Approach to patient safety must be based on safe practices. Every hospital must have a documented safety management program covering every aspect of safety as outlined below.
1. constituting a Safety Management Committee with wide representation from all the major departments and chief maintenance Engineer as its member secretary. The committee should carry out a periodic exercise of:
a. Hazard Identification and Risk Analysis (HIRA) involving a detailed survey and identification of:
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i. Unsafe buildings especially those in the earthquake prone areas and not designed / retrofitted for earthquake resistance
ii. Unsafe equipment, engineering services, materials, environs
iii. Ill trained, unqualified, negligent staff
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iv. Unsafe practices/processes.
b. Submission of recommendations for corrective actions for risk reduction.
2. On the basis of recommendations from the Safety Committee, implementation of effective and timely remedial measures to eliminate the risks/hazards and to improve the patient’s safety to the acceptable level.
3. Periodic regular review (internal audit) of effectiveness of the system.
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4. A system of continuous monitoring and analysis of the sentinel/adverse and even near-miss events to identify the lacunae and take corrective actions.
5. A system of informing and educating the patients/visiting public to co- operate in warding off the hazards.
6. An efficient system of surveillance and reporting of events so that no events are missed and there is dedicated staff responsible for collection and processing of data.
7. A system of impartial external audit to validate the safety measures implemented.
8. An efficient maintenance service ensuring safe facilities through a regular ongoing program of maintenance.
9. An efficient program of planned preventive (and break down) equipment maintenance to ensure fault free functioning of every equipment
10. An ongoing Fire safety program, with special emphasis on training of staff in fire fighting drills periodic mock drills with a record of observations/actions recommended/taken.
11. for safety of personal property of patients: All patients may be advised through notices prominently displayed, that they should not bring any valuables to hospital. Management cannot take the responsibility of security of their personal belongings.
12. Police Verification of Outsourced Staff: Before allowing the house keeping, security and other outsourced staff to work in the hospital premises a reference should be made to the police for character verification and check of antecedents.
13. An unobtrusive and yet effective security system with detailed protocols for safety/ security of patients, particularly the vulnerable groups.
i. Security staff/supervisor should have a mobile/walky talky for quick contact.
ii. Hospital should have a network of CCTV cameras for surveillance.
iii. Security supervisor on night duty should make periodic visits to every department on every floor, especially the terraces, basement, generator/AC plant area, manifold room and backyard to see that the staffs are alert on duty.
iv. They should ensure that no vacant room remains unlocked at night.
v. They should ensure that the security lights are on and adequate in all areas/ passages likely to be used by the attendants/patients/staff at night.
vi. They should keep a strict watch over unauthorized/suspicious movement of any persons at night.
vii. Security staff should address the safety/security of females with sensitivity and speed to instill confidence.
14. Other General Measures
i. Display of warning signs to forewarn the people about the possible hazards such as wet cleaning/waxing of floors.
ii. Denial of access to the roof tops and the power plant/high voltage equipment areas.
iii. Denial of access to other hazardous areas such as radiation prone areas in radio therapy/diagnosis.
iv. Use of personal protective equipments while performing the hazard prone jobs.
It is important for the hospital administrator and the members of safety committee to have a sharp eye for detecting the weak spots so that no safety hazard is missed. It is equally important to ensure prompt action once a security hazard is detected.