Among the 10 patient safety rights is the right to receive timely, effective and appropriate healthcare. — Filepic
There have been exceptional technological advances in medical care in the past half a century.
These advances have come about with a price though, i.e. a risk of patient harm.
This was aptly described by British paediatric nephrologist Professor Sir Dr Cyril Chantler in 1998: “Medicine used to be simple, ineffective and relatively safe.
“It is now complex, effective and potentially dangerous.
“The mystical authority of the doctor used to be essential for practice.
“Now we need to be open and work in partnership with our colleagues in healthcare and with our patients.”
Many publications have drawn global attention to the prevalence and consequences of medical errors, including To Err Is Human: Building A Safer Health System and An Organisation With A Memory: Report of An Expert Group on Learning from Adverse Events in the NHS.
The World Health Organization (WHO) embarked on its Patient Safety programme about two decades ago.
According to the WHO, about one in every 10 patients globally is harmed in healthcare, with more than three million deaths occurring annually due to unsafe care.
About half of these cases (one in every 20 patients) is preventable, with half of this harm attributed to medications.
Malaysian data can be found on the Technical Reports webpage of the Patient Safety Council of Malaysia.
Basic rights
The WHO formulated the Patient Safety Rights Charter after wide consultation with stakeholders.
It was adopted at the Sixth Global Ministerial Summit on Patient Safety in Chile on April 17-18 (2024).
The charter is intended to support the implementation of the Global Patient Safety Action Plan 2021-2030.
There are 10 fundamental patient safety rights as listed in it:
Such care should be tailored to the patient’s health needs, particularly where delays in receiving the required healthcare in a timely manner could lead to disease progression, clinical deterioration, failure to rescue, and poor outcomes such as preventable patient harm.
This right extends to receiving effective care after working hours, ensuring its availability around the clock and the right to be notified promptly of any critical test results, especially after discharge.
Health workers should follow safe processes and practices, and implement measures that identify, prevent and manage risks, and reduce preventable harm.
This includes maintaining correct patient identification and accurate documentation; evidence-based clinical and diagnostic pathways; ensuring safe and comprehensive handovers, referrals and smooth transitions of care; adhering to safe practices for medications, surgery, blood transfusions, injections, and infection prevention and control; avoiding overdiagnosis and underdiagnosis; and ensuring effective treatment.
Health workers should possess the necessary qualifications, skills and competencies, aligned with national and international standards, that enable them to provide safe care, and prevent and mitigate safety risks and harm.
Care should be delivered with professional integrity, compassion, empathy and respect for patients’ rights, unique needs, personal preferences and emotional well-being.
Patients are entitled to be informed about the names of their providers and details about their healthcare facilities, including licensing, certification and safety ratings where available.
Patients have the right of access to the medical products they need, including medicines, vaccines, medical devices, diagnostics, blood and blood products, traditional and complementary medicines, and assistive and medical technologies of recognised safety, quality, and efficacy standards and regulations.
This right encompasses the safe and rational use of these products, including appropriate prescribing, ordering, storage, dispensing, preparation, administration and monitoring of medicines and vaccines; safe use and maintenance of medical devices; and safe collection, testing, processing, storage, distribution and transfusion of blood and blood products and their monitoring.
Health workers and patients must be empowered on the safe use, identification and reporting to relevant authorities of suspected adverse drug reactions, transfusion reactions, adverse events following immunisation, medication errors, and substandard and falsified medicines and other medical products.
These facilities should be safe, resilient and easily accessible to everyone.
Particular attention needs to be given to persons with disabilities, with the adoption of a universal design-based approach.
Where this is not feasible, healthcare facilities are required to provide reasonable accommodation.
This right includes maintaining structural integrity and critical systems, ensuring climate resilience and smoke-free surroundings, implementing safe evacuation protocols and pathways, and adhering to safety standards for fire, electrical and radiation.
In emergencies and disasters, patients have the right to care in facilities with robust infrastructure designs that withstand natural and human-induced hazards to ensure the safety, quality and continuity of essential services like power, illumination, water, sanitation, waste management, ventilation and infusion systems, particularly in isolation units and operating theatres.
This should be throughout the patient’s healthcare journey, irrespective of their background, beliefs, values, cultures or preferences.
This right encompasses protection from any abuse, neglect, violence, degrading treatment or deprivation of liberty, and is especially crucial in sensitive care scenarios like palliative care and end-of-life situations, and extends to respecting patients’ autonomy and honouring their choices.
Patients have the right to receive timely, accurate and complete information about their health.
This includes clear explanations about their medical condition, management plan, prescribed medicines or medical products, including their names, purpose, benefits, possible adverse effects, interactions, contraindications and existing alternatives.
Patients are entitled to receive information that empowers them to proactively stay healthy, contribute to their own safety and manage their conditions effectively, including self-care.
They have the right to communication that is culturally appropriate and tailored to their age, literacy and individual needs, including the use of interpretation or alternative and accessible formats, if necessary, due to language or sensory barriers.
This includes obtaining a copy of their records in a usable and an understandable format, covering both physical and electronic records, which should be accurate and up to date.
Patients are entitled to request corrections to factual inaccuracies and control the use of their information.
A patient may designate a representative to access or obtain their records.
Patients have the right to easily transfer their medical records when seeking second opinions or changing healthcare facilities.
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Patients have the right to share their experiences, file complaints and report safety incidents occurring during their care.
This includes adverse events leading to patient harm, near misses and any other perceived safety risks or safety concerns.
Patients are to be provided with a supportive environment rooted in a culture of safety, whereby their voices are heard and their concerns expressed without the fear of retribution or negative repercussions.
In the event of an incident, patients are entitled to clear explanations about what happened, the reasons behind it, and the actions taken for redressal, fair resolution and prevention of reoccurrence.
Patients also have the right to be involved in a fair and just process for addressing any harm.
This involves a clear pathway for independent investigation, accountability, reconciliation and fair resolution, including compensation in line with the harm experienced, national legislation and best practices.
Appropriate mechanisms for reporting safety incidents and systems to learn from these incidents should be in place and functional.
In cases of serious incidents, patients are entitled to receive ongoing psychological and other forms of support needed, and should be reassured that the healthcare facility is committed to implement the learnings from the incident analysis to improve the safety and prevent future occurrences.
Patients have the right to be active partners in their care, with a focus on ensuring their safety at every step of care provision.
This partnership involves the right to self-determination and informed participation in decision-making, understanding and managing potential risks, and contributing to the planning and monitoring of treatment.
In such a partnership, patients have the freedom to choose their preferred care option and healthcare providers, and have the right to refuse care without coercion, pressure or undue influence from anyone.
Patients have the right to advance directives, which allow them to outline their healthcare preferences for future scenarios where they may be unable to make decisions.
Patients retain the right to seek the opinion of another physician at any stage of their care – a practice that can further safeguard against medical errors and misdiagnoses.
They are entitled to seek support from family members or caregivers throughout their healthcare journey.
Family members designated by the patient, have the right to be actively involved in discussions and decisions regarding the patient’s care, and play a vital role in identifying and flagging potential safety risks, particularly in situations where patients are unable to communicate or make decisions themselves.
Support needed
The Patient Safety Rights Charter focuses on mitigating risks and preventing inadvertent harm in healthcare.
It provides a guide to enhance healthcare practices and promote patients’ rights to safety.
It enhances global patient safety standards and the commitment to ensuring healthcare safety.
The Charter requires the support of everyone, particularly healthcare providers, whether they be the Health Ministry, private healthcare facilities, healthcare workforce or patients, as everyone is a potential patient.
Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email starhealth@thestar.com.my. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
