Patient safety

from Wikipedia, the free encyclopedia
Treatment of a patient, Greece, approx. 480-470 BC BC (Louvre Museum, Paris, France)

A person is naturally safe as long as he does not endanger himself or is endangered by third parties. Patient safety is a metric that describes deviations from such safety.

The task of therapeutic treatment includes the successful endeavor to ensure faultless and damage-free medical treatment and medical health care .

Patient safety is the result of all measures in medical practices , clinics and other health care facilities that are aimed at protecting patients from avoidable harm in connection with therapeutic treatment . Patient safety is an important part of quality assurance in medicine . Efforts are also being made to anchor the subject of patient safety in medical training.

Definition of the Association of Substitute Funds

The Verband der Ersatzkassen eV (vdek) defined patient safety in 2018 as

“The degree determined from the perspective of the patient, to which acting persons, professional groups, teams, organizations, associations and the health system

  1. have a state in which undesirable events rarely occur, safety behavior is encouraged and risks are controlled,
  2. have the ability to recognize safety as a worthwhile goal and to implement realistic options for improvement and
  3. to put their innovation skills at the service of making security a reality

are able to."

Patient safety in the hospital

According to Section 135a (2) No. 2 SGB V, hospitals in Germany are obliged to set up an in-house quality and patient-oriented complaint management system. Based on the documentation, examination and assessment of patient complaints as well as incorrect treatment events , after their evaluation using the determinative language of the German Medical Association, an ascending classification as near damage or near error , undesired event , avoidable undesirable event , critical event and error can take place, which are made more transparent and thus more instructive due to the progress in medical technology and human sciences, which are developing increasingly complex clinical processes, in order to achieve a well-founded improvement in patient safety.

In 2007, the German Council of Experts for the Assessment of Developments in the Health Care System presented an evaluation of 184 studies. This analysis showed an annual frequency of 5 to 10% adverse events , 2 to 4% damage, 1% treatment errors and 0.1% deaths due to errors in the hospital sector. With 17 million hospital patients annually, this equates to 850,000 to 1.7 million adverse events, 340,000 damages, 170,000 medical errors and 17,000 deaths due to avoidable adverse events.

The German Council of Economic Experts speaks of a conservative approach to the number of possible adverse events , which can be interpreted as a temporary decrease in the number of avoidable adverse events . The outpatient area was not the subject of the evaluation.

Quality reports from the hospitals

Since 2005, the hospitals in Germany according to Section 137a (2) No. 4 SGB V is legally obliged to publish structured quality reports on a regular basis. The reports provide information and transparency for patients, doctors and health insurance companies in the field of hospital treatment and provide a comprehensive overview of the structures, services and quality activities of the hospitals.

The Federal Joint Committee (G-BA) makes decisions on the content, scope and data format of these reports.

Reference database

The Federal Joint Committee (G-BA) has a reference database in which the machine-usable quality reports from German hospitals can be called up.

World Health Organization safety checklist

With the questions of a safety checklist from the World Health Organization ( WHO), 19 points that have apparently already been clarified should be checked before the anesthesia is initiated, before the surgeon makes the first incision and before the patient leaves the operating room. As a result, the error rates could be significantly reduced in extensive studies, in particular the endpoints complications after surgery and mortality after surgery decreased significantly and to a clinically relevant extent.

For example, the anesthetist or assistant asks the patient for his name and whether he should actually be operated on on his left knee as planned before the anesthesia is started. The surgical team introduces itself individually to make sure that they are there for the correct procedure. Before the procedure, the team should discuss possible complications during the operation. Or the checklist requires that all medical instruments must be counted before and after the operation. This ensures that no swab remains in the patient - everything is taken for granted, but none of which should be forgotten during any operation.

The German Society for Surgery has drawn its members' attention to the checklist of the Safe Surgery Saves Lives Study Group at an early stage and advised them to use it routinely after adapting to local conditions in everyday clinical practice. In the Helsinki Declaration on patient safety in anesthesiology , the checklist is also required.

Organizations

  • Institute for Patient Safety in Bonn: Germany's only institute for patient safety has existed at the University of Bonn since 2009. Tanja Manser has headed it since June 2014.

Other organizations that promote patient safety with their work:

See also

literature

  • Franz-Josef Hücker: Patient safety in difficulties. In Berlin there was a dispute about the future of the Heilpraktikergesetz. In: Sozial Extra 2 2019, 43rd year (VS Verlag, Springer Fachmedien DE, Wiesbaden), pp. 141–143.
  • Aktionbündnis Patientensicherheit eV (APS) (Ed.): M. Schrappe: APS white book on patient safety Safety in health care: rethinking, improving in a targeted manner. Medical Scientific Publishing Company, Berlin 2018, ISBN 978-3-95466-410-8

Web links

Individual evidence

  1. ^ Council of Europe (2006): Recommendation on management of patient safety and prevention of adverse events in health care. Retrieved September 27, 2008.
  2. ↑ E. Holzer, C. Thomeczek, E. Hauke, D. Conen, MA Hochreutener: Patient safety. Guide to Dealing with Healthcare Risks. Facultas, Vienna 2005. ISBN 3-85076-687-X
  3. ↑ K. Schmitz, R. Lenssen, M. Rosentreter, D. Groß, A. Eisert: Wide cleft between theory and practice: medical students' perception of their education in patient and medication safety. In: Die Pharmazie - An International Journal of Pharmaceutical Sciences 70 (5) 2015, pp. 351–354. https://doi.org/10.1691/ph.2015.4836 .
  4. ↑ APS White Paper on Patient Safety and Security in Health Care 2018, p. XXI. Retrieved November 29, 2019.
  5. ↑ Expert Council for the Assessment of Developments in the Health Care System (2007): Cooperation and Responsibility. Requirements for goal-oriented health care. Accessed January 31, 2011 (PDF; 4.7 MB).
  6. ↑ Federal Joint Committee (G-BA): Regulations on the quality report of the hospitals, Qb-R. Retrieved September 11, 2016 .
  7. ↑ Joint Federal Committee (G-BA): Regulations in accordance with Section 136b, Paragraph 1, Clause 1, No. 3 SGB V on the content, scope and data format of a structured quality report for hospitals approved according to Section 108 SGB V. (PDF; 4.3 MB) Retrieved September 11, 2016 .
  8. ↑ Federal Joint Committee (G-BA): Where can you find the quality reports of the hospitals? (No longer available online.) Archived from the original on August 10, 2016 ; accessed on September 11, 2016 . Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.g-ba.de
  9. ^ WHO Safe Surgery Checklist
  10. ^ AB Haynes: A surgical safety checklist to reduce morbidity and mortality in a global population . In: N Engl J Med . 360, No. 5, January 2009, pp. 491-499. doi : 10.1056 / NEJMsa0810119 . PMID 19144931 .
  11. ^ TG Weiser: Effect of a 19-item surgical safety checklist during urgent operations in a global patient population . In: Ann Surg . 251, No. 5, May 2010, pp. 976-980. doi : 10.1097 / SLA.0b013e3181d970e3 . PMID 20395848 .
  12. ↑ Learn from mistakes. Open discussion about mishaps as opportunities. In: forsch. Bonner Universitäts-Nachrichten, issue 4/2014. P. 45.