Patient safety : leadership perspectives are explained

1. Bonafide Administration
and Leadership:
Pavement to Patient
Safety
Dr. Latha Venkatesan
Professor Cum Principal
College of Nursing, AIIMS, NewDelhi

2. Topic …..
Bonafide : Genuine, real, not deceiving
Administration: While management
focus on implementing policies and
strategies, administration focus upon
formulation of policies
Leadership: practical definition?

4. International
Patient Safety
Goals

5. History….
• The global need for quality of care and patient safety
was first discussed during the World Health
Assembly in 2002
• and resolution WHA55.18 on ‘Quality of care: patient
safety’ at the Fifty-fifth World Health Assembly urged
Member States to “pay the closest possible attention
to the problem of patient safety”
• Since then, there have been several international
initiatives, which have brought the importance of the
matter to the attention of policy-makers in many
countries, including:
• Development of global norms and standards
• Promotion of evidenced-based policies
• Promotion of mechanisms to recognize excellence in
patient safety internationally
• Encouragement of research
• Provision of assistance to countries in several key
areas

6. National Patient Safety
goals
• Transfusion errors
• Critical results
• Anticoagulant safety
• Clinical alarm systems
• CDC vs WHO
• Reduce the risk for suicide

7. The conceptual
framework for the
International
Classification

8. National Patient
Safety
Implementation
Framework (NPSIF)
in India (2018 –
2025)
• Safe surgical care and safe childbirth
• Injection safety
• Blood safety
• Medication safety
• Medical device safety
• Safe organ, tissue and cell transportation
and donation
• bio-medical waste management
• prevention of healthcare associated
infections and much more.
• Patient safety research

9. Objectives of
NPSIF
• Strategic Objective 1: To improve structural systems to
support quality and efficiency of healthcare and place
patient safety at the core at national, subnational and
healthcare facility levels.
• Strategic Objective 2: To assess the nature and scale of
adverse events in healthcare and establish a system of
reporting and learning. Strategic Objective 3: To ensure a
competent and capable workforce that is aware and
sensitive to patient safety.
• Strategic Objective 4: To prevent and control health-care
associated infections.
• Strategic Objective 5: To implement global patient safety
campaigns and strengthening Patient Safety across all
programmes.
• Strategic Objective 6: To strengthen capacity for and
promote patient safety research

10. Paramount
provisions of
NPSIF:
• Constitute national level steering committee as a central
coordinating mechanism for Patient Safety.
• Integrate web-based grievance system and toll-free helpline for
Patient Safety.
• Introduce anonymous reporting system in healthcare facilities to be
used by healthcare facility staff, students, residents, patients and
families.
• Incorporating patient safety principles and concepts in the Public
Health Act and streamlining patient safety in different insurance
schemes.
• Strengthen quality assurance mechanisms, including accreditation
system.
• Establishment of a safety culture and improving communication,
patient identification and handing over transfer protocols in
healthcare facilities.
• Ensuring that patient safety processes are clearly communicated to
patients and caregivers prior, during and after the medical
intervention using different communication means such as videos,
mobile apps, etc

11. Challenges?
Creating
Patient safety
culture….
Error reporting
culture

12. Minimum
Information
model for
Patient safety
(MIM PS by
WHO)

13. What happens after a patient safety incident?

14. What’s new?
PFPS…
Patients for Patients
safety
• This program aims to incorporate the
patient, family and community voice
into all levels of health care
through engagement and empowerm
ent.
The goal is to advocate and facilitate:
• Patients taking ownership of their care;
• Bringing the voices of patients and
people to the forefront of health care;
• Patient, family and community
partnerships with health professionals
(health-care providers, policy-makers,
researchers).

15. Opportunity to
contribute….
Consultation: The third
draft Global Patient Safety
Action Plan 2021-2030
Timeline: Before 15
February 2021

16. Leadership
• Leadership is essential for making safe
and effective health care a reality.
• It is also necessary for improving the
quality and safety in health-care service
delivery and aligning systems for
improvements to occur.
• Management is essential for
implementing plans and strategies to stay
on that path.

17. Continued….
.
• Successful leaders are those who know how to
create a workplace culture in which the
• safe and high quality care of patients is a
priority
• A culture that promotes inter-professional
teamwork
• sets strategic goals for patient safety
• supports efforts within the organization to
achieve improvement goals
• provides resources for strengthening
systems
• removes obstacles for clinicians and health-
care staff that interfere with safe care
• maintains high performance of health-care
providers.

23. Structure
Of The
Framework
There are ten learning categories and in each the
following can be found:
 Learning category (e.g. communicate
effectively)
 Learning objective (e.g. establish goals, policies
and strategies for service improvement)
 Knowledge components to be understood
before demonstrating relevant performance (e.g.
articulate clearly and put into practice policies
and management plans for improving patient
safety and quality of services provided)
Performance features (e.g. delegating as
appropriate, empowering staff to communicate
openly, inspiring)

24. Learning Domain: Personal Attributes
Learning category 1. Exhibits leadership style, awareness and
adaptability
Learning objectives
• Demonstrates an appropriate leadership style
• Is aware and self-aware: knows how to determine one’s own strengths and weaknesses
• Identifies and understands the motivation behind behavior (critical to building a culture
of safety)
• Adapts to changing environments and trends
• Demonstrates an empathic attitude

25. Learning Domain: Personal Attributes
Learning category 2. Is a leader
in professional conduct
1
Learning objectives
•Is culturally knowledgeable
(inclusion activity- equality)
•Demonstrates equity and non-
discrimination (inclusion leadership)
•Adheres to and promotes good
governance principles
2

26. Learning category 3. Is
a learner as a leader
Learning objectives
Learns from other
organizations and
industries /HROs;
incorporates and use
knowledge and
expertise from HROs
and from one’s own
organization
Is a workplace learner
Learning
Domain:
Personal
Attributes

27. Learning Domain: Core Functions Of
Leadership
Learning category 4. Sets the direction
Learning objectives
•Thinks strategically and is innovative
•Has organizational awareness
•Translates evidence and prioritizes the development of organizational
policies to address risk /patient harm, improved environments and safe
cultures
•Puts in place mechanisms for addressing legal requirements related to
patients’ rights

28. Continued…..
• Puts in place policies and mechanisms for addressing ethical
requirements for patients/ ‘respectful care’;
• Understands and manages the issue of patients’ rights
• Obliges to organizational transparency, accountability (performance,
resourcing, political, ethical and community), practice standards of
staff professional conduct and ethical behavior

29. Learning Domain: Core Functions Of
Leadership
Learning category 5. Communicates effectively and sets the scene
Learning objectives
• Is a good communicator/advocates for safety and quality improvements
• Defines goals for establishing policies and strategies for service improvement
• Connects with providers/ employees and transfer ideas and intentions
• Understands/ engages with patients /their families in order to respond to the patients’
voice
• Engages and manages external stakeholders (health authorities, politicians, national
health assoc., experts) and responds appropriately
• Demonstrates being an effective workplace mentor/ teacher advocates for patient safety

30. Learning
Domain: Core
Functions Of
Leadership
Learning category 6. Leads positive
transformation to build and sustain a climate
of safety
Learning objectives
• Brings together collaborations
• Creates external and internal partnerships in order to
implement successfully strategies and plans
• Motivates, inspires and empowers individuals and
teams to implement change
• Empowers staff to speak up and openly challenge;
cultivates staff commitment; uses incentives

31. Continued….
.
• Cultivates the notion of compassionate
care
• Board/ Trustees links and development
• Understands the importance of human
factors in improving health service
delivery
• Understands the complexity of health
service delivery and health systems;
structure effectively a continuum of care

32. Learning Domain: Ability To ‘Execute’ (Or ‘Putting In Place’ Or
‘Making Operational’ Or ‘Mise-en-place’)
Learning category 7. Delivers competently and effectively
Learning objectives
• Brings about quality and safety improvements
• Change management (for safety and quality improvement)
• Demonstrates ability to manage human resources in order to ensure appropriate mix of
employees’ competencies to achieve the safety and quality goals
• Facilitates development of effective teams (IPE/ training etc)
• Prioritizes the development of improvement plans/mechanisms for delivering safe and
quality services; oversees their implementation
• Demonstrates ability to manage financial resources for quality and safety improvements

33. Learning Domain: Ability To ‘Execute’ (Or ‘Putting
In Place’ Or ‘Making Operational’ Or ‘Mise-en-
place’)
Learning category 8. Has political and social astuteness
Learning objectives
•Responds to changing individual and community expectations;
demonstrates responsiveness, participation and inclusiveness
•Facilitates alignment with national health reforms
•Responds to global trends
•Interacts effectively with the media and engages with them
where appropriate

34. Learning Domain: Ability To ‘Execute’ (Or ‘Putting
In Place’ Or ‘Making Operational’ Or ‘Mise-en-
place’)
Learning category 9: Establishes crises systems and
mechanisms for safe health service delivery
Learning objectives
•Financial preparedness
•Develops contingency plans to respond to breakdowns of
structures, communication and increased volume and needs of
patients during disasters
•Develops contingency plans to respond toe epidemics and
outbreaks

35. Learning Domain: Ability To ‘Execute’ (Or ‘Putting In
Place’ Or ‘Making Operational’ Or ‘Mise-en-place
Learning category 10. Uses evidence and information for
policy and health service improvements
Learning objectives
•Understands the importance of measuring, reporting, assessing risk,
reporting hazards for continuous learning and improvement
•Encourages research on quality and safety activities designed to
improve health services

36. Contd….
• Leads the application of IT to enhance performance, quality and
safety
• Use of www.information
• Is aware of the evidence-based practices and solutions for quality
and safety of services (HH, Safe surg., Med. Safety, Blood safety,
handovers, safety of medical equipment etc)
• Balances evidence and innovation (local solutions)