JOIN USWorld Patient Safety Day is celebrated on December 9 to raise awareness about the safety of patients. According to WHO, estimates show that in developed countries as many as one in 10 patients is harmed while receiving hospital care. The harm can be caused by a range of errors or adverse events.
Recent advancement in technology has created an immensely complex healthcare system. This complexity brings many challenges for healthcare staff in order to keep the patient safe. Though a lot of people are treated successfully, there are times when things can go wrong.
The most common Patient Safety Issues include:
a) Diagnostic errors: wrong, missed or unintentional delayed diagnosis.
b) Healthcare-acquired infections: errors which occur du ring patient's hospitalisation.
c) Medication errors: when a patient gets the wrong medication; when s/he receives the right medication but in the wrong dosage/wrong timing; or adverse effects/reactions from the right medicine.
d) Readmissions: when a patient needs to return to the hospital less than 30 days after being discharged.
e) Wrong-site surgery: an operation done on the wrong part of the body or on the wrong person.
f) Communication: proper communication between the hospital workers as well as bet ween the patient and doctor.
g) Radiation injury: radiation-related adverse effect on tissues.
Patient care technology has become increasingly complex, transforming and improving the way care is conceptualised and delivered. However, the implementation of new technologies also creates challenges for nurses and ward boys to ensure its safe and efficient use. Hospitals need to be extra careful while performing diagnostics and radiology on patients. Skills must be practised continuously to preserve them.
Diagnostic radiology is the most crucial division towards bringing quality analysis in healthcare. Today, nothing is possible without the use of radiology - X-rays, ultrasound, Doppler, CT, MRI, fluoroscopy etc. Consistent advancements have improved the equipment, in terms of variety, strength and post-processing method.
The aim of advancement is to enhance the safety of patients by reducing the radiation output, without impacting the high-quality imagery. The most visible advancement is the widespread use of digital X-ray. It has become a norm now due to its cost-effectiveness.
Every few months, the models of ultrasound and CT/MR are changing. New equipment with faster imaging and processors are entering the market. Companies are laying emphasis on reducing the radiation dose to patients during the examinations that are conducted using X-rays.
In radiology, MRI and ultrasound do not use radiation. However, general X-rays, mammography, BMD and CT scan and all procedures done under fluoroscopy, both in radiology and in the operation theatre (OT), emit radiation. Besides, the ERCP done by a gastroenterologist and various procedures done by cardiologists and orthopaedic surgeons in the OT, also use X-rays.
The radiology department is deeply aware of radiation and the dose imparted to the patient. But the increased usage of equipment by other departments is also posing a serious challenge to the safety of the patient and medical staff as they could inadvertently be exposed to the radiation. It is important to educate all doctors from different departments on the handling and usage of these equipment.
Most importantly, the patient needs to be educated on the chances of radiation damage. This can be done by conducting radiation awareness camps and talks to all healthcare providers who are not radiologists, and who lack awareness in this field.
To ensure the safe use of equipment, hospitals should do a regular servicing. New and updated equipment should be accepted which are safe and convenient to use. Every year, a quality check should be done by external agencies to prevent leakage of radiation and malfunctioning of equipment in the radiology system.
The safety of patients in the hospital does not come under a single parameter. It is a combination of quality parameters involving physical, clinical, technical, typing, educational, training and communication aspects. All these must be taken into consideration to achieve a wholesome safety programme for the patient.
(The writer is Director-Radiologist, Fortis Hospitals, Bannerghatta Road, Bengaluru)