Advancing patient safety governance in the Covid-19 response - OECD Health Working Paper (3 February 2023)

Summary

Against the backdrop of the Covid-19 pandemic, ensuring the safety of health and social care services remains a serious, ongoing challenge. This report examines how patient safety governance mechanisms in Organisation for Economic Co-Operation and Development (OECD) countries have withstood the test of Covid-19. It provides recommendations for further improving patient safety governance and strengthening health system resilience in OECD countries.

This working paper was produced by the OECD for the 5th Global Ministerial Summit on Patient Safety, held in Montreux, Switzerland in February 2023.

Content

The report notes that Covid-19 has made the continued vulnerability of healthcare delivery systems and the subsequent risk to patient harm increasingly evident to a wider global audience. The authors argue that since the beginning of the pandemic, that there has also been a decline in several key metrics on the performance of patient safety governance, stating that:

• over the course of the pandemic, countries have observed declining levels of trust in government and health system capacity to handle the crisis and implement coherent policies.
• during Covid-19, many health systems countries lacked the needed resources to control the spread of Covid-19 in the hospital setting. Studies show that as many as one-in-four of total confirmed Covid infections were acquired in hospitals during certain periods of the outbreak.
• data availability on healthcare-associated infections (HAIs) during the Covid-19 pandemic is still generally scarce. Even so, data from the United States shows that, as of the third quarter of 2021, several HAIs were higher than the 2015 baseline.
• trends in the occurrence of hospital acquired conditions need to be interpreted with data on decreased healthcare use. For example, the number of hip replacements fell by 16% in 2020 compared with 2019 across 27 OECD countries and knee replacements fell by 26%. Lack of timely care can lead to serious safety risks for those with ongoing health care needs and delays in treatment can cause patient harm.

The first chapter of this report focuses on safety governance in the context of Covid-19. It refers to the TAPIC framework (Transparency, Accountability, Participation, Integrity, Capacity) which this report uses to in this report to explore issues around patient safety governance in the Covid-19 context.

The second chapter of the report goes on to look at the impact of the pandemic on patient safety in health systems and consider the challenges and opportunities this has presented.

In the final chapter, the authors consider how this period of extreme challenge and policy change has the potential to strengthen patient safety governance, arguing that this can be capitalised on to embed patient safety at the top of the political agenda.