“We need a European Health Union. We need minimum quality standards for public heathcare systems in Europe, it is in the interest of all of us.”
MEP Istvan Ujhelyi
The virtual roundtable entitled “Pathways for fostering patient safety across Europe: Learning from regional success stories” took place on Tuesday 8 September 2020 at 11:00 – 12:30 Brussels time. The purpose of the discussion was to bring together healthcare authorities, academics, healthcare providers and workers as well as EU policymakers to discuss pathways for implementing best practices and for fostering patient safety in all healthcare settings.
European health systems still face significant challenges when it comes to patient safety. Regulatory responses and protocols vary considerably across Member States as well as across individual regions and even individual hospitals. Broadening lawmakers’ and health care professionals’ understanding of patient safety and the many issues associated with it as well as of the potential of innovation and digital solutions in preventing harm is needed in order to advance quality of care in Europe’s hospitals. This need has never been more pressing than in the face of one of the biggest challenges for European and global healthcare systems to date, namely the COVID-19 pandemic. The crisis has once again demonstrated the paramount importance of patient safety protocols for infection control and prevention and the need for timely and efficient implementation of best practices for preventing harm and saving lives. In this context, Health First Europe organized a webinar dedicated to showcasing patient safety success stories from across Europe’s regions and local governments in an attempt to demonstrate the value of innovation for the advancement of quality of care in European health care settings.
Patient harm can be caused by a range of adverse events both preventable and non-preventable. Such patient safety lapses can result from issues including hospital-associated infections (HAIs) due to growing anti-microbial resistance (AMR) or poor sanitation protocols, medication errors, diagnostic errors, pressure ulcers, patient falls, venous thromboembolism or death during interventions with typically low mortality rates. The discussion in the webinar focused primarily on best practices for mitigating medication error and preventing HAIs and AMR as well as on reporting systems for adverse events.
The debate was hosted by MEP Istvan Ujhelyi (Hungary, S&D) who called for the establishment of a European Health and stressed the need for ensuring universal access to high quality healthcare for all Europeans, an issue which has become even more pressing in the face of the COVID-19 pandemic. Boosting patient safety and tackling existing imbalances in the EU health systems is crucial for ensuring long-term social and economic development in the EU.
In order to know the challenges and identify policy solutions for patient safety, it is crucial to start from the state of play. Dr. Dominique Monnet, Head of the Antimicrobial Resistance and Healthcare-associated Infections Programme at the European Centre for Disease Prevention and Control (ECDC), elaborated on the burden of hospital-associated infections (HAIs) on the healthcare systems of EU/EEA countries. ECDC estimated that about 9 million HAIs occur each year in European acute care hospitals and long-term care facilities, with up to half of those being preventable with various interventions. Dr. Monnet highlighted the connection between growing antimicrobial resistance (AMR) and HAIs, and spoke of the importance of sustained efforts to reduce rates of AMR. Tackling AMR is not only crucial for ensuring patient safety but offers significant opportunities for reducing healthcare costs. Based on a study carried out in 2018 by the Organisation for Economic Co-operation and Development (OECD), each euro spent on measures to tackle AMR will convert into 2.5 euros of savings for the healthcare system. Although there are European and, in most countries, national-level action plans and guidelines, the challenge remains the implementation of tailored interventions in each individual healthcare settings.
The core of the webinar were three case studies focused on patient safety best practices, tackling the issues of medication errors, HAIs and AMR and adverse events reporting systems. The first one was introduced by Professor Elisabetta Caselli from the University of Ferrara. Her case study focused on innovative hygiene technologies and their potential for improving patient safety. In her intervention, Professor Caselli outlined the limitations of traditional chemical sanitization tools including their inability to effectively prevent recontamination, their negative environmental impact as well as their tendency to favour the selection of drug resistant bacteria strains which represent the largest share of HAI-associated pathogens. In comparison, alternative solutions such probiotic-based hospital sanitation technologies offer fewer harmful side effects while successfully limiting the growth of pathogens. Studies into the effectiveness of one such solution, the PCHS system, reported a 50% decline in HAIs incidence as well as 60% reduction in drug consumption and 75% reduction in associated costs. Such data highlights the importance of hospital hygiene (in addition to hand hygiene and other hygiene protocols) in preventing infections.
Alongside HAIs and AMR, the issue of medication error represents one of the most common sources of patient harm accounting for up to 25% of preventable adverse events recorded in the healthcare setting. Medication error refers to any error that occurs in the medication delivery process, from prescription to administration. Departing from the significant costs associated with such errors both in terms of patient suffering and in terms of healthcare spending, Professor Pascal Bonnabry, Chief Pharmacist at Geneva University Hospital, focused his presentation on the potential of IT solutions in overcoming this issue. Tackling the problem of medication error requires a multi-dimensional approach integrating processes, persons (healthcare professionals as well as patients) and the products themselves. IT solutions offer a number of benefits in this regard. They have the potential to improve safety through avoiding human errors and making processes more reliable, to boost efficiency allowing hospitals to do more with less staff and free up valuable time for patient care as well as to improve traceability thus aiding the fight against falsified medicines. In this context, concrete IT solutions such as automated dispensary cabinets, robotized medicine distribution and bedside scanning have the potential to reduce error incidents by as much as 60% from today’s levels.
Staying within the theme of technological innovation and automation, Dr. Paul Garassus, President of the European Union of Private Hospitals (UEHP) spoke of the importance of appropriate systems for risk management and “adverse event” reporting. Specifically, he presented the case study of Sana Kliniken’s Governance System for incident reporting paying particular attention at the issue of effective information management. In this context, Dr. Garassus acknowledged also the importance of managing cybersecurity risks and addressing issues such as data storage for advancing the safety of patients.
Following the presentations of the three case studies, Mr. Jean-Luc Vanraes from the European Committee of the Regions reflected on the role of the European Union in facilitating the scaling of successful patient safety practices and protocols as those outlined by the speakers. He reminded participants of the need to bolster political awareness of the problem of patient safety but also of the cost-saving benefits of addressing it effectively. Furthermore, Mr. Vanraes highlighted the issue of inconsistent protocols on patient safety across hospitals and spoke of the need for an EU-wide public accreditation system with clear standards of quality. This, he said, would be an important step in providing Europe’s regions with the tools to ensure the highest quality of patient care in their local hospitals.
Overall, participants in the debate agreed on the need to embrace innovation in tackling the issue of patient safety as well as on the benefits from knowledge sharing for facilitating the scaling of successful patient safety practices. Investment in the deployment of new technologies will not only markedly improve quality of care for all Europeans but has the potential to alleviate the significant financial burden of patient safety lapses in the long-term.
The discussion’s content will feed into a follow-up report on regional patient safety success stories, which will be published later this year.
This event was made possible thanks to unrestricted grants from BD and Copma Scrl.