Danger zone

No health care knowledge is more important than how to prevent harm to patients. So says Sir Liam Donaldson, chair of the World Health Organisation's World Alliance for Patient Safety. He is acknowledging that medical error is a major cause of death and disability, and that action to reduce known risks to patients has been poorly co-ordinated and regrettably slow the world over. In some countries, this is beginning to change.

The WHO Collaborating Centre on Patient Safety recently announced a seven-country initiative against major threats to patient safety. Its aim is to reduce five leading patient safety hazards: patient care handover errors; wrong site, wrong procedure, wrong person surgical errors; medication errors; high-concentration drug errors; and the promotion of effective hand-hygiene practices. The premise is that about 50 per cent of adverse medical events are avoidable.

Why is Hong Kong not part of this initiative? The answer is that patient safety does not have a high enough priority here. The explanation, I believe, is that the scale and costs of the medical error problem have not been appreciated.

Reliable international studies indicate that, in any one year, about 10 per cent of the population will end up in hospital: one in 10 inpatients will fall victim to a medical error resulting in harm; and the injury will cause or contribute to death in one-tenth of these cases. In developed countries, fatalities due to medical error rank high among all causes of death (10 per cent of the total), and substantially outnumber road traffic accident deaths (4 per cent).