Improvement in quality of service, as well as safety of patients and healthcare workers, are among the main lessons learnt during the pandemic, officials said at the three-day Patient Safety Virtual 2021 conference that started today.
Addressing the opening session, “The changing face of safety: The impact of COVID19 on defining and improving safety in healthcare” Dr Kathy Leonhardt, Principal Consultant for Quality & Patient Safety, Joint Commission International (JCI), Wisconsin, USA said that healthcare organisations need to adopt broader safety strategies, apply quality improvement using tools, and leverage technology in digital tools to bring safety into organisations to achieve the next generation Quality 4.0.
“The pandemic has made us more transparent and we have realised the good and the not so good in our efforts to improve safety across the globe.”
New processes have been created and existing ones have been disrupted. “This includes use of technology which many were not familiar or comfortable with such as doing telemedicine through the computer, e-visits and using different tools for patients to communicate with their families. All these changes impacted the outcomes and risks which also impacted patients,” she said.
Post-pandemic, the most frequently reported findings in JCI surveys identified in 1,500 hospitals in the US that Covid stress on healthcare industry contributed to worsening of existing safety events, and there was a significant increase in patient falls, pressure ulcers, central line and bloodstream infections. Medical care was either delayed or missed, while misdiagnosis of Covid and non-Covid care were also reported.
“But what we were not prepared for was the impact of Covid on the safety of our healthcare workers,” she added.
Other impacts were deaths as well as psychological and physical attacks on healthcare workers and consequently, an exodus of medical workers has been seen, leaving hospitals understaffed and unable to provide quality care to patients.
“Our healthcare systems have not been able to respond. However, we learnt and continue to adjust and prepare for the future.”
Recommending three strategies, Dr Leonhardt said that healthcare organisations need to adopt broader safety strategies, apply quality improvement using tools in standardised method to make decisions and adapt, and leverage technology in digital tools to bring safety into organisations.
“When you combine all these strategies, you get Quality 4.0 which is our next generation without replacing previous methods and building upon them.”
JCI is also moving towards, AI and machine learning to provide reliable services to its clients. “To eliminate harm for all, healthcare needs to optimise improvement efforts with the use of technological tools to empower people to build reliable systems,” she added.
Checklists key to patient care
At the keynote address “Implementing safety solutions/interventions in a health system – the patient safety toolkit post-Covid,” Prof Nick Sevdalis, Implementation Science & Patient Safety; Quality Improvement & Implementation Science CAG, King’s Health Partners; Founding Section Chief Editor, Frontiers in Health Services, King’s College London said that checklists are important for patient care.
“We need to start looking at methodologies and systems to develop what we already know and build upon them.”
He also said that there has been a noticeable shift in the knowledge gap in patient safety that was present years ago to implementation gap. “We need to work on being consistent in implementation.”
Moderate rise in antibiotic prescription and consumption in UAE during pandemic
In another session on "Antimicrobial Resistance (AMR) after COVID-19 – what challenges await?’", moderator Dr Jens Thomsen, Chair, UAE Sub-Committee for AMR Surveillance, and UAE National Focal Point for WHO Global AMR Surveillance (GLASS) Data Manager AMR, Ministry of Health and Prevention, Abu Dhabi, presented a global study done in 2020 showing that there has been a moderate increase in antibiotic prescription and consumption in UAE during the pandemic.
“An increase in antimicrobial resistance was also seen in different strains,” he said.
Dr Luke Moore, Infectious Diseases Physician and Clinical Microbiologist; Honorary Clinical Senior Lecturer, Faculty of Medicine, Department of Infectious Disease, Imperial College London, London, UK, said that the pandemic has changed prescribing habits, and the challenge is to see if this will continue in the future as well.
Dr Stefan Weber, Consultant Microbiologist, Sheikh Khalifa Medical City, Abu Dhabi, UAE said that there was a short disruption in supply of antibiotics during the pandemic, but it was largely overcome.
“During the pandemic, the doctors did not know where we were headed and let their guards down which led to us losing what we had achieved in infection control earlier. It will be a challenge to start again with a new energy.”