[e-drug] Canadian strategy to reduce medical error

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E-drug: Canadian strategy to reduce medical error
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Lancet 2001; 358: 1167 (9288, 6 October 2001)
http://www.thelancet.com/journal/vol358/iss9288/full/llan.358.928
8.news.17908.4

Canadian doctors' leaders take charge of project to reduce medical
error

The Royal College of Physicians and Surgeons of Canada will
spearhead a 1-year exercise to create a national patient-safety
strategy to alleviate concerns about medical error.

35 professional, hospital, physician, government, and licensing
bodies met at the Royal College's annual conference on Sept 22
and agreed to establish a steering committee to hammer out the
details of a national strategy over the next 6 months.

Participants argued that a national safety strategy, complete with
some form of oversight body, are necessary to restore Canadian
faith in the efficacy of the health-care system. Among the issues to
be tackled are whether or not regulatory changes are needed to
obligate physicians to make full and open disclosure to patients, as
well as report all incidents of medical error.

Although participants at a special plenary session on patient safety
at the conference on "Achieving Quality Health Care through
Education, Professional Development and Research" indicated that
Canada lags well behind international counterparts such as the UK
and Australia in addressing the problem of medical error. College
president Bernard Langer said in an interview that he hopes the gap
can be closed quickly once the regulatory and reporting issues are
resolved.

But Langer added that it is far too early to estimate how costly such
an initiative might ultimately prove, although he is hopeful that
federal and provincial governments will open their coffers once it
becomes apparent that spiralling health-care costs can be
constrained by reducing medical error.

The funding "would depend on the scope of the project that's
presented", said Langer. "But it's such an important issue and it
could have such a substantial impact on health care, and the quality
of health care, that I think to do it right, there may be quite large
amounts of money involved. We're talking millions of dollars. I just
don't know how many millions." 

Delegates heard that Australia needed US$50 million over 5 years
to launch its patient-safety strategy, which included measures to
establish national registration of physicians, national audit
arrangements, national incident monitoring, and mandatory
collection of morbidity and mortality data.

Physicians were also told that the medical community must
abandon its "culture of blame" and focus on improving health care
rather than assigning blame in cases of medical mishap. Taking that
first step will require significant modifications in physician attitudes,
argued adjunct professor of health policy Lucian Leape at Harvard
School of Public Health (Boston, MA, USA). Physicians must realise
that "safety is more important than my own ego and my own
power".

Wayne Kondro

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