Focus on safety for patients

Initiatives are under way to enhance patient safety in health facilities. An upcoming congress will focus on minimising adverse incidents at hospitals and will look at safety factors in developed and developing countries.

The Healthcare Expansion Congress Africa will take place on July 17 and 18.
Stuart Whittaker, chief executive and founder of the Council for Health Service Accreditation of Southern Africa (Cohsasa), who will speak about ways of improving patient safety in Africa, told the Mail & Guardian that research has indicated that, in developed countries, one patient in 10 is seriously harmed in a hospital as a result of injuries incurred during care and not from the process of disease.

Adverse events in health facilities are regarded as the biggest killer after cancer and cardiovascular disease. As a result the World Health Organisation is coordinating global efforts to advise countries how to address issues of patient safety.

Whittaker is recognised internationally as a leader in the field of healthcare quality improvement. In 2007 he was recognised as one of South Africa’s top 25 healthcare managers by the South African Institute. He says that a number of South African provinces are actively involved in formulating programmes to evaluate adverse events during healthcare, as well as “near misses”.

These give an indication of the potential risks that patients face. “Part of the challenge is to learn from adverse events,” Whittaker says.

He points out that once an occurrence—such as infant deaths—is identified in a health facility panic ensues, leading to the apportioning of blame and inevitable punishment.

“The unfortunate thing about being human is that we are programmed to make mistakes,” Wittaker says. “And we learn by making mistakes.”

New safety initiatives are aimed at putting barriers in place that will reduce the risk of error.

Surgery to the incorrect body part is a relatively common event and it is necessary to institute a mechanism to ensure correct patient identification. This will apparently eliminate the risk of the removal of a wrong organ during surgery.

Specialists speak of the importance of reporting every incident, however small. In other sectors this has had benefits. Airlines, for example, have reduced the number of air crashes by vigilantly reporting minor incidents, Whittaker says.

In his presentation to the healthcare congress Whittaker will discuss the manner in which disciplinary measures are applied, so as to avoid anomalies. Malpractice should be punished equally, whether it results in death or not.

While there needs to be an understanding that people make mistakes, Whittaker says measures should be taken to counsel and train culprits to prevent them from repeating errors. However, risky behaviour should not be punished: “You train them,” he says.

Where mistakes have been made that involve unacceptable or even reckless behaviour, where protocols or supervisors’ instructions are disregarded, there should be some form of punishment.

Cohsasa has been working in healthcare quality improvement in South Africa for more than 12 years. In that time it has been active in more than 450 facilities in both the public and private sectors here and in the South African Development Community region. The organisation has received global recognition and is one of only a handful of internationally accredited bodies recognised by the International Society for Quality Assurance (ISQua).

The Real Medicine Foundation will also be represented at the congress. This group provides humanitarian support to people living in disaster, post-war and poverty-stricken areas.

The organisation’s chief executive is paediatrician Martina Fuchs, who helped to establish a children’s clinic in a refugee camp in south Sri Lanka after the 2004 tsunami.

Fuchs, who will address the congress, said: “Going into disaster areas, we support the immediate relief efforts and stay for the longer term, maintaining care and helping to rebuild. This includes medical, emotional, educational, social and economic support.

“We form partnerships with individuals and existing organisations across the globe.”

Mozambique is among the countries in which the Real Medicine Foundation is active (others include Pakistan, India, Indonesia, Burma, the US, Kenya, Nigeria, Uganda and Peru).

In areas of flooding and disaster there is often limited road access and a threat of cholera. 

“We decided to modify the concept of a refugee clinic,” says Fuchs, “so we designed a mobile clinic, which can be duplicated and multiplied—to bring medical care to those who need it the most.”

Other high-profile speakers at the congress include Kgosi Letlape, president of the African Medical Association; Sulaiman Shahabuddin, chief executive of the Aga Khan Hospital in Mombasa, and Aslam Dasoo, chair of Meditech SA.

“Debates and disagreements around the hottest topics in the industry such as healthcare financing, access, patient safety and combating Africa’s epidemics are just some of the relevant issues being addressed at the congress,” says event producer Kirsty Slater.

The Healthcare Expansion Congress Africa will be held at the Westin Grand Arabella Quays in Cape Town on July 17 and 18. For information visit

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