By Jennifer Zelmer
New data just released by the Canadian Institute of Health Information (CIHI) show unintended hospital harm is up across Canada for the second year in a row. With healthcare systems across the country under ongoing strain, it is more important than ever to focus on safety. Renewed efforts to encourage effective “safety conversations” aimed at identifying and reducing potential risks can help to turn this trend around.
We know everyone across Canada wants—and deserves—safe, high-quality healthcare. Everyone providing care should also be safe in the workplace. But we also recognize that even before the pandemic began, neither were a reality for all. Given ongoing challenges, Healthcare Excellence Canada wants to equip everyone with tools we all can use to realize shared safety objectives. While most people cared for in Canadian hospitals receive safe care, unintended harms do happen. According to CIHI, during 1 in 17 acute hospital visits in 2021-22, patients experienced unintended harm. That equates to about 140,000 out of 2.4 million hospital stays.
While not all instances of unintended hospital harm could be prevented, of course, we know adoption of evidence-informed practices could have helped prevent many of them. The overall Hospital Harm Measure, at 6 per 100 hspitalizations in 2021-22, is up from a pre-pandemic rate of 5.4 per 100 hospitalizations in 2019-20—a rate that had been stable since it was first reported in 2014-15. Harm rates were mainly driven by healthcare- and medication-associated conditions and healthcare-associated infections.
The Hospital Harm Measure is intended to monitor variations in patient safety in inpatient, acute-care settings at the national level (with the exception of Quebec, which was not included for methodological reasons). The measure captures unintended harm across facilities over time and is designed to help identify safey improvement opportunities.
Of the unintended hospital harms reported by CIHI:
- 47 per cent involved healthcare and medications, such as bedsores or getting the wrong medication
- 31 per cent involved infections, including those related to surgical sites
- 18 per cent were procedure-related, such as bleeding after surgery
- 4 per cent involved patient accidents, such as falls
The theme of this year’s Canadian Patient Safety Week, from Oct. 24 to Oct. 28, was “Press Play on Safety Conversations.” This call to action highlighted the importance of having ongoing safety discussions—and acting on them. Safety conversations are respectful discussions about safety between two or more individuals involved in organizing, delivering, seeking, and/or receiving care. They can fundamentally change the way we think about safety.
Together, we have opportunities to help shift our perspectives on safety collectively. It is not simply the absence of harm but a sustained, proactive effort involving everyone in the care journey. This includes physicians, clinicians, and other care providers, as well as patients and those who support them, such as family members and other caregivers. It’s all about creating space that invites impactful dialogue and empowers effective responses.
Healthcare providers, managers and leaders need to be able to talk openly and honestly about the factors that influence their ability to deliver safe care and to be safe at work themselves. Care recipients and their essential care partners also need to feel comfortable speaking up about their care, asking questions, and articulating what they need to feel safe. It’s about learning from past experiences, understanding the reliability of clinical systems and processes, reflecting continuously on whether care is safe today, anticipating and preparing for safer care in the future, and systematically responding and improving.
To support opportunities to reflect, be inquisitive, think ahead, plan, and respond appropriately to safety needs, Healthcare Excellence Canada has assembled an array of evidence-informed online resources—including easy-to-use tip sheets and other knowledge products—available at SafetyConversations.ca. These resources are designed to help everyone, whether care providers or recipients, to ask, listen and act to help reduce risks, as well as to deliver and get safer care, each and every day.
We invite those delivering and receiving care to:
- Dig deeper into safety conversations at the Now is the Time to Press Play on Safety Conversations recorded webinar
- Use quality and safety tools and resources to make care safer, especially for older adults, who experience higher rates of unintended hospital harm
The latest patient safety data offer a timely reminder of the importance—and the challenges—of making care safer. Everyone has an important role to play in reversing unintended hospital harm and Healthcare Excellence Canada encourages you to take the time to access our online tools and resources to help.
Now, more than ever, let’s strengthen Canada’s healthcare safety culture by creating environments that invite safety conversations, empower effective responses and drive ongoing, positive change.
Jennifer Zelmer is President and CEO, Healthcare Excellence Canada