Patients need to speak up for their own safety

This year's WPSD theme, 'Engaging patients for patient safety', recognises the role that patients, their families and caregivers play in the delivery of safe healthcare. — Filepic

World Patient Safety Day (WPSD) is commemorated annually on Sept 17.

The theme this year (2023) is “Engaging patients for patient safety”, which is in recognition of the role played by patients, their families and caregivers in the delivery of safe healthcare.

The objectives of WPSD 2023 are to:

  • Raise global awareness of the need for active engagement of patients, their families and caregivers in all settings and at all levels of healthcare to improve patient safety.
  • Engage policymakers, healthcare leaders, health and care workers, patients’ organisations, civil society and other stakeholders in efforts to engage patients and families in the policies and practices for safe healthcare.
  • Empower patients and families to be actively involved in their own healthcare and in the improvement of healthcare safety.
  • Advocate urgent action on patient and family engagement, aligned with the Global Patient Safety Action Plan 2021–2030, to be taken by all partners.

WPSD 2023 aims to influence all stakeholders, including patients, their families, policy- and decision-makers, healthcare staff, patient organisations and civil society, to cooperate in designing policies and safety interventions that are truly reflective of patients’ needs and preferences, which would, in due course, ensure safe healthcare globally.

Unsafe healthcare

It is the right of all patients to always have safe healthcare delivered to them in all healthcare settings.

However, the reality is different.

Millions of patients globally are harmed annually by unsafe healthcare, which is one of the 10 leading causes of deaths and disability worldwide.

According to World Health Organization (WHO) estimates, one in every 10 patients is harmed while receiving hospital care in high-income countries, with nearly half of these adverse events preventable.

As many as two in five patients globally are harmed in primary and outpatient health care, with about 80% of harm preventable.

Most of the errors are related to diagnosis, prescription and medication use.

From the economic perspective, about 15% of total hospital activity and expenditure in OECD (Organisation for Economic Co-operation and Development) countries, is a direct result of adverse events.

There is no national data on adverse healthcare events in Malaysia.

However, the voluntary e-incident reporting in Health Ministry hospitals provide some perspectives on adverse healthcare incidents.

In 2021, there were 6,759 actual incidents and 1,150 near misses reported.

The main incidents were patient falls (33.2%), medication errors (21.8%) and obstetric-related (involving pregnancy and childbirth) incidents (10.2%).

The outcomes were harm in 3,616 (53.5%) patients, with 245 (3.1%) severe harm, 181 (2.3%) deaths and 603 (7.6%) indeterminate.

The top eight incidents that led to severe outcomes or death were patient falls, obstetric-related incidents, clinical management error, adverse outcome of clinical procedure, medication error, delay in treatment, equipment malfunction/unavailable, and pre-hospital care (including ambulance-related).

No data from private hospitals were available.

Patient safety their priority

Patient and family engagement is increasingly recognised as integral to healthcare delivery and a key strategy to developing a safer healthcare system.

It is recognised that engaged patients are better at making informed decisions about their healthcare options.

Furthermore, healthcare resources can be better utilised if patients’ priorities align with critical impact on the sustainability of the healthcare delivery system.

Users of healthcare services are increasingly expecting healthcare delivery to be more responsive, open and transparent.

Notwithstanding individual variations, patients expect to be engaged in the decision-making process.

While healthcare staff have multiple competing priorities that may conflict with patient safety, patients have their own safety and well-being as their primary consideration.

Patient engagement may also promote better understanding and mutual accountability between patients and healthcare providers.

As primary care is often the first contact of patients with the healthcare system, primary care providers are best placed to engage patients in mutual discussion(s) about their health conditions, circumstances, health needs, and personal values and preferences.

Informed patients are more likely to share about both positive and negative experiences.

This improves health outcomes, promotes learning and improvement, and reduces adverse events.

The paternalistic approach to healthcare delivery has to give way to a more patient-centred approach.

A paradigm shift from care designed for patients to care designed by patients is necessary.

Patients and families should be involved at every level, from shared decision-making at the point of care to policy-making and planning.

The patient voice has to be listened to and learnt from, to ensure that no one is harmed in healthcare.

How to engage

There are various ways in which patients and their families can be engaged.

They can be engaged in the design or development of patient-centred processes and systems (e.g. advisory committees) at the local level.

They can also be engaged at state and/or national level in the development and dissemination of tools, information and educational materials; in educating and empowering fellow patients to recognise their health needs and seek healthcare in a timely manner; and in research.

In Malaysia, all hospitals, whether public or private, have a Board of Visitors.

Whether their members, who are mostly political appointees, have fulfilled their roles and responsibilities to be the patients’ voice is an open question.

There are also consumer organisations who voice out patients’ grievances occasionally.

The Malaysian Society for Quality in Health (MSQH) and the Health Ministry, in collaboration with the WHO, organised the first Malaysian Patients for Patient Safety workshop in Putrajaya in November 2013.

A Patients for Patient Safety section formed by the MSQH announced the Patients for Patient Safety Malaysia (PFPSM) Declaration on April 29, 2014.

The PFPSM co-organised a second workshop with the MSQH, the Health Ministry and WHO in September 2014, and was involved in a pilot project in 2015-2016.

All appears to have been quiet since then.

The message for the reader is that patient safety involves everyone, including policy- and decision-makers, patients and their families, healthcare staff, patient advocates and civil society.

Everyone has a role to ensure safe healthcare!

Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Patient safety , healthcare


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