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Collaboration and support for the Action on Patient Safety: High 5s Project
Six countries take formal, concrete step towards preventing patient safety problems

Experts agree that knowledge is of little use if it is not put into practice with proven solutions.

Washington, D.C., November 1, 2007 (PAHO)—A group of six countries, including two Pan American Health Organization (PAHO) Member States, took a bold step today in Washington, D.C., to vigorously develop and implement standardized protocols related to patient safety solutions over the next five years.

The solutions for patient safety seek to save lives by improving healthcare security and preventing avoidable catastrophic or disabling events in hospitals and other health facilities due to errors, mistakes and/or adverse events related to medication administration, wrong or mistaken medical and surgical procedures and lack of proper hand hygiene practices, among others.

The signing was part of the Commonwealth Fund's 2007 International Symposium on Health Care Policy, which brings together Ministers of Health of the Commonwealth Countries to debate on healthcare policy and practice.

By signing the unprecedented collaborative action towards the implementation of five concrete, evidence-based and cost effective patient safety protocols, Health Ministers and/or their representatives from Canada and the United States, along with those from Germany, the Netherlands, New Zealand and the United Kingdom, formally recognized today in Washington, D.C., the critical and urgent need to act in cooperation and unison to solve and prevent major but avoidable patient safety problems.

The ceremony was attended by several PAHO leaders and experts, including Dr. Carissa Etienne, Assistant Director; Dr. Jonas Gonseth, Associate Expert in Quality of Healthcare Services; Dr. Homero Vasquez, a consultant on Quality of Healthcare Services; and Mr. Babak Mohit, also a PAHO consultant on Quality of Healthcare Services.

Other major attendees were Sir Liam Donaldson, Chairman of the World Alliance for Patient Safety - World Health Organization; Dr. Dennis O'Leary, President of the Joint Commission; Dr. Karen Davis, President of the Commonwealth Fund; and Robin Osborn, Vice President and Director, International Program in Health Policy and Practice, also from the Commonwealth Fund, among many others.

At the end of the event, Dr. Etienne thanked all parties for the work done by the Joint Commission and by the Commonwealth Fund on behalf of patient safety. In referring to the High 5s, Dr. Etienne indicated that "we sincerely hope, and expect, that it will become a vehicle for coordinating the energy and enthusiasm for tackling unsafe care."

It is estimated that those patient safety problems cause harm to at least one out of ten patients in industrialized countries while receiving health care. In developing countries, the probability of patients being harmed in hospitals is higher than in industrialized nations. The risk of healthcare-associated infection in some developing countries is as much as 20 times higher than in developed countries.

"The interest and commitment being shown by the six countries to implement these solutions is inspiring," Sir Liam Donaldson said. The Chief Medical Officer of England and Chair of the World Alliance for Patient Safety - World Health Organization (WHO) - underscored that "over the years to come, risks to patients will be reduced, lives will be saved and many lessons will be learned as a result of the High 5s action being initiated in Washington, D. C., today."

The High 5s Project has developed five standard operating protocols to address five significant patient safety problems, he said. "These protocols will be used in hospitals in the six partner countries over the next five years. And their impact will be monitored."

The selected five solution areas that the six countries agreed to develop and implement within the framework of the High 5s initiative over five years are:

  • Managing concentrated injectable medicines
  • Assuring medication accuracy at transitions in care
  • Communication during patient care handovers
  • Improved hand hygiene to prevent healthcare-associated infections, and
  • Performance of correct procedure at correct body sites.

The High 5s initiative is supported by the Commonwealth Fund and sponsored by the World Health Organization's (WHO) World Alliance for Patient Safety. The project is coordinated by the WHO Collaborating Centre for Patient Safety, which is led by The Joint Commission and Joint Commission International. It builds on the established partnership of the Commonwealth Fund with Canada, Germany, the Netherlands, New Zealand, the United Kingdom of Great Britain and Northern Ireland, and the United States of America.

"The commitment of Health Ministers to this patient safety effort is a significant step towards achieving a high-performance health system in each country. This unique collaboration also promises to serve as a model for fostering cross-national exchange and policy learning," said Commonwealth Fund President Karen Davis.

The Joint Commission indicates that "no adverse event should ever occur anywhere in the world if the knowledge exists to prevent it from happening. Such knowledge is of little use if it is not put into practice."

The Joint Commission is an independent, not-for-profit organization of the United States governed by a 29-member Board of Commissioners that includes physicians, administrators, nurses, employers, a labor representative, health plan leaders, quality experts, ethicists, a consumer advocate and educators."

Although the collaborative action signed today in Washington includes just two PAHO Member States (Canada and United States), countries throughout the Americas are turning their combined efforts, both regional and national, towards advancing the imperative of quality and safe care.

Ministers of Health of the countries in the Americas gathered last month in Washington, D. C., on the occasion of the 27th Pan American Sanitary Conference approved a resolution CSP27.R10 titled "Ensuring the Quality of Health Care, Including Patient Safety" that urges Member States to "prioritize patient safety and quality of care in sector health policies and programs, including the promotion of an organizational and personal culture of patient safety and quality of care to patients."

PAHO countries also agreed to allocate the necessary resources for developing national policies and programs to promote patient safety and quality of care, involving clients in processes for improving the quality of the health care.

Link of interest

The Pan American Health Organization, founded in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. It serves as the Regional Office of the World Health Organization (WHO).

The World Alliance for Patient Safety is a WHO program launched in 2004. The Alliance, chaired by Sir Liam Donaldson, Chief Medical Officer of the United Kingdom, addresses 10 major action areas:

  • The Global Patient Safety Challenge will galvanize global commitment and action on a patient safety topic, which addresses a significant area of risk for all countries. In 2005-2006, the Global Patient Safety Challenge is focusing on health care-associated infection with the theme Clean Care is Safer Care. For 2007-2008, the Global Patient Safety Challenge will focus on the topic of safer surgery with the theme Safe Surgery Saves Lives.
  • Patients for Patient Safety will ensure that the voice of patients is at the core of the patient safety movement worldwide.
  • Reporting and learning will promote valid reporting, analytical and investigative tools and approaches that identify sources and causes of risks in ways that promote learning and preventative action.
  • Taxonomy for Patient Safety will develop an internationally acceptable system for classifying patient safety information to promote more effective international learning.
  • Research for patient safety will facilitate an international research agenda which supports the safer health care in all WHO member states.
  • Safety Solutions will translate knowledge into practical solutions and disseminate these solutions internationally.
  • Safety in Action: High 5s will spread best practices for implementation of changes in organizational, team and clinical practices to improve patient safety.
  • Technology and patient safety will focus on the opportunities to harness new technologies to improve patient safety.
  • Care of acutely ill patients will identify key patient safety priorities for action in the care of seriously ill patients.
  • Patient safety knowledge at your fingertips will work with Member States and partners to gather and share knowledge on patient safety developments globally in the form of a global report.

Further information on the work of the Alliance is available at WHO's web siteWHO's web site.

Founded in 1951, The Joint Commission seeks to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. The Joint Commission evaluates and accredits nearly 15,000 health care organizations and programs in the United States, including more than 8,000 hospitals and home care organizations, and more than 6,300 other health care organizations that provide long term care, assisted living, behavioral health care, laboratory and ambulatory care services. The Joint Commission also accredits health plans, integrated delivery networks, and other managed care entities. In addition, The Joint Commission provides certification of disease-specific care programs, primary stroke centers, and health care staffing services. An independent, not-for-profit organization, The Joint Commission is the nation's oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission here.

Joint Commission International (JCI) was established in 1997 as a division of Joint Commission Resources, Inc. (JCR), a private, not-for-profit affiliate of The Joint Commission. Through international accreditation, consultation, publications and education programs, JCI extends The Joint Commission's mission worldwide by helping to improve the quality of patient care by assisting international health care organizations, public health agencies, health ministries and others evaluate, improve and demonstrate the quality of patient care and enhance patient safety in more than 60 countries.

For more information please contact , PAHO, Public Information, 202-974-3122.

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