Basics
- Event: World Patient Safety Day observed annually on September 17, declared by WHO in 2019.
- Theme 2025: Focus on safe care for every newborn and every child (WHO campaign).
- Global Context:
- WHO estimates: 1 in 10 patients harmed during hospitalization.
- 4 in 10 patients harmed in primary/ambulatory care, with 80% of harm preventable (WHO, 2023 fact sheet).
- Indian Context:
- Disease burden shifting to chronic conditions (cancer, diabetes, CVD, mental health).
- Complexity in acute care (multi-speciality coordination) increases risk of patient harm.
Relevance:
- GS-II (Governance, Social Justice):
- Right to Health (Directive Principles, judicial debates).
- Public health institutions, policies, and regulation.
- Role of civil society and CSR in health awareness.
- GS-III (Science & Technology):
- Use of AI, EHRs, digital tools in patient safety.
- GS-II (International):
- WHO’s role, India’s commitments in global health governance.
Dimensions of Patient Harm
- Clinical Causes:
- Hospital-acquired infections, unsafe injections, transfusion errors.
- Adverse drug reactions, inappropriate medication combinations.
- Delayed diagnoses, preventable surgical errors, patient falls.
- Systemic Causes:
- Overburdened staff (low doctor-patient ratio, long shifts, attrition).
- Weak quality monitoring and low NABH accreditation (<5% of hospitals).
- Limited patient awareness, passive role in care decisions.
India’s Initiatives
- Policy & Frameworks:
- National Patient Safety Implementation Framework (2018–25) – roadmap for embedding safety in clinical programs, event reporting, capacity-building.
- NABH (National Accreditation Board for Hospitals & Healthcare Providers) – standards on infection control, patient rights, medication safety.
- Institutions & Networks:
- Society of Pharmacovigilance, India – ADR (adverse drug reaction) monitoring.
- Patients for Patient Safety Foundation (PFPSF) – awareness to 14 lakh households weekly, supporting 1,100 hospitals and 52,000 professionals.
- Patient Safety & Access Initiative – focuses on medical devices regulation.
- Civil Society & Technology:
- CSR-funded campaigns, workplace health programs, safety tech (e-prescriptions, interaction alerts).
- WHO Global Patient Safety Action Plan promotes Patient Advisory Councils (PACs) – patient representation in hospital governance.
Gaps & Challenges
- Accreditation: Out of 70,000+ hospitals in India (NHP 2023), fewer than 5% NABH-accredited.
- Awareness: Low patient literacy; hesitancy in questioning doctors.
- Implementation Gap: Policy exists but enforcement and monitoring remain weak.
- Resource Constraints: Public hospitals face overload; private sector highly fragmented.
Overview
- Polity/Governance: Patient safety ties into Right to Health debates; requires stronger regulation and accountability.
- Social: Safety lapses disproportionately affect vulnerable groups – poor, elderly, children, women in maternity care.
- Economic: Unsafe care increases out-of-pocket expenditure; WHO estimates adverse events cost trillions globally.
- Technology: AI-driven prescription checks, EHRs, digital ADR reporting can reduce risks.
- International: WHO benchmarks provide templates; India’s progress modest compared to high-income countries with strong PACs and reporting culture.
Way Forward
- Renew Patient Safety Framework (post-2025) with measurable targets.
- Strengthen NABH/NQAS accreditation coverage, link to insurance empanelment.
- Institutionalize Patient Advisory Councils in Indian hospitals.
- Integrate patient safety modules in MBBS, nursing curricula.
- Create national patient safety registry for transparent reporting of adverse events.
- Expand public participation: digital health literacy campaigns, family-based safety checklists.
