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Keeping Patients Safe: Interventions Based on Efficacy


In recent years, there has been a significant shift in the culture of health care, with the focus of this shift falling squarely on the design and delivery safe patient care.

While it has become a core issue and the central driving force in health care expenditures, uptake in patient safety has been riddled with challenges, such as shifting priorities, limited access to capital/resources, and the complicated process of deciding which intervention to implement. This Marsh Insights highlights the key challenges when implementing patient safety initiatives, which practices best improve patient safety, and assess the economic implications on the health care system, and on society as a whole.

Various U.S. studies have identified that “approximately 3-4% of hospitalized patients suffer a serious adverse event… a substantial proportion (between 30-50%) are preventable.”1, 2 Recent Canadian literature has demonstrated that the rate of adverse events in Canada is 7.5% of all hospital admissions3.

To better understand this issue from a global perspective, the World Health Organization (WHO) Patient Safety team conducted a global study on patient safety issues. Despite discrepancies among the different countries based on their economic status (developed/ high income, transitional/medium income, and developing/low income) 23 major safety issues were identified4, further subdivided into three categories: structure, process and outcomes5.

1 Jha, A, ed. Summary of the evidence on patient safety: Implications for research. Geneva World
Health Organization 2008.
2 Jha, A.K., Praposa-Plazier, N., Larizgitia,I. et al. Patient Safety Research: an overview of the global
evidence. Qual Saf Health Care 2010 19:42-47.
3 Baker, G.R., Norton, P.G., Fintoft, V. et al: The Canadian Adverse Events Study: the incidence of
adverse events among hospital patients in Canada. CMAJ 2004: 170:1678-86.
4 Based on World Bank 2006 classification
5 Leape, L.L., Berwick, D.M., & Bates, D.W. What Practices will most improve Safety? Evidence Based
Medicine Meets Patient Safety JAMA 2002;288(4)501-7