Enhancing Patient Safety across Pakistan’s Healthcare Sector

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Enhancing Patient Safety across 
Pakistan’s Healthcare Sector
Dr. Muhammad Hasan Abid*

Patient safety forms a fundamental domain of high-quality healthcare delivery as powerfully articulated by the four words on clinician’s primary responsibility for patient safety in the Hippocratic Oath – “First, do no harm”. Poor quality healthcare causes an estimated 8.4 million deaths every year and $1.6 trillion lost productivity across low-and-middle-income countries.

In a resource limited healthcare system of Pakistan, patient safety and quality improvement are relatively new concepts. Government has recently launched Provincial Healthcare Commissions (PHC), charged with accrediting healthcare entities based on compliance with quality parameters. This journey is proving arduous because of a culture of hierarchical authority, poor safety culture, and knowledge gaps in quality improvement sciences.


Dr. Hassan Abid

Medical Professional Societies and healthcare communities in Pakistan are in an early phase of the journey to improve the patient safety and quality of care. Multiple PHC’s and stakeholders are involved in healthcare quality improvement in the country. The Minimum Service Delivery Standards developed by each PHC are the principle accreditation instruments. But in the healthcare workforce, there still remains a ‘knowing-doing’ gap in the awareness of quality and patient safety. In the current times, it is crucial for the society to create enabling environment for all stakeholders to work in prioritizing the provision of accessible, safer and high-quality healthcare in Pakistan.

In order to enhance the profile of a worthy Cause or a Movement, it is customary to celebrate or mark ‘Days’ or ‘Weeks’, such as April 7, the “World Health Day” or “No Smoking day on March 11. Similarly, the world health organization (WHO) marks September 17 as “World Patient Safety Day”. This is a day of global solidarity and commitment to making health care safer for each and every patient in the world. Moreover, Boston based Institute for Healthcare Improvement (IHI) sponsors national Patient Safety Awareness Week (PSAW), a weeklong event in mid-March, again to raise awareness around patient safety. The PSAW provides a format for national effort to educate and engage healthcare providers, administrators, and the public-at-large.

The healthcare community in Pakistan must begin to follow similar steps by establishing days or weeks to enhance nationwide awareness. Awareness of the importance and practice of patient safety and quality of care. Catchy and appealing slogans in Urdu, media blitz, banner displays, educational seminars, essay contests and public rallies can be some of the programs to achieve the three key objectives. First, initiatives designed to create and build the will of workforce by engaging the healthcare leadership and frontline staff on the relevance of patient safety and need to act. Second, initiatives aligned towards utilizing common analytical approaches based on robust local and national data collection on patient safety measures, to brainstorm the ideas on areas of improvement. And third, multiple educational, policy, process improvement and system levels fixes to bring measurable improvement in patient safety across Pakistan. It is also of immense importance to include patients and families during the PSAW events at every level. These events can provide unique opportunities for elevating the Cause of patient safety in Pakistan. By setting expectations of healthcare workforce, education and then adding constant reinforcement in the form of PSAW across the country can be a small step towards a paradigm shift in establishing a highly reliable and safe healthcare industry.

There is a dire need for the healthcare system in Pakistan to move towards risk-based thinking and to proactively mitigate the possibilities of patient harm. The current novel coronavirus (COVID-19) pandemic highlights the importance of and provides a compelling need to continuously focus on patient safety. Handwashing is a cornerstone for infection prevention and control domain of patient safety and healthcare quality. The COVID-19 pandemic is an opportunity for society to reinforce the simple hand hygiene technique as outlined by WHO in combination with other public health practices like social distancing to bring a drastic decline in the rate of COVID-19 spread in Pakistan and help flatten the curve. Adequately supporting our healthcare workforce, system and processes with a focus towards the safer community and patient centered practices will remain an area of significant progress for patient safety in Pakistan. Acknowledgement: Prof. Sarwat Hussain, MD

*Dr. Muhammad Hasan Abid,
Fellow- Institute for Healthcare Improvement, Boston, MA, USA.
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