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Reflections on Safety is a monthly column presenting the insights of Tejal K. Gandhi, MD, MPH, CPPS, Chief Clinical and Safety Officer, Institute for Healthcare Improvement (IHI). Dr. Gandhi was president and CEO of the National Patient Safety Foundation prior to its merger with IHI in May 2017.


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Going Global on Patient Safety

Posted By Administration, Wednesday, March 23, 2016

This month’s Patient Safety Global Action Summit should inspire us all to come together

to advance patient safety.

By Tejal K. Gandhi, MD, MPH, CPPS

Tejal K. Gandhi


Earlier this month I had the privilege of attending the Patient Safety Global Action Summit in London. Co-hosted by the health ministers of England and Germany, the meeting brought together health officials of many countries, including England, Scotland, Switzerland, Germany, Saudi Arabia, and Japan, to name a few, as well as leaders of health care organizations and non-governmental organizations such as the World Health Organization, the National Patient Safety Foundation, and others.


Health leaders from the U.S. who spoke at the meeting included Dr. Don Berwick, president emeritus of the Institute for Healthcare Improvement and former administrator of the Centers for Medicare and Medicaid Services; Dr. Gary Kaplan, president and CEO of Virginia Mason Health System and a long-serving member of the NPSF Board of Directors and the NPSF Lucian Leape Institute; and Dr. Atul Gawande, surgeon and best-selling author.


As one of the participants noted in a commentary, a goal of the meeting was to begin a “global drive to reduce errors, improve care, and save lives.” It was truly inspiring to see international interest and real commitment from so many countries.


In advance of the meeting, researchers based at Imperial College London and affiliated with England's National Health Service produced a report called Patient Safety 2030. The panel I participated in at the meeting specifically addressed one part of this report: The Patient Safety Toolbox for the Next 15 Years.


If that sounds familiar, it may be because there is remarkable synergy between the NHS report and the NPSF report, Free from Harm: Accelerating Patient Safety Fifteen Years after To Err Is Human, which NPSF published last December. Both reports put a strong emphasis on leadership, education and training, more centralized and coordinated oversight of patient safety, data and measurement, technology and digital health, and the need for research into implementation science and learning from other fields.


In discussing the toolkit needed to advance patient safety from now until 2030, the panel I took part in called for greater understanding of how behavior change happens. How do we get people to practice hand hygiene or use checklists consistently? Lessons we learn from behavioral economics, psychology, and neuroscience can help us understand how human beings behave in certain circumstances and how we make decisions. This knowledge, in turn, can help us identify the most effective ways of implementing known safety interventions.


I left the Patient Safety Global Action Summit energized by how much can be achieved when various stakeholders come together. It was particularly gratifying to follow up that experience with Patient Safety Awareness Week, and to see and hear what so many are doing here in the U.S. and abroad to help advance safe care.


The themes discussed in Free from Harm and Patient Safety 2030 are clearly resonating with clinicians, leaders, patients, and advocacy organizations. We need to keep this momentum going, to involve policy makers and all stakeholders, until we get to the stage where “Every day is patient safety day.”

What are the top patient safety issues in your organization? Comment on this post below. Note: To comment, you must first register on the website. If you are already registered, you must log in to comment.

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Tejal K. Gandhi, MD, MPH, CPPS, is president and chief executive officer of the National Patient Safety Foundation and of the NPSF Lucian Leape Institute.

Tags:  collaboration  stakeholders 

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