Systems Approach towards patient safety in Indian healthcare set up.

1. SYSTEMS APPROACH TO ENSURE PATIENT SAFETY CULTURE IN HOSPITALS
Dr Murli Janardan Sabath, MBBS, MD (Hospital Administration)
1. The systems approach to ensure a safety culture within the oganisation depends upon varius
areas of concern. Some of these spheres of activities can be controlled but majority of events and
activities that are of concern have no control at individual level. Certain activities may influence
change towards developing a safety culture, but ultimately it is the activities under control of the staff
and other stakeholders which involves implementation of laid out protocols and procedures that has a
definitive impact to ensure safety. These spheres of activities towards a systems approach can be
described as under:-
(a) Organisational Culture. An area which is of concern but we don’t have much control
on it:-
 Mission/Vision/Goals
 Commitment of Leadership & Management
 Patient Satisfaction
 Patient Safety
 Staff Safety
 Environment safety
(b) Safety Culture. An area where we can influence change but may not achieve 100%
achievement as we do not have total control on these:-
 Attitudinal changes
 Behavioural Change
 Awareness of staff
 Participation of Stakeholders
 Evidence Based Clinical Practices
 Competence of staff
(c) Safety Action Plan. Area on which we have full control and can be implemented,
monitored and evaluated for further improvement:-
 Training and skill development
 Effective Communication - Feedback
 Safety Audit incl Facility audit
 Safety Devices
 Automation
 Protocols & SOPs
o Hand Hygiene
o Handover protocols
o Re-assessment
o Patient Identification
o Checklists
 CMEs/Updates
 Reporting of errors/adverse events

2. SYSTEMS APPROACH
Organisational
Culture
Safety Culture
Safety Action Plan
SAFETY ACTION PLAN
Area on which we have full
control and can be
implemented, monitored and
evaluated for further
improvement.
 Training and skill
development
 Effective Communication
- Feedback
 Safety Audit including
Facility audit
 Safety Devices
 Automation
 Protocols & SOPs
o Hand Hygiene
o Handover
protocols
o Re-assessment
o Patient
Identification
o Checklists
 CMEs/Updates
 Reporting of errors /
adverse events
SAFETY CULTURE
An area where we can
influence change, but
do not have total control
on these.
 Attitudinal changes
 Behavioural Change
 Awareness of staff
 Participation of
Stakeholders
 Evidence Based
Clinical Practices
 Competence of staff
ORGANISATIONAL
CULTURE
An area which is of concern
but we don’t have much
control on it.
 Mission/Vision/Goals
 Commitment of
Leadership &
Management
 Patient Satisfaction
 Patient Safety
 Staff Safety
 Environment safety