When people receive health care, they should be able to expect the care to be clinically effective, safe and responsive to their needs. But all too often patients are unintentionally harmed, and while many devoted professionals are already working hard to help prevent safety failures, more can be done.
Patient safety
Ensuring patient safety during medical care remains a pressing issue with substantial social and economic costs. It is estimated that up to 13% of healthcare spending across OECD countries goes towards the treatment of patients who are harmed during care. Much of this harm can be prevented through coordinated action and adequate investment in developing safer health systems.
Key messages
The cost of care-related patient harm in hospitals is considerable, with 15% of hospital activity and expenditure estimated to be directly attributed to patient harm. Much of this is avoidable, representing a waste for health systems. While efforts to reduce harm are not free, the cost of prevention is often dwarfed by the cost of failure.
Measuring preventable patient harm is central to strategies that improve patient safety. These include measures based on the experiences of both patients and health workers in preventing and managing incidents, which are a complement to traditional patient safety indicators. In addition to measuring the safety of care delivered in hospitals, primary, and long-term care, OECD works to quantify the economic costs of poor patient safety and help countries develop policies to improve.
Context
Patient safety incidents during treatment
Efforts to monitor patient-reported experiences of healthcare safety have spread across countries in recent years. This is largely due to the increasing importance given to patients, families, carers and communities’ perspectives in understanding the prevalence of patient safety incidents.
Patient perspectives are critical to make health systems safer and more people-centred. The proportion of patients reporting experiences of medical mistakes in the past two years varied between about 6% to above 10% in 2020. Among hospitalised patients, the proportion of adult patients who experienced patient safety incidents during their last hospitalisation ranged between 4% and 17%.
Clinical data on patient safety
Patient safety incidents can also happen after treatment. A good example of this can be seen with complications following hip and knee surgery. Joint replacement surgery carries the risks of post-surgery pulmonary embolism (PE) and deep vein thrombosis (DVT). PE and DVT cause unnecessary pain, reduced mobility and – in some cases – death, but can be prevented by anticoagulants and other measures.
The number of patient safety incidents following hip and knee surgery ranged from 57 cases of PE or DVT per 100 000 surgical discharges in Italy to 1 192 in Australia. Variation may be due to several factors, such as differences in diagnostic and coding practices. Higher rates may signal more complete patient safety monitoring systems and a transparent patient safety culture rather than worse care.
Promoting a safe care environment
A good patient safety culture among health workers means they all agree on the importance of safety. . It also promotes transparency and trust and higher levels of shared responsibility, along with improved confidence in organisational and national safety initiatives.
For example, it is important that patient care information is transferred properly across hospital units and during shift changes . However, positive perceptions from staff on the safety of handoffs and transitions range widely across countries, with an over 20 percentage point difference. Among countries with available data , only about 6 in 10 health workers felt that handoffs and information exchange was adequate for maintaining a safe care environment.
