Health literacy and patient safety
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Health literacy and patient safety

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  • Introduction: mother’s story… 12/05/12
  • Health illliterate patient is at risk of medical error. Can you believe that such a patient can risk his doctors life? Don’t believe . Here is my story. 12/05/12
  • This is a story of two patients both from well to do families. On incidence took place about seven years back when the patient who had a heart surgery had not disclosed the same tome. I realised this straight away on operation table. Just around six months back I was doing an emergency c section at 2 am. As soon as I got the baby out, there came a long catheter out. I was stunned and shocked. My assistant stared pulling it out. We realised that this lady had under gone a major surgery on the brain in the past which she had not disclosed. 12/05/12
  • This is enough to establish that health literacy can reduce medical accidents and improve safety. The victims of medical accidents are not only patients and the relatives. But it is well established that the victims of such accidents are doctors and health care providers as well. 12/05/12
  • The WHO considers this as an pandemic. The problem of medical errors can not be resolved only by health care providers . WHO recognises that the patients are important stake holders in the whole process. 12/05/12
  • But is this a reality? The paternalistic attitude of doctors to practical difficulties such as time constraint may make it impossible to rely on doctors alone for this work. Even amongst patients who are so called literate, they find it difficult to comprehend the complex medical jargon even it is explained . 12/05/12
  • It is a well known fact that : The health illiterate patients are more likely to skip preventive measures, require hospital admissions, less likely to use services to prevent complications, feel vulnerable….. A perfect setting for medico-legal cases 12/05/12
  • To conclude , in reality it is hardly a partnership… It is actually a big void or a gap. Across the world there have been number of innovations to bridge this gap. In todays conference you will hear many such innovations. But I am going to share with you a few … 12/05/12
  • I and couple of like minded friends and colleagues , doctors and non doctors started this initiative called as patient safety alliance. I was particularly inspired to work on this concept when I worked with the department of health and WHO as a common wealth fellow in 2009. I am proud to say that this is the first of its kind organisation in the country trying to do some interesting work in India. 12/05/12
  • The objective of this NGO is working towards …. 12/05/12
  • We started this workshop called “ Be alert … Be safe” workshops. Now we are creating some very interesting educational videos by recreating the true mishap stories. The first workshop was conducted at the HELP library. We are happy to do these workshops in your organisations as well. 12/05/12
  • The PSA released few simple tools which are available on our website for free . People can start using these tools. 12/05/12
  • Consent for a surgery is another very crucial issue where patient understanding is of utmost importance. We along with PEAS are working on ……… 12/05/12
  • Process mapping….. 12/05/12
  • We recognised all these issues which doctors have in their mind while taiking consent or giving this vital piece of information to patients such as 12/05/12
  • Thus we are trying to ensure that the patients are made literate about there health care and simultaneously providing easy and protection to doctors. 12/05/12
  • 12/05/12

Health literacy and patient safety Health literacy and patient safety Presentation Transcript

  • Health Literacy & Patient SafetyDr Nikhil D DatarMD DNB FCPS FICOG LLB DGO DHA•Consultant Gynaecologist: Nanawati Hospital & Hinduja HealthcareSurgical•Director Datar Nursing Home ( Malad) & Yashada Maternity &Surgical Home( Goregaon)•Founder President : Patient Safety Alliance.
  • Are YOU at risk? AS A PATIENT: Safe, transparent, evidence based, “patient centric” medical care AS A DOCTOR: Perceived negligence is responsible for 85% of medico- legal cases.2
  • True story• Patient NOT disclosing that she has undergone a major surgery in the past
  • Victims of medical accidents
  • WHO• “Unintended medical harm” 8th common cause of deaths• 50% deaths are preventable• Patients are the most important stake holders
  • Is Health care “patient centric?”• Doctors adopt highly paternalistic attitude, see informed consent as waste of valuable and scarce time. (Sanwal etal J R Soc Med 1996,89 196-98)• 40% patients could not understand basic instructions such as take tablet on empty stomach, 60% could not understand standards consent document. (Williams etal JAMA. 1995;274:1677-1682)6
  • Those with limited health literacy are more likely to:• Skip preventive measures• Require hospital admissions• Use services designed to treat complications than services used to prevent complications• Feel shameful & vulnerable• Spend more money• Feel unsatisfied(http://www.health.gov/communication/literacy/quickguide/factsliteracy.ht m)
  • The “Gap”8
  • Bridging the gap Case Studies:• Patient Safety Alliance• “Be alert… Be safe” workshops by PSA• PSA tools• Project “Digital Consents”
  • Patient Safety Alliance• Empowering patients• Supporting healthcare professionals to reduce medical harm.Education & activism in Health policy and law
  • “Be Alert… Be Safe” workshop• Interactive 2 hour workshop• Topics: – Why errors occur? – Effective consultation with the doctor – How to prevent medication errors – Infection control: role of patients – Internet for authentic health information – Legal recourse against HCP
  • PSA Tools• Effective consultation• History that helps• Medication card• Check list for hospital admission
  • Case study : Digital Consents• Multi lingual, audio visual, interactive patient information and consenting tool using IT
  • Process mapping DAY 1 : 730 – 750 PM DAY 2 : 930 AM14 DAY 2 : 10 30 AM BETWEEN 930 – 1030 AM
  • Addressing the gap • What information is sufficient? • How much to disclose? • How to do so without frightening the patient? • How to document the communication • How to get over the language barrier? • How to give this kind of time? • How to improve patient recall? • How to improve patient experience?15
  • Benefits of Digital consents• Brings transparency and fairness• Shared decisions and shared risks• Ensures that sufficient information is given every time• More effective, less time consuming• Protects medico-legally
  • सर्वे सर्ुखिखिनः सर्न्तुख , सर्वे सर्न्तुख िनरामयः • Do join us at www.patientsafetyalliance.in