REGIONAL COMMITTEE Sixtieth session Thimphu, Bhutan 31 August – 3 September 2007
Provisional Agenda item 16.2 SEA/RC60/18 Add. 23 August 2007
FOLLOW-UP ACTION ON SELECTED RESOLUTIONS/ DECISIONS OF THE LAST THREE YEARS: PROMOTING PATIENT SAFETY IN HEALTH CARE The Jakarta Declaration on Patients for Patient Safety in Countries of the South-East Asia Region is included as an addendum to Agenda item 16.2. The Declaration calls for open and honest communication between patients and health-care professionals who must work in partnership to build a health care system in which ‘no patient should suffer preventable harm’. It was endorsed at a regional workshop held in Jakarta, 17-19 July 2007, which brought patients, consumer-advocates, health-care professionals, policy-makers and representatives of nongovernmental organizations, professional associations and medical councils from Member countries of the Region together to discuss the issue through an open dialogue.
SEA/RC60/18 Add.
Jakarta Declaration on Patients for Patient Safety in Countries of the South-East Asia Region We, the patients, consumer advocates, health-care professionals, policy-makers and representatives of nongovernmental organizations, professional associations and regulatory councils having reflected on the issue of patient safety in the regional workshop on ‘‘Patients for Patient Safety’’, 17-19 July 2007, in Jakarta, Indonesia, Referring to the Regional Committee resolution SEA/RC59/R3 on Promoting Patient Safety in Health Care, adopted at the fifty-ninth session of the Regional Committee for South-East Asia Region, which notes “with concern the high human and financial toll of adverse events” and the vicious cycle of adverse events, law-suits, and the practice of defensive medicine which contributes to the rising cost of health care, and urges Member States to “engage patients, consumer associations, health-care workers, and professional associations, hospital associations, health-care accreditation bodies and policy-makers, in building safer health care systems and creating a culture of safety within the health care institutions”, Considering the recommendations made at the first Regional Workshop on Patient Safety, 12-14 July 2006, New Delhi, India, Inspired by the WHO World Alliance for Patient Safety, Patients for Patient Safety London Declaration (March 2006), We, 1. Declare that no patient should suffer preventable harm; 2. Agree that patients are at the centre of all patient safety efforts; 3. Acknowledge that fear of blame and punishment should not deter open and honest
communication between patients and health-care providers; 4. Recognize that we must work in partnership in order to achieve the major behavioural
and system changes that are required to address patient safety in our Region; 5. Believe that: • • •
transparency, accountability and the human touch are paramount to a safe health care system; mutual trust and respect between health-care professionals and patients are fundamental; patients and their carers should know why a treatment is given and be informed of all risks, big or small, so that they can participate in decisions related to their care, and patients should have access to their medical records;
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6. Recognize that when harm does occur: • • • • •
there should be a system in place whereby the event can be reported and investigated with due respect to confidentiality; patients and their families should be fully informed and supported; providers involved in unintentional harm should also receive support; corrective actions should be taken to prevent future harm and lessons learnt should be shared widely, and there should be a mechanism to compensate the patients and their families fairly;
7. Commit to: • • • • •
consumer empowerment through frank and candid education; partnering with the media to encourage responsible reporting and to seize opportunities to educate the public; active consumer participation in adverse event reporting; two-way communication between patients and health-care providers that encourages questioning; meaningful patient representation on patient safety committees and forums;
8. Pledge to achieve through sustained efforts the following goals: •
functioning patient safety systems at every health-care facility, both public and private, starting with the establishment of a patient safety committee and of an adverse event reporting and response system; adherence to guidelines that are evidence-based and ethical, and avoidance of irrational treatments such as unnecessary medicines, investigations and surgical procedures; continuing medical education for health-care professionals; integrating patient safety concepts into pre- and in-service training of allied healthcare professionals; rational load of patients at each health-care facility; adequate resources devoted to patient safety; motivated and competent health-care professionals, and satisfied patients and providers.
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REGIONAL COMMITTEE Sixtieth session Thimphu, Bhutan 31 August – 3 September 2007
Provisional Agenda item 16.2 SEA/RC60/18 13 July 2007
FOLLOW-UP ACTION ON SELECTED RESOLUTIONS/ DECISIONS OF THE LAST THREE YEARS: PROMOTING PATIENT SAFETY IN HEALTH CARE “Promoting patient safety at health care institutions” was the topic for Technical Discussions at the Forty-third Meeting of the Consultative Committee for Programme Development and Management (CCPDM) held in 2006. This paper documents the progress made in the Region in the area of Promoting Patient Safety in Health Care through various activities such as advocacy, capacity building, country visits and research. Furthermore, the Regional Office is working with Member countries of the Region to ensure patient safety in the areas of blood safety; injection and immunization safety; health care waste management and drug safety. Programmes like Making Pregnancy Safer, Child Health and Strengthening Human Resources for Health continue to support the Region’s activities in this regard. This document was discussed at the Joint Meting of Health Secretaries and the CCPDM, held in the Regional Office, New Delhi from 2-6 July 2007. The Joint Meeting made the following recommendations: Action by Member States (1) To implement programme activities as stipulated in SEA/RC59/R3 on promoting patient safety in health care. (2) To develop/strengthen programmes on patient safety through intra- and intersectoral collaboration, including private sector. Action by WHO-SEARO (1) To support/facilitate Member States in the implementation of programme activities as stipulated in SEA/RC59/R3 on promoting patient safety in health care, including South–South collaboration. (2) To develop a minimal data set of patient safety indicators for the Region, in close collaboration with Member States. (3) To document and share the rich country experiences from the Member States. The document is now submitted to the Sixtieth session of the Regional Committee for its consideration.
SEA/RC60/18
Promoting Patient Safety in Health Care 1. The following activities were carried out in the South-East Asia Region in the area of Promoting Patient Safety in Health Care:
Advocacy •
India, Bangladesh, Bhutan, Thailand and Indonesia signed national pledges to address health care-associated infection under the WHO Global Patient Safety Challenge, “Clean Care is Safer Care”. In conjunction with the above, the ministries of health of India, Bangladesh and Thailand prepared technical reports and organized sessions covering areas such as blood safety, injection safety, and health care waste management.
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Capacity Building •
A Regional Workshop on “Clean Care is Safer Care” was held in Bangkok, Thailand (18-22 June 2007), to build capacity to prevent health care-associated infections with a focus on hand hygiene. A Regional Patient Safety Workshop on “Patients for Patient Safety” was held in Jakarta, Indonesia (17-19 July 2007), to engage patients and consumers as partners in all aspects of quality and safety initiatives. A Regional Patient Safety Workshop on “Safe Surgery at the First Level of Care” will be held in Paro, Bhutan (19-21 October 2007), to promote safe clinical procedures at first level emergency surgical care.
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2. Country consultations (towards the development of strategic framework and package of interventions) • •
Site visits were conducted in Maldives, Sri Lanka and Thailand, and are scheduled in the latter half of July 2007 in Indonesia and Timor-Leste.
The regional workshops described above are also part of the consultative process
Research •
Thailand co-chaired the First Meeting of the Expert Working Group to advance Recommendations for Strengthening the Infrastructure for Patient Safety Research held in Bangkok (10-11 December 2006). Thailand is a member of the Expert Working Group to Establish Priority Areas for Research on Patient Safety as well as the Expert Working Group to Develop Research Methodologies and Tools in Data-poor Settings. The draft WHO “Guidelines on Hand Hygiene in Health Care” are being field tested at the Chittagong Medical College in Bangladesh.
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Publications •
A review article entitled “Placing patient safety at the heart of quality in health care in South-East Asia” was published in the 2006-2007 Reference Book of the International Hospital Federation (IHF).