Executive Summary
The report begins by emphasizing that the pursuit of universal health coverage (UHC) is closely linked to patient safety. Unsafe healthcare is a major global health issue, with millions of patients harmed each year. Around 12% of adverse events in healthcare settings result in permanent disability or death, and about half of these are preventable. It is estimated that unsafe care causes over 3 million deaths annually, with two-thirds of the harm occurring in low- and middle-income countries (LMICs). The economic burden of unsafe care is also significant, with approximately 15% of health expenditures in high-income countries (HICs) being used to address patient harm. These figures underscore the need for urgent and coordinated action.
Key Findings of the Report
- Global Patient Safety Initiatives: The report presents data from the first-ever global patient safety survey, indicating uneven progress in implementing patient safety initiatives across regions. While many countries recognize patient safety as a national health priority, only a third have fully integrated it into their national healthcare strategies. Key global initiatives, such as the WHO’s Global Patient Safety Challenges, have been adopted by most countries, though the level of implementation varies.
- Challenges in LMICs: LMICs face the greatest burden of patient harm, particularly in hospital settings, where 134 million adverse events occur each year, contributing to 2.6 million deaths. Infections, medication errors, and surgical complications are significant sources of harm in these settings. Financial constraints and limited resources often impede the implementation of safety measures.
- Economic Impact: The economic costs of unsafe care are substantial. In HICs, 15% of healthcare spending is used to address patient harm, while the indirect costs, such as lost productivity and reduced income, often exceed direct costs. Investments in patient safety, however, offer a high return, with strategies like infection prevention and medication error reduction being particularly cost-effective.
- High-Risk Healthcare Settings: The report identifies intensive care units (ICUs), surgical units, and emergency departments as high-risk environments for patient harm. In ICUs, up to 34% of patients experience some form of harm, with 18% being preventable. Similarly, surgical procedures account for a significant proportion of healthcare-associated harms, with complications occurring in up to 25% of patients.
- Patient and Family Engagement: Engaging patients and their families in safety initiatives is crucial for improving healthcare outcomes. However, only 13% of countries have appointed patient representatives to hospital boards, and most countries lack mechanisms to fully integrate patient feedback into safety improvement efforts.
Strategic Objectives and Progress
The report is structured around the seven strategic objectives of the Global Patient Safety Action Plan 2021–2030, which include:
- Eliminating Avoidable Harm: Although most countries have policies aimed at reducing avoidable harm, only 29% have developed a national patient safety action plan. Licensing and regulatory frameworks for healthcare facilities are common, but fewer countries report adequate resources for implementation.
- Developing High-Reliability Systems: A safety culture is critical for achieving high-reliability systems in healthcare. While many countries acknowledge the importance of safety culture, only a quarter have made efforts to develop it in healthcare settings. Similarly, human factors principles are not widely integrated into clinical practices.
- Ensuring Safety of Clinical Processes: Around 41% of countries have implemented patient safety improvement programs, with a focus on healthcare-associated infections and medication errors. However, patient safety in primary care remains under-prioritized, with only 17% of countries addressing safety issues in these settings.
- Patient and Family Engagement: Engaging patients and their families in safety improvement efforts remains limited. While most countries have developed patient rights charters, only a few have fully integrated patients into decision-making processes at the hospital level.
- Health Worker Education and Safety: Comprehensive integration of patient safety into health worker education remains limited, with only 20% of countries incorporating it into undergraduate and postgraduate curricula. The COVID-19 pandemic highlighted the critical importance of health worker safety, leading to increased efforts to protect health workers from occupational risks.
- Information, Research, and Risk Management: Patient safety incident reporting systems exist in 70% of countries, but their effectiveness is limited. Only a third of countries actively report safety incidents to these systems. Moreover, interoperability between reporting systems is lacking, and few countries use patient safety indicators to inform national safety strategies.
- Synergy, Partnerships, and Solidarity: Stakeholder engagement is critical for advancing patient safety. While a third of countries have identified key stakeholders, only 17% have implemented effective coordination mechanisms to engage them. Multisectoral collaboration is growing, but the private sector remains under-involved in many countries' safety efforts.
Case Studies and Comparative Analysis
The report includes several case studies that highlight successful patient safety initiatives in various countries. These case studies provide insights into how different countries have approached the challenges of patient safety in unique contexts. For example, some countries have made significant strides in reducing healthcare-associated infections through national programs, while others have focused on improving medication safety through technological interventions like barcode systems.
Comparative analyses across regions and income groups offer a deeper understanding of the global state of patient safety. HICs generally perform better in terms of implementing safety measures, while LMICs struggle with resource constraints. However, there are notable exceptions, with some LMICs achieving significant improvements in specific areas, such as infection prevention and control.
Conclusion and Recommendations
The Global Patient Safety Report 2024 underscores the urgent need for continued investment in patient safety. While progress has been made, much work remains to be done, particularly in LMICs, where the burden of harm is greatest. The report calls for increased financial and human resources to support patient safety initiatives, as well as stronger regulatory frameworks to enforce safety standards. Key recommendations include:
- Strengthening National Patient Safety Plans: Countries should develop and implement comprehensive national action plans for patient safety, with clear targets and indicators.
- Enhancing Health Worker Education: Integrating patient safety into the education and training of all health workers is essential for building a culture of safety in healthcare.
- Promoting Patient and Family Engagement: Patients and their families should be empowered to actively participate in safety improvement efforts, and healthcare organizations should prioritize transparency and communication.
- Investing in Health Information Systems: Effective reporting and learning systems are critical for identifying safety issues and preventing harm. Countries should invest in electronic health records and interoperable data systems to improve safety monitoring and reporting.
By following these recommendations, countries can make significant strides toward achieving the goals outlined in the Global Patient Safety Action Plan 2021–2030 and ultimately save millions of lives each year.
My LinkedIn articles on Patient Safety during 2024
