Last year there was a watershed moment for patient safety with a World Health Assembly resolution from the WHO Member States. The resolution was for “Global action on patient safety.” Governments, civil and patients’ organizations, professional bodies, academics and industry would be enabled to promote, prioritize and embed patient safety in health policy and strategy. The resolution was to integrate patient safety strategies in clinical programmes in order to prevent avoidable harm related to procedures, products and devices. This included medication safety, surgical safety, infection control, sepsis management, environmental hygiene, injection safety, blood safety and radiation safety. They resolved to promote safety culture through training of health professionals, to develop learning and blame-free safety incident reporting cultures, to address human factors within multidisciplinary teams, to promote translational research and new technologies, and to build leadership and management. Engagement and empowerment of patients, their families and communities to share their experiences of safe and unsafe care was accepted as crucial in order to build effective safety strategies.
It does not escape one’s attention that all of these areas are encompassed and integral to the daily work and aspirations of the members of our Association of Anaesthetists. The resolution established an annual WHO World Patient Safety Day to be observed on 17 September in order to promote patient safety. The first, in 2019, was themed “Speak up for patient safety!” and iconic landmarks and buildings were lit up in orange across the world.
We were positioned on the front line because of our adaptability, our essential skill set and our willingness to volunteer to be drafted in.
A lot has happened since 17 September 2019. The COVID-19 pandemic has been devastating to the safety and the mental wellbeing of our general population and also to our healthcare workers. An epicentre of the pandemic has been in emergency departments and the ICU. This has particularly affected anaesthetists and the nursing and paramedical staff with whom we work. We were positioned on the front line because of our adaptability, our essential skill set and our willingness to volunteer to be drafted in. Anaesthetists returned from retirement in the face of the deadly combination of the major risk factor of age and high exposure potential. This was despite sometimes needing to work at the peripheries of our experience and under the shadow of personal risk. During this time, front-line staff have been routinely exposed to the loss of their patients and the challenges of supporting families from afar, personal illness, the loss of colleagues, high levels of stress, dealing with inevitable errors and the uncertainty around an increased exposure to COVID-19. This would seem a fertile breeding ground for personal health risk and mental health issues.
The WHO call for action this year is for stakeholders to recognise and invest in health worker safety as a priority for patient safety.
It is welcome that the theme for World Patient Safety Day 2020 is “Health Worker Safety: A Priority for Patient Safety” and will be focusing on the interrelationship between our safety and that of our patients. The WHO call for action this year is for stakeholders to recognize and invest in health worker safety as a priority for patient safety.
All of this strikes a chord with the Association’s core business and workstreams. In addition to the physical risks to anaesthetists (increased exposure to the virus) and mental risks (the tremendously stressful working conditions) there is also a professional risk (exposure to an environment wherein errors and misjudgements are inevitably high despite best intentions).
To mitigate risks, the Association has provided free webinars and statements directly through our website and jointly through the COVID-19 response collaborative hub.
Despite our high virus exposure risk the morbidity and mortality in our specialty has been thankfully low in the UK. The Association also has provided longstanding, active support in mental wellbeing, fatigue and mentoring for members. Regarding our professional safety, the Association has lobbied government, our regulators and the judiciary to improve an understanding of human factors, the inevitabilities of good people making errors and misjudgements and damaging effects of blame cultures on individuals and the wider profession. All of this work aligns to the WHO call.
The emotional challenge of frequent patient-colleague deaths in the COVID-19 period
This year our President, Kathleen Ferguson, will be addressing the International Forum on Perioperative Safety and Quality on World Patient Safety Day 2020 on “The emotional challenge of frequent patient-colleague deaths in the COVID-19 period.”
Suggestions from the WHO for how you can enhance the safety of health workers can be found here. The Association of Anaesthetists supports World Patient Safety Day and the WHO couldn’t have chosen a better slogan for 2020 to reflect our times: “Safe health workers, safe patients.”