Patient safety: learning from Europe

Last week the European Union launched its joint action on patient safety. The three year programme will share knowledge on approaches to improving patient safety across the community and support implementation of some evidence based interventions. The overall goal is to create a permanent collaborating network for good practice across the EU.

As a nation that often looks to the US for insights into healthcare improvement, we perhaps sometimes overlook how much there is to learn from Europe. Furthermore, learning is not only a 'nice to do' – with the free flow of labour across the EU, creating common approaches to patient safety is increasingly a necessity. 

It is easy to take for granted many of the developments the UK has embraced over the past 10 years. Systems for reporting and learning from incidents and near misses, national indicators of harm – while still needing development, they have become cornerstones of our safety culture. Yet, in some countries across the EU, there are still no national measures of safety and quality, and there remain strong blame cultures without the expectation or mechanisms to report and learn from mistakes.

The cultural context for patient safety also varies. It’s a fair guess that most people in the UK would have some concern and understanding about the risks of healthcare acquired infection, but probably have little appreciation of the levels of harm in the system arising from problems in medicines management. In contrast, in Spain, public awareness of medication errors and the approaches to reduce their risk has been the subject of public awareness campaigns, whereas problems with infections are low on their radar. 

The joint action is looking at gathering and mobilising knowledge in the EU across three areas: 

• Proven safety interventions where there is a strong case to pro-actively encourage take up across the EU. A working party will be identifying such examples and will support the implementation in test sites.
• Current good practice in safer clinical practice that can be shared across the member countries. As a member of this workstream, the Health Foundation will be identifying examples to contribute from teams that we have supported. A mechanism for sharing these examples through wiki approaches, study visits and placements is being developed.
• System level approaches to support safer care, building on previous EU work to understand the factors that contribute to creating high performing quality systems (see http://www.duque.eu/).

The project is ambitious but has significant potential. The UK can do much to share the good practice we have developed since the publication of An organisation with a memory, but there is also much we can learn. The country I have my eye on is Denmark. Their Danish Society for Patient Safety is doing groundbreaking work in its involvement of patients and carers in improving their own safety. They have already developed ten top tips for patient safety aimed at the public to help them think about how they can reduce risk during encounters with the healthcare system and now want to build on this, to make patient safety awareness as much second nature to the general public as road safety awareness. 

They are developing and testing a national campaign to focus on three specific actions that will serve to improve everyone’s safety when coming into contact with healthcare:

1. always have someone with you during a clinical consultation
2. always know what the next step is, and
3. always know who to contact if it doesn't happen. 

Seemingly simple stuff, but in a system where we know that harm frequently arises from poor integration and co-ordination of care, a public that has these behaviours hard wired into their pysche could do as much for safer care as Clunk Clink did for road safety.

Jo is Director of Strategy at the Health Foundation.