World Alliance for Patient Safety

http://www.who.int/patientsafety/worldalliance/alliance/en/
World Alliance for Patient Safety

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The purpose of a world alliance

The creation of the World Alliance for Patient Safety would be a significant step in the struggle to improve the safety of health care in all Member countries. At present no single player has the expertise, funding or research and delivery capabilities to tackle the full range of patient safety issues on a worldwide scale.

The world alliance would provide a mechanism to decrease duplication of investment and activities and benefit by economies of scale. Such an alliance would provide an environment in which major new initiatives could arise that individual partners might not be able or willing to undertake alone. It could become a vehicle for the sharing of knowledge and resources to improve effectiveness. For example, solutions identified and evaluated by one or two members could be adapted for global or multicountry implementation. The establishment of similar alliances in other health care areas has accelerated momentum and attracted support and funding by building a common “brand” that gains legitimacy. Most importantly, such partnerships have reduced unnecessary or detrimental competition between institutions and individuals by coopting potential rivals as members of a single, unified team.

The fundamental purpose of the Alliance would be to facilitate the development of patient safety policy and practice in Member States. This could be achieved through the fulfilment of a number of core functions and other short-term initiatives as set by the Alliance in an annual work programme.

Possible core functions

Supporting the development of patient safety policy and practice

At present WHO and other agencies are playing a key role in helping countries develop patient safety policy and practice. There is, however, a pressing need for additional coordination and facilitation of international expertise and learning in order to reduce duplication of effort and minimize the waste of valuable resources. This is important for all health care systems, but it is particularly necessary to conserve resources in developing health economies. The Alliance would be well-placed to facilitate international learning by providing advice and information to Member States who are keen to access expertise from international colleagues in relation to patient safety. This function could be linked to the development of a web site and ease of access to other information sources.

The Alliance could also play a significant role by coordinating expert teams to support countries and organizations that are facing challenges in relation to policy or practice issues. The secretariat could negotiate the terms of support to be provided with all parties or provide advice in relation to the project/activity parameters.

Enabling countries to assess their progress on patient safety

As policy-makers become increasingly concerned with patient safety issues (8), there is an emerging need for the development of an instrument that will allow countries to assess the state of readiness of their health systems in terms of safety of care. WHO intends to work with a group of international experts to develop such an instrument. This will enable each country to benchmark its position and monitor its own progress over time against international standards. Findings of such reviews will provide a sound basis for within-country decisions on patient safety policy and action needed to enhance performance.

The Alliance could provide support to countries, who would be asked to commit to the use of the tool and to sharing outcomes, particularly in relation to policy action.

Global reporting

The growing interest in patient safety reporting and learning systems means that large databases and repositories will be needed to collate information from many sources. The Alliance could consider the merits of global reporting and its potential benefits. At present WHO and its collaborating centres are engaged in global reporting in a number of areas (Annex 3); the development of national/subnational reporting systems in countries could also facilitate this.

The Alliance could decide to undertake short-term global reporting in an area of particular interest, linked to problem identification or solution development. In parallel, it might also be possible to consider long-term global reporting in an area where a sufficient number of countries have the capacity to provide appropriate data and where there is a clear benefit in relation to knowledge growth.

Solution development

Internationally, the issue of solution development raises a number of challenges. As the number of solutions increases, there is a need to ensure that this learning is shared. Learning from adverse events within health care systems has been identified as a major obstacle to improving safety (10); learning across health care systems is an even greater challenge. Recent initiatives to develop international libraries will be of great assistance and the Alliance might wish to join forces with the sponsors of these initiatives to ensure ongoing development.

Solution development also means there is a pressing need to design a process by which countries can decide whether a solution is appropriate for use in their health economy. Again, this is an area of work that a world alliance could support.

The Alliance could also play a role in sharing “work in progress” in relation to problem identification or solution development, and on occasion might wish to coordinate international work in a specific area.

Consideration could also be given to the merit of developing joint WHO/Alliance alerts and bulletins on patient safety. It might be appropriate to issue a small number of carefully selected global alerts where a problem that has been identified by Member States could prevent deaths elsewhere in the world. Likewise, it might be useful to issue bulletins, guidelines, etc., in an area where a solution has been developed that is important and appropriate internationally.

Research and development

Research on patient safety is growing rapidly in advanced health care systems, stimulated by such initiatives as the United States Agency for Healthcare Research and Quality’s major funding programme. The AHRQ has established centres of excellence for patient safety research and is also engaged in building research capacity by forming networks of clinicians and researchers to develop research strategy and specific study proposals. Smaller-scale programmes have been established in a number of other countries, and informal networks of researchers have developed across the world. These activities, however, are largely confined to advanced health care systems and very little attention has been given to the major safety problems of developing countries.
By assisting countries to develop patient safety research programmes to solve specific problems in their health care systems.
By promoting research on major patient safety issues in developing countries (e.g. injection safety) that affect millions of people, rather than issues (such as wrong-site surgery) that may attract headlines but affect relatively few people.
By establishing action teams of leading researchers who would be prepared to collaborate on research on patient safety issues in developing countries.
By holding a premier global research conference for patient safety, reducing the need for attendance at multiple, and often repetitive, conferences.

Membership

The Alliance would want to encourage membership from a range of sectors, including:

Countries

WHO would work through its regional offices to support and increase national membership of the Alliance. Individual Member States might decide to have representation from their health departments/ministries or to nominate an organization to act on their behalf.

Interested bodies

Organizations that could demonstrate a significant involvement in patient safety matters would be enrolled to become members.

Experts

International and national experts in the field of patient safety would be encouraged to join the Alliance.

It is anticipated that initial membership would include countries with developed and developing health care systems. A key target for the Alliance would be the development of a membership that provided representation from all WHO regions and, in the fullness of time, from all WHO Member States.

Conclusion

The WHO Secretariat will report to the Fifty-seventh World Health Assembly on progress achieved in the implementation of resolution 55.18. Since the resolution was passed, we have witnessed an exceptional interest in patient safety from Member States in all WHO regions.

The creation of a world alliance will enable us to harness our complementary experience and expertise to ensure that the challenges we face can be overcome efficiently and effectively. This will enable us to improve the quality of care that we wish to provide to all populations.

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