More Involvement in Decision-Making Necessary

Photo: Doctor with patient

Hospital staff can involve patients, their next-
of-kin and patients' associations to ensure
patient safety; ©

Patient safety is not just a matter of concern for individual professionals. Rather, it is a product of the entire organization’s actions. The new adaptive management model takes account of the networked nature of health care, unbroken treatment chains for patients and the well-being of healthcare personnel.

"Patient-safe management must be viewed as a common cause. In addition to harmonizing rules and procedures, cooperation between actors and self-organization must be supported. Patients should also be viewed as part of management and better use should be made of their personal expertise", says Elina Pietikäinen. "Discussion mainly revolves around highly visible issues related to patient safety, such as falls. However, patient safety can also be endangered in an unnoticed, gradual manner. For example, poor nutrition can present a safety problem in long-term care." A key goal is to create good preconditions that help experts identify the hazards related to their work, how their work connects to that of others, and to do their jobs flexibly and well.

Patients themselves also play an important role in ensuring patient safety. For example, patients can report dangerous situations via the same system as that used by nurses. Patients should be given more information about the hazards and risks related to taking their medication, for example, and receive guidance in the safe use of medicine. It is not enough that patients know what to do. They should also understand why things are done in the way they are, and what might happen if the patient, for one reason or another, is unable to comply with treatment instructions.

Representatives of patients' associations can participate in the design of hospital practices and changes in them, contributing the perspective of the group they represent. In many cases, patients' associations have first-hand knowledge of typical risks and problems related to treatments, as well as ideas on new solutions for them. They can function as mediator between patients and hospitals.

In Vaasa, systematic patient safety management emphasized the harmonization and guidance of the actions of individuals and units at first, but more focus has gradually been given to the other key principles of adaptive patient safety management. For example, groups and networks for facilitating communication on matters related to patient safety have been established. Regular evaluations of the state of patient safety have also begun, and long-term development goals related to patient safety have been set for the organization.

The organization has also encouraged discussion of how personnel might flexibly account for patient safety in the conflicts they encounter in their daily work. Vaasa Central Hospital has appointed special patient safety experts and working groups, which also include representatives of patients' associations. Patients can also use the hospital's incident system to report any incidents they may encounter.; Source: VTT Technical Research Center of Finland