A patient enters an operating theatre for a procedure on the right knee. The limb is marked, the scans are available and the surgical team has checked the records. A nurse reads out the patient’s identity, the procedure planned, the side of the body to be operated on and the type of anaesthesia. The surgeon, anaesthetist and other members of the team confirm the details. This brief pause, known as ‘timeout’, may take only a few minutes. But it is one of several layers of checks designed to prevent a potentially devastating mistake.
Just before the operation begins, the team stops.
For all the technology, protocols and checklists being introduced into hospitals, the doctors point to one element that cannot be removed from the equation, the patient. Doctors say patient safety has to be viewed much more broadly than preventing an obvious surgical or medication error . Policymakers, accreditation agencies, patients, caregivers, families, communities and even housekeeping staff have roles to play. Patient safety begins even before treatment starts, notes Dr. Burri. The availability of sophisticated diagnostic equipment has not necessarily solved the problem of ensuring an accurate diagnosis. He attributed part of the problem to doctors moving away from basic clinical examination, including auscultation, percussion, palpation and physical examination. He described the emerging situation as ‘no touch’ healthcare, where doctors can sometimes begin looking at a computer even before adequately engaging with the patient. Neurologist Sudhir Kumar of Apollo Hospitals, Hyderabad, also pointed to the importance of ensuring quality of medical education as the number of medical colleges and seats increases. Medication safety remains another major area of concern. Dr. Some patient-safety risks are less dramatic but can still have serious consequences, particularly among older patients. Dr. “Hospitals need to ensure that their physical environments are designed to prevent slipping and other hazards. For Dr. Burri, infection prevention and antimicrobial resistance (AMR) remain central to the patient-safety conversation. These risks can become particularly important for patients with chronic diseases, who may require repeated interactions with healthcare facilities. Dr. Dr.
Ranga Reddy Burri, president, Infection Control Academy of India, said the understanding of patient safety has now expanded considerably: the responsibility cannot rest only with doctors and nurses. “A hospital just having an accreditation doesn’t actually guarantee the kind of safety that is required,” Dr. Burri said, stressing the need to train all stakeholders involved in a patient’s journey. “The diagnosis quality has actually gone down over a period of time,” he said. “If we don’t ensure quality services, then it will worsen the patient’s safety because diagnosis may be missed; treatment may not be perfect,” he said. Kumar said spurious and fake medicines continue to pose a patient-safety risk despite the existence of drug inspectors and regulatory checks. Burri said falls in hospitals , including falls while patients are going to the bathroom or getting out of bed, can result in major injuries. Unnecessary antibiotic administration, delayed diagnosis, unhygienic environments and non-adherence to infection-prevention and control guidelines can all contribute to the problem, he said. Burri said patients with conditions such as chronic kidney disease, lung diseases and cancer may have vulnerabilities that make infection prevention an important component of safe care. “Healthcare workers and administrators therefore have a central role in ensuring that infection-control practices are followed,” he added. Burri said patients, families, caregivers and communities must understand their own role in ensuring safety.
