One of the principal precepts in the practice of medicine is “Primum non nocere” (First, do no harm). Its origin is uncertain, but it may have come from the Hippocratic Oath, which enjoins all medical practitioners to “abstain from doing harm” to their patients.
Of course, no physician, dentist, nurse, pharmacist, lab technician or other health professional would intentionally inflict harm on their patients. But being humans, there’s always that possibility of unwittingly committing mistakes which may compromise the patient’s safety.
Well-intended plans can go awry, especially in emergency situations. The judgment of both the patient and the attending physician may be impaired in these situations.
That’s why patient safety has emerged as an important advocacy in the past two decades. Some hospitals abroad even have senior professionals who serve as “patient advocates.” The advocates, though sometimes employed by the hospital, look after the best interests of the patients, and help guide them in decision-making.
They serve as the patient’s spokesperson, backer, guide, believer, liaison person, among other roles.
For these important roles, the patient advocates must be assertive and have good communication skills. They present to the patients their options—specialists to attend to them, diagnostic tests, procedures and other interventions, and the spectrum of treatment choices. The advocates also give the patients an idea as to the costs of treatment, and what could be covered by health insurance.
Upon request, the advocates may even accompany the patient during procedures to ensure safety.
We’re happy to note that patient safety awareness has spread to the Philippines. The University of the Philippines (UP) Colleges of Medicine, Nursing and Pharmacy have organized a two-day Patient Safety Congress on March 28-29 at the Philippine International Convention Center, a follow-up to the successful congress in 2015.
“For many reasons, concern about the quality and safety of patient care is reaching new heights, both locally and globally,” says Dr. Armand Crisostomo, UP professor of surgery and UP Manila vice chancellor for research. He heads the organizing committee of the congress.
He explains that patient safety is a complex, multifaceted objective that demands a multipronged approach. Hence, during the congress, they’ll be discussing it from both perspectives—top-down and bottom-up.
These approaches emphasize the importance of health-care provider education to reduce inadvertent errors, as well as the importance of patients’ expectations, perceptions and engagement. A rattled health provider and a very demanding patient make a bad combination that may redound to the detriment of patient care.
The topics also go beyond the hospital to consider other settings, including community and primary care settings and mental health institutions. An important goal, stresses Dr. Crisostomo, is to standardize and institutionalize protective and preventive measures for the patient, whether through policies, accreditation and regulation, or practices in hospitals, doctors’ offices, pharmacies and homes.
On social media, many have read alarming reports of possible negligence that may have inflicted harm on a patient. On some occasions, health-care provider bashing has done away with respect and courtesy for doctors, nurses and other health providers. This is quite unfair, especially in government hospital emergency rooms.
ER personnel are overworked and underpaid, and every patient who goes to the ER would like to be attended to first. The doctors have to exercise judgment on who needs to be treated first and who can be asked to wait.
Because of the volume of patients and work, it’s possible that errors may be committed. “The scale of harm has translated to alarming costs, not only to the individual patient but to our health-care institutions,” says Dr. Crisostomo.
Patient safety, as an advocacy and emerging discipline in medicine, aims to temper rising public expectations, soaring medical costs, and shrinking health budgets. “Such conditions place a premium on strategies that tackle waste and inefficiency,” explains Dr. Crisostomo. “When safety becomes part of the culture of clinical care, health systems see a reduction in unnecessary, costly, and often dangerous care.”
Dr. Crisostomo and other advocates see some challenges for this young discipline, though. “These include the need to change human behavior, and the reluctance of medical professionals to acknowledge errors, on their part or that of others,” he says. “As a young discipline, patient safety also needs a scientific framework rooted in multiple lines of evidence, a shared vocabulary, an accepted system of measuring and classifying adverse events, and a culture of transparent reporting.”
Because health providers are only humans, 100-percent risk-free health care is not possible. But we can certainly minimize the risk. Patient safety advocacy hopes to make these errors extremely rare, and not “so disconcertingly common” as it is now, says Dr. Crisostomo.
A patient-centric approach is an excellent mindset for every health provider.
“The best way to make progress is to learn from each other, with our eyes clearly on the patients as the ultimate winners. Our ultimate goal is to heal, not harm,” Dr. Crisostomo concludes.
For those interested to attend the congress, call tel. 5361319 or 0916 795-5341.