In India, like many other developing countries, the government authorities or the health care providers have not yet been sensitized to the issue of patients’ safety.
A National Safety Council (NSC) was constituted in 1966 by the Ministry of Labor, GOI with laid down role and functions to generate, develop and sustain a voluntary movement on Safety, Health and Environment (SHE) at the national level.
It is an apex nonprofit making, tripartite body, registered under the Societies Registration Act 1860 and the Bombay Public Trust Act 1950 and has State chapters as well as district action centers for nationwide implementation of the safety program.
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To fulfill its objective NSC carries out various activities. These include organizing and conducting specialized training courses, conferences, seminars and workshops; conducting consultancy studies such as safety audits, hazard evaluation and risk assessment; designing and developing HSE promotional materials and publications; facilitating organizations in celebrating various campaigns e.g. National Safety Day, Fire Service Week, World Environment Day.
A computerized Management Information Service has been setup for collection, retrieval and dissemination of information on HSE aspects.
Every year, 4th of March the foundation day of the Safety Council is observed as the National Safety Day all over the country, to create awareness about the importance of safety at work place and to focus the attention of employers, employees, general public and all others concerned with occupational safety and health, towards the importance of preventing injury and illness at work place, besides reminding them of their responsibility in making the work place safe and healthy.
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It has now been expanded to be a week long campaign and includes the administration of the following Safety Pledge by the chief executive to all the employees of the organization.
“On this day, I solemnly affirm that I will rededicate myself to the cause of safety, health and protection of environment and will do my best to observe rules, regulations and procedures and develop attitudes and habits conducive for achieving these objectives.
I fully realize that accidents and diseases are a drain on the national economy and may lead to disablement, death, damage to health and property, social suffering and general degradation of environment.
I will do everything possible for prevention of accidents and occupational diseases and protection of environment in the interest of self, my family, community and the nation at large.”
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However, the focus here is primarily on the occupational health. There is no specific and focused program pointed towards improvement or assurance of patients’ safety in hospitals.
There is no organization, government or nongovernment, engaged in collection of data about the patient safety violations in the hospitals.
There is no regulation requiring the health care providers to report the incidence of patient safety violations. There is no agency engaged in research on promotion of patients’ safety.
The safety of patients, as of now, depends totally on the level of awareness and alertness (or the lack of it) of the doctor, nurse or the technician providing care to the patient.
Due to recent start of quality movement and NABH accreditation in health care, the level of awareness among health care professionals involved in these programs, about safety of patients, is progressively increasing.
This is so because patient safety is an integral and important component of NABH Standards and many of the standards are directly related to patient safety compliance.
However, percentage of such professionals is rather small. A large majority of health care professionals, like the public at large, continue to remain ignorant / Indifferent.
The main reason for this indifference is that nobody in the country has any idea of the extent and the magnitude of patient safety violations.
There has been no research on the subject and no data are available. There have been no reports like “The Deep Sleep” or “To Err is Human”.
In fact, there is no system of collection of data about the cases of medical errors in the past or present.
There have been no (honest) efforts by the health care providers ever to study even the incidence of hospital acquired infections. No one has raised a voice against the damage being done by the medical errors so far.
The health care professionals continue to be complacent because their mistakes are getting a quiet burial without raising an eyebrow and the government, in any case, would not do anything on their own.
In a country, where thousands die every year because of hunger, floods or droughts or just non-availability of medical care, deaths due to medical errors could hardly become a major issue to stir the conscience of the nation.
As a result, there has been no organized effort on the part of Government or the NGOs to research the incidence of deaths/disabilities due to medical errors in India.
The reader may wonder that all the discussion in this chapter revolves around the medical errors.
Not a world about the many nonmedical hazards that the patients’ are exposed to in India such as the incubator burns, the theft of babies, the rape and molestation, the collapse of ceiling, the patients jumping from terrace and killing themselves or the failure/fall of lifts injuring the patients.
These hazards are no fewer killers in India. Is it that these hazards are nonexistent in western countries? Perhaps not may be that the incidence is not as alarming as in India, because of better physical and facility safety standards due to deterrent legal provisions.
NABH has, for the first time, addressed the issue of patients’ safety in their standards for NABH Accreditation of Hospitals.
Although NABH accreditation is on voluntary basis so far and safety standards are mandatory only for those desirous of accreditation, market competition and increasing preference for NABH accredited hospitals is, gradually driving the health care providers towards accreditation. And that brings a ray of hope for the future users of health care facilities in India.