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5 June 2013
On 30 May, Health First Europe attended the European Parliament’s workshop co-chaired by the Rapporteur and Shadow Rapporteurs on the Own-initiative report on ‘Patient Safety’. The draft report will be considered in the Committee on Environment, Public Health and Food Safety on 20 June and the workshop provided an ideal setting to explore the various challenges faced by the EU and Member States for protecting patients while receiving care.
Rebecca Taylor (ALDE, UK), Shadow Rapporteur and chair of the first panel, invited the representative of the European Commission and her colleague MEP Oreste Rossi (EFD, Italy) to give their perspectives on the ongoing debate on patient safety. As Ms. Nathalie Chaze - Head of Unit for Healthcare Systems at the Directorate General for Health & Consumer - clarified, the Commission assessed Member States’ implementation of the Council Recommendations of 2009 in a report published in November 2012 (that HFE discussed with a roundtable of high-level attendees). The report shows that most countries have developed strategies for patient safety that include measures to prevent and control healthcare associated infections (HAIs). Even though the commitment from Member States on the issue is strong, the Commission sees room for improvement especially in regard to the surveillance of HAIs.
MEP Rossi gave an overview of his report which touches upon several recommendations put forward by Health First Europe. He highlighted the need to improve the training of healthcare professionals in the area of patient safety and urged Member States to do more in terms of prevention of HAIs which represent a major burden for society and even more so in times of austerity. As outlined in the report, MEP Rossi places great importance on harmonising classifications and indicators among Member States in order to have a clear picture of patient safety in Europe.
The second panel, chaired by Shadow Rapporteur MEP Michèle Rivasi (Greens, FR), looked specifically into the issue of HAIs. MEP Rivasi reminded the audience that millions of people are affected by such infections in Europe and gave the floor to Dr. Fabrizio Oleari of the Italian National Health Institute. HAIs refer to any infection acquired by patients in hospitals and they affect 1 of 10-to-20 hospitalised patients in Europe, Mr. Oleari explained. Most common infections include urinary tract infections and surgical wound infections. The sources of infection can be patients’ own flora (auto-infection), the environment (exogenous) or another patient or a member of the staff (cross infection). As the costs related to these adverse events cannot be internalised in the tariffs that citizens pay for healthcare services, they represent a real economic burden for Member States .The key challenge when discussing the monitoring of the quality of care through clinical indicators, reported Dr. Oleari, “is that everyone wants measurement but no one wants to be measured.”
Dr. Boudewijn Catry shared the outcome of a project carried out by the Scientific Institute of Public Health (WIV-ISP) in cooperation with the European Centre for Disease Prevention and Control (ECDC). The project, called HALT, aimed at measuring the phenomena of HAIs and antimicrobial resistance (AMR) in Long-Term Care facilities in Europe. When presenting the fifth Belgian hand hygiene campaign, Dr. Catry reported that nurses were more diligent than physicians. The main risk factors identified were impaired mobility, disorientation and incontinence. Dr. Catry concluded saying that intensive care units in hospitals are hotspots and called for patient side testing.
Another panel explored the way to respond to challenges in implementing a true European system of patient safety. Dr. Agnès Leotsakos updated the participants on the activities of the World Health Organization (WHO) in this field. A study conducted in 2009 shows that several structural factors,together with poor processes, contribute to unsafe medical care. Not only poor training, as rightly pointed out by the other speakers, but also stress and fatigue of healthcare workers put the safety of patients at risk. “If drivers are not allowed to drive when drunk,” Ms. Leotsakos asked, “why shouldn’t we pay the same attention to the conditions of hospital staff?” Finally, she concluded, the report shows that there is an overall culture of blame as well as a lack of data and evidence of what is the most effective way to promote patient safety.
Dr. Dominique Monnet from the ECDC expanded on the issue of how multidrug-resistant infections pose a threat to the safety of patients in Europe. To make the audience aware of the consequences of such a threat, he told the story of Lill-Karin, a patient from Norway who got infected with an antibiotic-resistant bacterium when having her hip replaced at a hospital in India.
A final panel was chaired by MEP Renate Sommer (EPP, DE). Between 25% and 50% of acute hospital beds are occupied by patients with wound and surgical site infections account for a good part of nosocomial infections, patient safety is a core issue in wound management. Therefore, the chair gave the floor to an organisation linking wound management associations in Europe, the European Wound Management Association (EWMA). As the challenges to achieving safe care are often associated with failing processes rather than related to individual practitioners, Prof. Zena Moore of the EWMA, made a case for multidisciplinary team work as well as education and training.
Ms. Cristina Padeanu, who thanked the MEPs Taylor and Rivasi for their support to the work of the European Patients’ Forum (EPF), said that patients are no longer passive recipients of care but they are playing an increasingly important role in the area of patient safety. Their involvement, she added, must be promoted both at the individual and at the collective level. The EPF views this new piece of EU legislation as an opportunity to foster patients’ engagement and on this note the organisation is carrying out a survey on the Council Recommendations among its members.
Overall, the workshop clearly demonstrated that while there is greater commitment from health ministries to discuss patient safety, there are still many necessary steps that must be taken to minimise avoidable risks to patients in healthcare settings. Mr. Rossi’s report will provide the European Parliament’s view on patient safety and hopefully help to drive increased safety for all EU citizens.