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ADVANCES oN PATIENT SAFETY IN MEXICO
Dra. Odet Sarabia González
Advisor of the Under Secretary of Quality and Innovation, Ministry of Health Mexico, Mexico
City, Mexico
August/2008
CONTENT Location of the program on the national
agenda Progress in training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins Patient Safety Quality Committee Indicators of good practice in patient safety Lessons learned
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins on Patient Safety Quality Committee Indicators of good practice in patient safety Lessons learned
National Development Plan(PRONASA 2007-2012)
Five objectives
“To provide efficient health services, quality, warmth, and patient safety”
Chapter III - Objectives and strategies.Strategy 3Action Line 3.1
To link public hospitals of middle and high complexity with the programme of patient safety, including measures to ensure a clean care and prevent the occurrence of adverse events, medication errors and insecure surgery.
PRONASA 2007-2012
Chapter III - Objectives and strategiesStrategy 3Action Line 3.1
To contribute to reduce the morbidity and mortality from hospital-acquired infections. The goal is that 60% of public hospitals have a risk management model for nosocomial infections.
PRONASA 2007-2012
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins on Patient Safety Quality Committee Indicators of good practice in patient safety Lessons learned
At present, progress on training hospital personel of the Secretary of Health is around 40%.
PROGRESS IN TRAINING
0%-24%
25% – 49%
50% -74%
75% - 99%
100%
This is throughout many hospitals of the Health System.
PROGRESS IN TRAINING
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins on Patient Safety Quality Committee Indicators of good practice in patient safety Lessons learned
Signature
On September 21, 2007, Mexico, along with 6 other countries of Central America and the Caribbean, signed the joint declaration in favour of the first challenge of the World Alliance for Patient Safety of the World Health Organization.
Signature
Clean care is a safer
care
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins on Patient Safety Quality Committee Indicators of good practice in patient safety Lessons learned
National Campaign for Hand Hygiene
The National Campaign for Hand Hygiene will be launched in October.
The campaign represents a commitment from the whole health system.
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins on Patient Safety Quality Committee Indicators of good practice in patient safety Lessons learned
Considered a potentially serious and preventable
problem, with great economic and social impact.
A study of the Under Secretary of Quality and
Innovation, through the Directorate of
Performance Evaluation has documented
prevalence of adverse events of 11.8% on two
general public hospitals.
4 Observatorio del desempeño hospitalario 2006. Secretaria de Salud. México DF.
Research
At this stuydy the main adverse events in
hospitals are:
a) Acquired pneumonia (33.3%)
b) Surgical wound infection(25%)
c) Infection with medical procedures(20%)
e) Others (21.7%)
Research
Patients who experienced any adverse events
had an ALOS of 23-day.
This represented 10 days more regarding the
comparison group.
Research
Most of adverse events occurred in women
unrelated to obstetric conditions (53.7%) and in
children under 5 years (33%).
Research
Mexico participated in the study “Iberoamerican
Advers Events” (IBEAS, by its Spanish initials).
This study measures the prevalence of adverse
events in 5 countries in the region of Central and
South America.
Research
28 mexican hospitals
participated in this study,
involving approximately 500
professionals.
The databases have already been send to
Spain and we are awaiting feedback.
We are confident that their findings result in
valuable information regarding Patient Safety
in the Region and in Mexico.
Research
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins Patient on Safety Quality Committee Indicators of good practice in patient safety Lessons learned
In order to disseminate knowledge in the field of
patient safety, a threemonthy newsletter has been
published from September of 2005 until now.
Bulletins
Currently, we have 9
volumes of this newsletter.
In the last issue, Tomas
Flores and his wife Rosa
Garcia, shared their
experience when their
children suffered
Kernicterus undetected
timely.
Bulletins
Bulletins
These parents demonstrate their strength to work
in workshops and conferences which provide
preventive information on this disease.
With this work the health system have an
opportunity for improvement.
http://dgces.salud.gob.mx/seguridaddelpaciente/
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins on Patient Safety Quality Committee Indicators of good practice in patient safety Lessons learned
Commissions
5 commissions 10 actions in Patient
Safety
Taxonomy Implementing the
programme in hospital
units
Analysis of cases of SINRAECE for
issuing recommendations
Nosocomial infections
National Quality Committee
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins on Patient Safety Quality Committee Indicators of good practice in patient safety Lessons learned
Indicators of good practice in patient safety
1. Use limited and regulated abbreviation of dose and annotations
2. To implement protocols to prevent wrong surgical site and wrong patient
3. Assessment and prevention of decubitus ulcers
4. Assessment and prevention of deep vein thrombosis
5. Appropiate management of anticoagulants6. Prevention of infections associated with the use of central catheter
Indicators of good practice in patient safety
7. Prevention of surgical infections
8. Washing or disinfecting hands before and after direct contact with patients or objects around
Indicators of good practice in patient safety
9. Identification of high alert medications
10. Method for standardized labelling and storage of medicines
11. Assessment of climate for patient safety
Indicators of good practice in patient safety
CONTENT The program in the national healthcare
agenda Progress on training Signing the joint statement in favour of the
first challenge of the World Alliance for Patient Safety of WHO
National Campaign for Hand Hygiene Research Bulletins on Patient Safety Quality Committee Lessons learned
Lessons learned
To continue the actions undertaken during the previous administration it was necessary to obtain political support for the new Administration.
The management changes bring slowness in the process already started. This is easy to reduce if you can put the item on the national agenda.
The training in cascade has helped bringing the issue of patient sfety to different hospitals in the health services throughout Mexico.
Lessons learned
The gain international commitments facilitates and promotes actions regarding patient safety.
The investigation into patient safety has been a great tool for raising awareness of the problem, not just to get the results, but from the moment starts training and conducts research in itself.
Lessons learned
The dissemination of knowledge from bulletins seems to be a good tool to create awareness and commitment.
To include the best practices in patient safety indicators on the process of accreditation seems to be a good measure to encourage work in favour of safety.