Transcript The patient experince as a catalyst for medication optimisation

Patients for
Patient Safety
In honour of
those who have died,
those who have been left disabled,
our loved ones today,
we will strive for excellence,
so that all people receiving healthcare
are as safe as possible,
as soon as possible.
This is our pledge of partnership
Margaret Murphy,
Patient Advocate
External Lead Advisor
Patients for Patient Safety
WHO Patient Safety
PRIMM
LONDON 23 January 2015
THE PATIENT EXPERIENCE AS A CATALYST
FOR MEDICATION OPTIMIZATION
INTRODUCTION
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The patient as a collaborative partner
Patient Autonomy
Patient Centred Care
WHO Patients for Patient Safety
Patient and Family as a constant in the
continuum of care.
 The Report Safety First 2006
Yesteryear vs Today
 The patient expectation
 Mystique vs blind faith
 Patient responsibility and understanding of
complexity of care
 Report of Irish Commission
Knowledgeable Patients receiving safe & effective
care from skilled professionals
in appropriate environments
with assessed outcomes
 Compliance, adherence, education of patients
 Equipping and training professionals
THE PROCESS
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The need for robust diagnosis
Deficits in consultation process
Patient Centred Care
The elderly patient – a personal
experience
 The elderly patient – a community
experience.
 Errors of commission and omission
FURTHER CONSIDERATIONS
 Risks / Benefits
 Supporting the patient
o Written instructions and alerts
o Reflective listening
 Transition points and perceived
discrepancies
 Medication Reconciliation – a role for the
patient?
 Clinician role at transition points
AREAS FOR SPECIAL ATTENTION
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The high-risk patient
When administering high-risk drugs
Patient Centred Care
Medication safety in psychiatry
Ethical issues – patient autonomy vs
patient competence to decide
 Untrained or inadequately trained
personnel
 Empowering/reassuring patient & family
CAUSES OF MEDICATION ERROR
Leape, Bates, Cullen, et al JAMA 1995
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Lack of knowledge about the drug
Lack of information about the patient
Violation of rules
Slips and memory lapses
Errors of transcription
Faulty checking of patient identity
Faulty interaction with other services (communication)
Faulty dose checking
Infusion pump problems
Inadequate patient monitoring
Drug stocking & delivery problems
Preparation errors
Lack of standardisation
CHALLENGES, INITIATIVES (Global and Local)
 Responsibility and Accountability
 Cultural shift
 WHO – PS Curriculum & 3rd Global
Challenge
 JCI and Medication Safety
 Encouraging and Educating Patients
 The role of the community pharmacist
 A Danish example - An Irish example
‘Let’s Talk Medication Safety’
 The Basics: Why, Name, Dose, How often, How long, Side effects,
Storage
 Understanding your Medicine: Prescription, Over-the-counter,
complementary, herbal, alternative
 Names: Brand and Generic
 Useful tips for safe use of medicine
 Do and Don’t list
 Following instructions
 Storing
 Tips for when admitted to hospital & questions to ask
 Tips for when discharged & questions to ask
 Keeping a medication list and what to include on that list.
- A Resolution Going Forward -
More than anything,
what distinguishes
the great from the mediocre,
is not so much that they fail less,
it is that they rescue more.
- Atul Gawande
THE ACID TEST
DISCLOSURE and the LIVED EXPERIENCE
 Disclosure = ?
 Blame vs Integrity and Professionalism
 Learning?
 Preventing recurrence?
 The burden of error
 Respectful Management of Serious Clinical Events - IHI
Patients for Patient Safety
The London Declaration - a vision statement for Patients for
Patient Safety, written at 1st PFPS workshop by patients and
families from every region of WHO
In honour of
those who have died,
those who have been left disabled,
our loved ones today,
we will strive for excellence,
so that all people receiving healthcare
are as safe as possible,
as soon as possible.
This is our pledge of partnership
“To err is human,
to cover up is unforgivable
but to fail to learn is inexcusable.”
[email protected] Liam Donaldson,Chair, WHO Patient Safety