Pakistan needs to redesign its healthcare delivery system-Paul Barach


 Pakistan needs to redesign its healthcare
delivery system - Paul Barach

Patient safety is not so simple, it is complex and needs compliance

KARACHI: Patient Safety is not so simple, it is complex and needs all round compliance. To ensure that Pakistan needs to redesign its healthcare delivery system. If the patient has to see four different doctors and visit three different places for various procedures, it will definitely increase the healthcare cost but if you provide all this at one place, it will be not only cost effective but also welcomed by the patients. This was stated by Prof. Paul Barach while talking to Pulse International during the recently concluded Second International Conference on Patient Safety organized by Riphah International University in collaboration with Aga Khan University Karachi from October 28-29, 2017. Patient education, he opined, was very important and if we are able to reduce the hospitalization period, it will be helpful. Patient’s prolonged hospital stay not only increases the cost of healthcare but also exposes them to Hospital Acquired Infections.  Hence, if we take care of preparation of the patient before coming to the healthcare facility, make sure that all required investigations, OPD procedures are performed, this will considerably reduce the hospital stay of the patient. Unless the whole healthcare system changes, it is not possible to achieve the desired results.

Prof. Paul Barach

Replying to another question regarding the use of modern medicine and developments in medical technology which has made the healthcare and death much more expensive Prof. Paul Barach said that we have made lot of progress in the last few decades. He particularly referred to cystic fibrosis, congenital heart diseases, laparoscopic surgery and cervical dislocation disability which has considerably decreased. There are many elements in improvement but we are still struggling with the care of elderly frail patients. We see these elderly patients are alright but suddenly some minor thing happens, and they are gone. They are frail, their bone health is not so good, they suffer from malnutrition and they suffer from fractures too often. We need to deal with frailty and concentrate on co-morbidities. For improving healthcare and ensuring patient safety, we need to do regular clinical audit, start accreditation of the healthcare professionals, healthcare facilities, concentrate on training, start Registries and start Adverse Drug Reporting system. When asked that the Government of Pakistan as well as the College of Physicians & Surgeons of Pakistan both have tried in the past to establish an Adverse Drug Reporting Centre but failed since doctors do not report this, Prof. Paul Brach said that once the doctors are convinced that it is not going to be used against them, used in litigations but this information will be used to improve the systems, they will start reporting not only Medical Errors but also Adverse Drug Reactions. They have to be convinced of its usefulness. You need to concentrate on building Trust, unless it is there, you cannot move forward. At present there seems to be a trust deficit between the people and Government of Pakistan.  Make sure that the data so generated through ADR Centers will not be used against them. You need to find out why physicians in Pakistan are not prepared to change their practices, show them the way, review these practices and convince them. All healthcare professionals including doctors, nurses, paramedics and hospital staff as well as the general public needs to be educated on patient safety and patients should be made aware of their rights as well.   Media can play a very positive role promoting health education but most often media makes the things worse. For example, India and Pakistan can have good relations but media plays up minor things and you fail to have peace with the neighbors. Same is the case with North and South Korea. One has to achieve Pease with enemies for progress, he added.

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