Transcript Nombre de la presentación

ADVANCES oN PATIENT SAFETY
IN MEXICO
Dra. Odet Sarabia González
Advisor of the Under Secretary of Quality and
Innovation, Ministry of Health Mexico, Mexico City,
Mexico
August/2008
CONTENT
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Location of the program on the national agenda
Progress in training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins Patient Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
CONTENT
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The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins on Patient Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
National Development Plan
(PRONASA 2007-2012)
 Five objectives
“To provide efficient health services, quality,
warmth, and patient safety”
PRONASA 2007-2012
Chapter III - Objectives and strategies.
Strategy 3
Action Line 3.1
 To link public hospitals of middle and high complexity
with the programme of patient safety, including
measures to ensure a clean care and prevent the
occurrence of adverse events, medication errors and
insecure surgery.
PRONASA 2007-2012
Chapter III - Objectives and strategies
Strategy 3
Action Line 3.1
 To contribute to reduce the morbidity and mortality
from hospital-acquired infections. The goal is that
60% of public hospitals have a risk management
model for nosocomial infections.
CONTENT
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
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

The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins on Patient Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
PROGRESS IN TRAINING
 At present, progress on training hospital personel of
the Secretary of Health is around 40%.
0%-24%
25% – 49%
50% -74%
75% - 99%
100%
PROGRESS IN TRAINING
 This is throughout many hospitals of the Health
System.
CONTENT









The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins on Patient Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
Signature
On September 21, 2007,
Mexico, along with 6
other
countries
of
Central America and the
Caribbean, signed the
joint
declaration
in
favour of the first
challenge of the World
Alliance
for
Patient
Safety of the World
Health Organization.
Signature
Clean care is
a safer care
Signature
CONTENT









The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins on Patient Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
Poster
Stickers
Flyer (forward)
National Campaign for Hand Hygiene
The National Campaign for Hand Hygiene will be
launched in October.
The campaign represents a commitment from the
whole health system.
Flyer (back)
Flyer for the patient (Outside)
Flyer for the patient (Inside)
CONTENT
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






The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins on Patient Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
Research
 Considered a potentially serious and preventable
problem, with great economic and social impact.
 A study of the Under Secretary of Quality and
Innovation, through the Directorate of Performance
Evaluation has documented prevalence of adverse
events of 11.8% on two general public hospitals.
4 Observatorio
del desempeño hospitalario 2006. Secretaria de Salud. México DF.
Research
 At this stuydy the main adverse events in hospitals
are:
a) Acquired pneumonia (33.3%)
b) Surgical wound infection(25%)
c) Infection with medical procedures(20%)
e) Others (21.7%)
Research
 Patients who experienced any adverse events had an
ALOS of 23-day.
 This
represented
comparison group.
10
days
more
regarding
the
Research
 Most of adverse events occurred in women unrelated
to obstetric conditions (53.7%) and in children under 5
years (33%).
Research
 Mexico participated in the study “Iberoamerican Advers
Events” (IBEAS, by its Spanish initials).
 This study measures the prevalence of adverse events in
5 countries in the region of Central and South America.
28 mexican hospitals participated
in this study, involving approximately
500 professionals.
Research
 The databases have already been send to Spain and
we are awaiting feedback.
 We are confident that their findings result in
valuable information regarding Patient Safety in
the Region and in Mexico.
CONTENT









The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins Patient on Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
Bulletins
 In order to disseminate knowledge in the field of patient
safety, a threemonthy newsletter has been published
from September of 2005 until now.
Bulletins
 Currently, we have 9 volumes
of this newsletter.
 In the last issue, Tomas Flores
and his wife Rosa Garcia,
shared their experience when
their
children
suffered
Kernicterus undetected timely.
Bulletins
 These parents demonstrate their strength to work in
workshops and conferences which provide preventive
information on this disease.
 With this work the health system have an opportunity
for improvement.
http://dgces.salud.gob.mx/seguridaddelpaciente/
CONTENT









The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins on Patient Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
National Quality Committee
Commissions
5 commissions
Nosocomial
infections
Taxonomy
Implementing
the programme
in hospital
units
10 actions
in Patient
Safety
Analysis of cases of
SINRAECE for
issuing
recommendations
CONTENT









The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins on Patient Safety
Quality Committee
Indicators of good practice in patient safety
Lessons learned
Indicators of good practice in patient
safety
1. Use limited and regulated abbreviation of
dose and annotations
2. To implement protocols to prevent wrong
surgical site and wrong patient
3. Assessment and prevention of decubitus
ulcers
Indicators of good practice in patient
safety
4. Assessment and prevention of deep vein
thrombosis
5. Appropiate management of anticoagulants
6. Prevention of infections associated with the
use of central catheter
Indicators of good practice in patient
safety
7. Prevention of surgical infections
8. Washing or disinfecting hands before and after
direct contact with patients or objects around
Indicators of good practice in patient
safety
9. Identification of high alert medications
10. Method for standardized labelling and storage
of medicines
11. Assessment of climate for patient safety
CONTENT








The program in the national healthcare agenda
Progress on training
Signing the joint statement in favour of the first
challenge of the World Alliance for Patient Safety of
WHO
National Campaign for Hand Hygiene
Research
Bulletins on Patient Safety
Quality Committee
Lessons learned
Lessons learned
 To continue the actions undertaken during the previous
administration it was necessary to obtain political support
for the new Administration.
The management changes bring slowness in the process
already started. This is easy to reduce if you can put the
item on the national agenda.
The training in cascade has helped bringing the issue of
patient sfety to different hospitals in the health services
throughout Mexico.
Lessons learned
 The gain international commitments facilitates and
promotes actions regarding patient safety.
The investigation into patient safety has been a great
tool for raising awareness of the problem, not just to get
the results, but from the moment starts training and
conducts research in itself.
Lessons learned
The dissemination of knowledge from bulletins seems
to be a good tool to create awareness and commitment.
To include the best practices in patient safety
indicators on the process of accreditation seems to be a
good measure to encourage work in favour of safety.
We all can make a difference
Thank you
[email protected]