Reducing risks to hospital patients
Media attention is often directed at the safety standards of our hospital system. The Australian Commission on Safety and Quality in Health Care (ACSQHC) found that hospital errors were on the increase with one in ten patients harmed by hospital treatment.
Australian hospital patients needlessly died or were put at serious risk at least 130 times between 2004 and 2005, the report shows.
Several health reform measures are being implemented to improve the national safety standards and reduce risks to patients and healthcare workers.
• In 2009 the ACSQHC endorsed a proposal for hospitals to direct purchasing preferences towards standardised drug concentrations to avoid the risks associated with customized IV infusions prepared under less than rigorously controlled conditions.
• Recommendations from ACSQHC (2003) advised hospitals to replace potassium chloride ampoules with premixed potassium in order to avoid potentially fatal errors associated with administering potassium inappropriately.
What this means for the healthcare team
Health care professionals should:
• Standardise prescribing of IV potassium chloride and prescribe premixed potassium chloride where possible;
• Reject “bolus” potassium chloride directives; and
• Follow hospital guidelines requiring premixed potassium chloride.
Australian Health Service Safety and Quality Accreditation Scheme
• In 2010 Australian Health Ministers endorsed a new accreditation scheme, called the Australian Health Service Safety and Quality Accreditation Scheme. The scheme will be implemented between 1 July 2011 and 31 December 2012. Full implementation of the scheme will commence from 1 January 2013.
• Relevant standards that will need to be met for hospital accreditation include Healthcare Associated Infections and Medication Safety.
• Healthcare professionals and hospital administrators should know that safe medication and infection control system management is mandatory criteria for accreditation.
Medication and other medical errors are often the result of an overstretched and under resourced healthcare system. National Health Reforms and policies developed by the ACSQHC recommend that effective clinical governance frameworks and quality assurance systems are in place.
As part of The National Healthcare Agreement 2011, hospitals will need to meet medication safety performance targets to control costs and meet funding allocations.
From July 1st 2012, hospital services will be funded via Activity Based Funding according to “national efficient prices” with a view to improving the cost effectiveness of health services. Services offering little relative benefit (eg; avoidable clinical errors) are unlikely to receive funding.
What can your healthcare team do?
• Take direct action to reduce or prevent risks of patient harm during clinical and other work;
• Take an active role in adopting recommendations for change arising for incident analysis of healthcare errors; and
• Follow the policies, procedures and protocols of your hospital to support provision of safe and high quality medication care and safety.
Useful URLs
Australian Safety and Quality Framework for Healthcare www.health.gov.au
National Health Reforms - Department of Health and Ageing www.health.gov.au
National Safety and Quality Health Standards 2010 - Department of Finance and Deregulation - click on Health ris.finance.gov.au/category/health