WHA72.6 resolution on Global Action on Patient Safety urges all Members States to recognize patient safety as a health priority in all health sector policies and implement systematic measures to reduce risk to all individuals and requests WHO to measure and report on the progress made by Member States in the implementation of the resolution. Further WHA decision WHA74(13) request the Director-General to report back on progress in implementation of Global Patient Safety Action plan every two years.

1. Existence of a national action plan (or equivalent) for implementing patient safety policy and strategies in public domain. A national patient safety action plan typically includes a vision, goals, objectives, indicators, actions, timelines and responsibilities for different actors, such as governments, health care organizations, professionals, patients, families, and civil society.

2. A system for reporting of never events* (or sentinel events**) is operational.
Whereas never event is defined as a patient safety incident that results in serious patient harm or death (particularly shocking medical errors such as wrong-site surgery that should never occur) and
Sentinel event is defined an unexpected occurrence resulting in death or serious physical or psychological injury or the risk thereof. Serious injury specifically includes loss of a limb or function. The phrase “or risk thereof” includes any variation in a process a recurrence of which would carry a significant risk of a serious adverse outcome.

3. National target been set for the reduction in medication-related harm based on local baseline ?” whereas medication-related harm is defined as “the harm caused by medication if taken incorrectly, monitored insufficiently or as the result of an error, accident or communication problem”

4. Targets established for reduction of health care-associated infections in the country based on local baselines. whereas the health care-associated infections defined as “an infection acquired by a patient during the process of care (including preventive, diagnostic and treatment services) in a hospital or other health care facility, which was not present or incubating at the time of admission; HAIs can also appear after discharge. HAIs are also acquired by health workers during health care delivery, and by visitors.”

5. A patient representative has been appointed to the governing board in the majority of hospitals. Whereas majority means 60% or more health care facilities, including public and private.

6. Patient safety has been included in undergraduate professional education curricula

7. The government has endorsed and signed the WHO charter on “Health worker safety: a priority for patient safety”

8. Majority of health-care facilities participate in a patient safety incident reporting and learning system whereas majority means *60% or more of public and private health-care facilities . Patient safety incidents reporting and learning systems are structures within health care aimed at collecting, analyzing, and disseminating information on adverse events, errors, and near-misses. Their purpose is to foster a culture of transparency and improvement by encouraging reporting, investigating incidents, analyzing data, disseminating lessons learned, and implementing changes to prevent future occurrences

9. An annual report on patient safety performance is published every year

10. National patient safety network has been established whereas national patient safety network means a formal network to coordinate implementation, share best practices, exchange ideas and promote mutual learning on patient safety. Could be hosted on a virtual platform for all stakeholders.

Official country response to Member State survey on implementing Global Patient Safety Action Plan 2021-2030

Countries answered Fully met/Partially met/ Not Initiated/Not Applicable/ Information not available to the following criteria (Except indicator 3 and 4) –

1. A national patient safety action (or equivalent) plan has been developed.

 
• Not initiated = No national patient safety action plan has been developed.


• Partially met = A national patient safety action plan is being developed.


• Fully met = A national patient safety action plan (or equivalent) has been developed and is in the public domain.

2. A system for reporting “never events”* (or sentinel events**) is in place

• Not initiated = No system has been initiated for reporting never events (or sentinel events).


• Partially met = Reportable never events (or sentinel events) have been defined.


• Fully met = A system for reporting of never events (or sentinel events) is operational.

3. National target been set for the reduction in medication-related harm based on local baseline

• Countries answered yes/no/information not available to the following questions “Has a national target been set for the reduction in medication-related harm”.

4. Targets established for reduction of health care-associated infections in the country

• Countries answered yes/no/information not available to the following questions “Have any targets been established for reduction of health care-associated infections in the country?”

5. Patient representative has been appointed to the governing board in the majority of hospitals.

• Not initiated = No action has been taken.


• Partially met = Guidelines or directions have been issued for appointing patient representatives to hospital governing boards and for their role.


• Fully met = A patient representative has been appointed to the governing board of most (60% or more) health-care facilities.

6. Patient safety has been included in undergraduate professional education curricula

• Not initiated = No initiative has been taken.


• Partially met = Patient safety has been included in the curriculum of at least one undergraduate professional education course.


• Fully met = Patient safety has been included in undergraduate education curricula of all health professionals (e.g., medical, nursing, pharmacy and paramedicine).

7. The government has endorsed and signed the WHO charter on “Health worker safety: a priority for patient safety”.

• Not initiated = No initiative has been taken.


• Partially met = The government is considering endorsing the WHO charter on “Health worker safety: a priority for patient safety”.


• Fully met = The government has endorsed and signed the WHO charter on “Health worker safety: a priority for patient safety”.

8. Majority of health-care facilities participate in a patient safety incident reporting and learning system

• Not initiated = A reporting and learning system is not functional.


• Partially met = A patient safety incident reporting and learning system is functional, but very few health-care facilities participate.


• Fully met = Majority of (>60%) health-care facilities participate in the patient safety incident reporting and learning system.

9. Annual report on patient safety performance is published every year.

• Not initiated = No initiative has been taken.


• Partially met = An annual patient safety report is being developed.


• Fully met = An annual patient safety report has been developed from information on performance in the past 2 years, is published and is in the public domain.

10. National patient safety network has been established.

• Not initiated = No initiative has been taken.


• Partially met = A national patient safety network is being developed.


• Fully met = A national patient safety network is functional.

Calculation of proportions (%)

Percentage

Every 2 Years

Every 2 Years

ngupta@who.int

Nikhil Prakash Gupta