medical associations and medical regulatory authorities are also highly engaged in safety. Whether it’s continuing medical education or physician wellness initiatives offered by medical associations or federations, or Colleges monitoring and maintaining standards of practice, healthcare safety is a significant part of their mandates.
Hospitals and other health facilities
Hospitals, regional health authorities, and other health facilities are also central to healthcare safety. Within organizations, a robust culture of safety is a powerful tool for reducing patient harm. That culture is strengthened when healthcare providers, leaders, and patients share a collective commitment to safety and quality improvement processes that are based on fairness and trust. Further, the culture is strengthened by teamwork, structured communication, measurement, and safety teams.
We all benefit when hospitals across the country continue to demonstrate their commitment to safety and tackle areas for improvement, whether through hand hygiene or falls prevention programs, for example, or by improving discharge plans to reduce preventable readmissions.
Every physician countsEvery physician has a part to play in improving the safety of care. No matter what the practice arrangement or work setting, physicians should review their practice, knowledge, communication skills, and team functioning abilities with a view to consistently providing safe medical care.
Strong physician leadership is essential in enhancing patient safety. Physician champions can have a huge impact on an organization’s culture, infrastructure (such as safety committees or workgroups), practices, and even the uptake of technology to enhance patient safety.10 By getting involved in improving healthcare safety, physicians can provide direction, contribute knowledge, and partner with patients and other providers for better outcomes.
Healthcare provider safety
The future of healthcare safety also includes the safety of physicians and other providers. Physicians, nurses, and all healthcare professionals must be safe at work, including safe from infections, medical equipment mishaps, verbal and physical assault, and other harmful situations.
When a patient is harmed, doctors and other providers often suffer shock, sadness, fear, and stress. These providers require treatment that is just, and they require respect, compassion, supportive care, transparency, and an opportunity to contribute to the prevention of future safety incidents. Hospitals and other healthcare institutions need to establish effective support initiatives for healthcare providers involved in patient safety incidents, and providers must know how to access assistance.11
Sharing lessons learned
There is growing recognition that healthcare providers everywhere need to share their safety knowledge to prevent the reoccurrence of patient safety incidents and to improve patient outcomes. While reporting systems for sharing information exist, all healthcare stakeholders need to learn safety lessons from other providers, organizations, or jurisdictions. If insights and lessons arising from patient safety incidents or near misses are not shared, neither healthcare providers nor patients benefit, and the healthcare system is weakened. Physicians should support the sharing of patient safety lessons, as well as the solutions implemented to prevent harm. Physicians can do so while respecting any restrictions or requirements that might apply due to provincial or territorial legislation, regulations, hospital/institutional bylaws and policies, and legal privilege.
The CMPA is committed to being an essential component of the healthcare system. As the Association continues to advance a system level approach to the prevention of harm, it expects to collaborate even further with other healthcare organizations to push the healthcare safety agenda forward.
- For more information about the Canadian Patient Safety Institute, see: http://www.patientsafetyinstitute.ca/English/About/Pages/default.aspx
- For more information about the Canadian Patient Safety Institute’s Safer Healthcare Now! program see: http://www.saferhealthcarenow.ca/EN/Pages/default.aspx
- For more information about Patients for Patient Safety Canada, see: http://www.patientsafetyinstitute.ca/English/toolsResources/GovernancePatientSafety/Documents/PDF%20of%20Contents/Message%20from%20Patients%20for%20Patient%20Safety%20Canada.pdf
- Kushner, Carol, Davis, Donna, “Improving safety: engaging with patients and families makes a difference!” Healthcare Quarterly (2014) Vol. 17 special issue, p.41
- Saskatchewan Health Quality Council, “Improving Primary Health Care.” Accessed October 31, 2014 from: http://hqc.sk.ca/improve-health-care-quality/primary-care/
- For more information on the British Columbia Patient Safety and Quality Council, see: http://bcpsqc.ca/
- For more information, see: http://www.msss.gouv.qc.ca/ministere/vigilance/index.php?accueil
- Accreditation Canada, “Required Organizational Practices Handbook 2014,” 2013. Accessed October 31, 2014 from: http://www.accreditation.ca/sites/default/files/rop-handbook-2014-en.pdf
- For more information on ISMP Canada, see: http://www.ismp-canada.org/
- ECRI Institute, Medical Leaders in Patient Safety, Accessed October 31, 2014 from: https://www.ecri.org/Products/Pages/Medical_Leaders_in_Patient_Safety.aspx
- Institute for Safe Medication Practices, “Too many abandon the ‘second victims’ of medical errors,” 2011. Accessed October 31, 2014 from: http://www.ismp.org/Newsletters/acutecare/articles/20110714.asp