Health Worker Safety Deserves a Second Look

Context: The key the health worker safety is to adopt a systems approach and lay emphasis on a culture of health worker well­being.

Global focus on Healthcare Safety:

The World Health Organization observes World Patient Safety Day every year (September 17). The theme for 2020 was ‘Health Worker Safety: A Priority for Patient Safety’ with a call to action to ‘Speak up for health worker safety!’

Challenges with the Healthcare in India

• Unsafe Healthcare Practices: 

• Unsafe healthcare practice refers to unsafe or unnecessary procedures, wrong medications, medications given in the wrong dosage, etc.
• Studies in India have shown that more than two­ thirds of injections are given in an unsafe manner;
• Over two-thirds of injections in primary care are unnecessary in the ?rst place.
• Long working hours during COVID: affects their mental and physical Health
• Studies have shown that health workers, residents who have been on duty for more than 24 hours at a stretch, have a higher risk of making mistakes, increasing the likelihood of a direct impact on patient safety.

• Unsafe Healthcare Communication: refers to mistakes made in healthcare settings due to miscommunication between health professionals, for e.g. during patient handover in between sta? shifts. 

• Presence of Strict Hierarchies: between various designations, doctors and health professionals.

• Such power differences can further prevent reporting and cooperative organizational learning and may increase chances of abuse -verbal, physical or sexual.

• Lack of Healthcare Facilities:  Many health workers are over­ worked not by choice, but rather the lack of it since understaffing and shortage are common features of Indian healthcare.

• The lack of adequate social care, such as care homes, community health services and community-based rehabilitative and palliative services, unduly increase the burden on healthcare facilities.

Solutions:

• Encourage Organizational Learnings: Organizational learning is more important than individual learning. 

• This is because instances of patient harm, even when they occur at the individual level, are often an end result of a chain of organisational failures. 
• For, E.g. Following are the organizational failures that could result in a cascade leading to harm to patients: 
• Systemic under sta?ng,
• Lack of reporting mechanisms,
• Lack of dedicated time for handovers, audits, training and team building, 
• Poorly maintained equipment and corruption in purchases, 

• Adopt Systems Approach: Managing the different areas of healthcare management by specifically finding a solution to them.

• For, E.g. the solution of overcrowding gin hospitals can be tackled through 3 throughputs – 
• The need for an emergency patient to be treated in the same hospital rather than in the community itself.
• Looking at inefficiencies like shortage of doctors, nurses, equipment or space.
• Looking for if the patients are spending more time in the emergency department due to unavailability of non-emergency beds.

• Involve Stakeholders

• Patients themselves need to be aware of patient safety as well as be empowered to demand safe health care and resist unnecessary medications and procedures. 
• Hospital managers must understand the need for and be empowered to create systems of reporting, monitoring and organizational learning.
• Policymakers must prioritize sta?ng, codesigning functional and safe workplaces, and ethics in health care. 

Conclusion: We can help improve patient safety by taking a systems approach and promoting a culture of health worker safety and wellbeing.