Abstract: Theme: Leveraging Technology for Transforming Standards of Care across Nations

Technology for safe patient care in healthcare institutions. - Shakti Kumar Gupta*

The progressing medical science has seen, experienced and adopted the inputs of technology rapidly over last 3 to 4 decades. However, the areas in which these transforming technology changes have taken place are mainly diagnostic and invasive sciences. The impact of technology on patient safety and quality has been very little. Patient safety has emerged as one of the most important concerns in healthcare delivery and though procedural changes have been recommended to achieve patient safety goals, it has not yet received a helping hand from the technology. From an economic perspective, Hospital infections accounts for a loss of 1.5 billion Disability adjusted life years. It has also been estimated that just 7% of the cost of treatment of Hospital infection is cost of infection control measures. In a study conduct by Department of Hospital Administration, AIIMS it has been found that in large Indian hospitals, HAIs increase the average length of stay in hospital by more than 200% and increase the cost of treatment by more than 300% per patient. In response to the patient safety agenda, World Health Organization gave a call to healthcare providers to improve patient safety conditions in healthcare institutions and work towards achieving 13 international goals. In support, JACHO recommended 6 most important of these goals in the Hospital Quality Standards and NIPS (National Initiative

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for Patient Safety) a venture by AIIMS, New Delhi prioritized 4 out of these goals as those relevant to Indian conditionals and achievable with the healthcare workforce of the country. Some of the International patient safety goals are 1. Identify patient correctly 2. Improve patient communication and Handovers 3. Improve safety of high alert medications 4. Ensure correct patient, correct site, correct procedure 5. Reduce the risk of healthcare associated infections 6. Reduce the risk of patient harm resulting from falls. In fact, WHO recommends- Technology for patient safety as one of the core areas of work in the dimension of patient safety. The potential to achieve other patient goals increases manifolds, if there is an effort to integrate technology application to achieve them. For eg Patient identification using finger printing assures that the unique identification of patient is tallied with the various processes that a patient becomes a part of. Similarly, safety of high alert medications could be achieved if the medications and dozes are bar coded as per prescription and radio-frequency ID or magnetic bar coding is incorporated with medication management. Surgical safety checklist is recommended for achieving the goal of correct patient, correct site and correct procedures. However, they are still subject to human alertness and accuracy which unintentionally get compromised in a stressful operating room environment. Technology can bring in command codes and simulation to ensure the

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correctness of process much before the actual surgery starts and can also monitor the intra-operative processes. Safe hands happens to be one of the biggest popularized themes for all types of patient care. There have been in the past many recommendations, procedural changes and cleaning agent selections to enhance patient safety and reduce the risk of transmission of infection. However, it is to be noted that, there is no test to check the completeness and safety of any of these recommendations when actually practiced by a healthcare professional. Technology bring in the hope of hand-hygiene sensors and laser particle counters which could be installed at the entrances of the critical areas, thus helping a healthcare worker, know whether he or she is safe to entre and deliver care. Similar, detectors could be helpful in letting care givers know if the patient is crossing the physical limits of stretchers, beds, trolleys and can greatly reduce patient falls. Patient safety which is thought to be a change in work culture might as well be a pathway to harness technology to bring direct and qualitative good to the patient community.

*Dr. Shakti Kumar Gupta, Head-Dept. of Hospital Administration & Medical Superintendent, All India Institute of Medical Sciences, Dr. R.P. Centre for Ophthalmic Sciences, New Delhi.

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