British medical doctor Cyril Chantler wrote in the British Medical Journal (BMJ) in 1998 that “Medicine used to be simple, ineffective, and relatively safe. It is now complex, effective, and potentially dangerous. The mystical authority of the doctor used to be essential for practice. Now we need to be open and work in partnership with our colleagues in healthcare and with our patients.”
The World Health Organization (WHO) estimates that one in 10 patients are harmed while receiving hospital care in developed countries; that of every 100 hospitalised patients at any given time, seven in developed and 10 in developing countries are harmed; that the likelihood of being harmed by air travel is more than one in a million, but is one in 300 for healthcare; and that medication errors cost an estimated US$42bil (RM180.75bil) annually.
Patient safety and healthcare quality
The US Institute of Medicine defines healthcare quality as “the degree to which healthcare services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”.
Healthcare quality has the following properties:
• Effectiveness, which relates to providing care processes and achieving outcomes as supported by scientific evidence.
• Efficiency, which relates to maximising the quality of a comparable unit of healthcare delivered or unit of health benefit achieved for a given unit of healthcare resources used.
• Equity, which relates to providing healthcare of equal quality to those who may differ in personal characteristics other than their clinical condition or preferences for care.
• Patient-centred, which relates to meeting patients’ needs and preferences, and providing education and support.
• Safety, which relates to actual or potential bodily harm.
• Timeliness, which relates to obtaining needed care while minimising delays.
The WHO defines patient safety as “the absence of preventable harm to a patient during the process of healthcare”.
While healthcare has become more effective since World War 2, it has also become more complex, with the use of new technologies, medicines and treatments, which may potentially harm patients.
The patients today are older and sicker, many of whom have significant co-morbidities requiring difficult decisions as to healthcare priorities.
Patient safety is a discipline that applies safety science methods toward the goal of achieving a trustworthy healthcare delivery system.
Patient safety is also an attribute of healthcare systems; it minimises the incidence and impact of, and maximises recovery from, adverse events.
In short, patient safety is the foundation upon which all other aspects of quality in healthcare are built.
International Forum on Quality & Safety in Healthcare
The forum is jointly organised by the BMJ and the Institute for Healthcare Improve-ment (IHI) in the United States.
Both are internationally recognised not-for-profit organisations.
The BMJ was founded in 1840.
IHI was officially founded in 1991, but its precursor from the late 1980s, was the National Demonstration Project on Quality Improvement in Health Care, led by Dr Don Berwick and his colleagues.
The forum, which has a 22-year history, has the mission of supporting “the movement for healthcare improvement”.
Its vision is to “improve outcomes for patients and communities; provide practical ideas that can be implemented in the workplace; build coalitions to inspire understanding between healthcare organisations; promote research into quality and safety improvement; foster effective innovation; gather the evidence needed to support local improvement; connect healthcare leaders and practitioners worldwide; and translate concern about the quality and safety of care into effective action”.
The forum is the premier quality and safety conference for international delegates, drawing close to 4,500 attendees annually. There are two events annually, one in Europe (April/May) and one in the Asia-Pacific region (August/September).
Realising that the costs of attending the forum in Europe may be challenging for many, the BMJ and IHI held the first Asia-Pacific forum in Hong Kong in 2015, followed by Singapore in 2016, with more than 1,300 attendees each.
The local strategic partners of this year’s forum in Kuala Lumpur on Aug 24-26, are the Academy of Medicine of Malaysia (AMM) and the Malaysian Society for Quality in Health (MSQH).
The high-quality programme has been developed by the BMJ and IHI, with the assistance of the International and Local Programme Advisory Committees, AMM and MSQH.
It will provide relevant learning; greater insight into quality improvement, and patient safety principles and initiatives; and an opportunity for everyone involved in healthcare to learn from and share experiences with internationally recognised experts, and local and international colleagues.
There are keynote sessions by world leaders in patient safety and quality: Dr Berwick, who is the former administrator of the US Centres for Medicare and Medicaid Services and IHI chief executive officer; IHH Healthcare Bhd chairman and former Health director-general Tan Sri Dr Abu Bakar Suleiman; IHI chief executive officer Derek Feeley; and neuroscientist, medical doctor and Paralympian William Tan.
The conference streams of Safety; Quality, Cost, Value; Person and Family-Centred Care; Population and Public Health; and Building Capability and Leadership has 35 main programme sessions with over 40 international and local speakers.
There will be poster displays on patient safety and quality improvement works; and Learning and Networking Zones for Questions & Answers and connecting colleagues.
A new aspect at the forum will be the rapid-fire lunchtime sessions on the impact of technology on healthcare.
There will be experiential visits to local Malaysian healthcare organisations, in-depth mini-courses on quality improvement, and a patient safety mini-course for students.
In addition, the WHO will be holding a policy roundtable during the forum with a report to be presented at the forum as well.
The Programme Advisory Committee is confident that the forum will provide an impetus to patient safety and quality improvement in healthcare in Malaysia, and that healthcare providers and managers will be empowered to provide better and more effective care to patients.
Doctors, nurses and other healthcare professionals, policy makers, CEOs, directors of hospitals and other healthcare facilities, managers, patient advocates and groups, and anyone interested in healthcare are welcome to register at http://internationalforum.bmj.com/kuala-lumpur/. Early bird registration discounts are valid until June 20.
Dr Milton Lum is co-chair of the forum’s Programme Advisory Committee. The views expressed do not represent that of any organisation the writer is associated with. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Maintaining healthcare standards is an important goal