Keynote Address by Angel Gurría
OECD Secretary-General
Tokyo, Japan - Friday 13 April 2018
(As prepared for delivery)
Ladies and Gentlemen,
I am delighted to be here today to address the Third Patient Safety Global Ministerial Summit. Let me begin by congratulating the Government of Japan and in particular Minister of Health, Labour and Welfare, Mr. Katsunobu Kato, for hosting this very important conference and for placing patient safety high on the global agenda.
Important achievements in patient safety
First of all, let’s recognise some of the important steps that we have taken in recent years.
For example, data collected by 8 hospitals in eight different countries at various levels of development (Canada; India; Jordan; New Zealand; Philippines; Tanzania; England; USA) show that the adoption of the WHO Surgical Safety Checklist – similar to the pre-flight checklists used by airlines – halved surgical mortality and reduced post-op complications by almost 40%.
However, in spite of these efforts, despite this progress, most countries are still facing very important challenges in improving their healthcare safety. Evidence suggests that over 15% of hospital expenditure and activity in OECD countries can be attributed to treating safety failures, many of which are preventable.
Patient harm continues to occur with important consequences both for society and the economy.
Our two studies on The Economics of Patient Safety provide some stark examples:
- Safety failures in health care are the 14th leading cause of death and injury globally. That makes patient harm comparable to tuberculosis or malaria.
- One in ten hospitalisations worldwide results, on average, in a safety failure or other adverse event. This means that as many as 42 million patients go into
hospital hoping to get better, but in fact are harmed.
- The primary and ambulatory health sector is often ignored. But as our latest study prepared for this Summit shows, as many as 4 out of 10 patients face safety
lapses in the primary and ambulatory setting, causing unnecessary human suffering.
- About 15% of all hospital activity and expenditure is a direct result of adverse events; the costs of treating them amount to trillions of dollars each year across
the globe Globally, the cost associated with medication errors alone has been estimated at USD 42 billion annually.
- Quality is something that health systems in developing countries in particular cannot afford to ignore. Two-thirds of patient harm occur in low- and middle-income
countries.
- We spend far too much time and resources on dealing with avoidable safety errors. Evidence shows that many adverse events can be avoided. We therefore need
to invest more in prevention. Building quality requires both strong political leadership as well as a culture of transparency and greater patient engagement,
regardless of a country’s level of economic development.
Designing safer health systems
The good news is that we can tackle these challenges and raise the level of patient safety in health care by focusing on a number of concrete actions.
First, a sustainable reduction in harm has to be based around the four fundamental building blocks of an effective health system: 1) Sound professional education and training; 2) Integrated information systems; 3) Patient engagement, and 4) Safety standards linked to accreditation and certification.
Once these building blocks are put in place, a range of specific interventions to improve clinical practice will lead to a higher return per dollar invested. These interventions include protocols to prevent pressure injuries, infection control, patient hydration and nutrition standards, and more accurate use of medications.
Second, high-quality and timely information on safety risks and patient harm is very important. Every part of the system can improve when we know more about when things go wrong, as well as when they go well. Moreover, information allows benchmarking of safety across facilities and institutions, and across countries. For many years now, the OECD has collected and published a range of indicators on safety and harm in its member and partner countries. Learning from each other, like we do at this Summit today, is critical to preventing safety failures.
Third, it is also important to move towards a “no-blame” culture. We should not be pointing fingers at caring and motivated health care professionals who make honest mistakes. Mistakes are made because they don’t have the right training or the right equipment; or because they are overworked. The problem is not bad people in health care, it is that good people are working in inefficient systems that need to be made safer.
Patient feedback can influence the quality of care
Let me now conclude with one specific element that can be of great help to improve patient safety – the patients themselves. Patient feedback is now essential for the quality of care. Good and safe care relies on providers and patients working as a team. Patients need to be involved in their own care. They often see and hear things that are not noticed by providers and are not picked up in routine data.
As such, an essential part of their involvement is asking them about the outcomes - both good and bad– and their experience of their care.
The OECD’s Patient Reported Indicators Surveys (PaRIS) initiative, which I launched one year ago at our Health Ministers Meeting, integrates patient-reported metrics into health systems’ performance measures. One of its main ambitions is to shed better light on what happens in ambulatory and primary care for patients suffering from one or more chronic conditions. This will fill in a major information gap. PaRIS measures what people need, not just what providers can do; in this sense it is part of a broader attempt to put people back at the centre of health systems.
Ladies and gentlemen,
Patient safety remains a crucial factor in developing efficient and trustworthy health systems where the difference between good and bad is life and death.
Let’s continue working together, let’s continue to share our knowledge, our experiences, our best practices to design, develop and deliver better patient safety policies for better lives. Thank you.
See also
OECD work on Health
OECD work with Japan
