Maintenance and improvement of health of citizens is a fundamental priority of the government in the current conditions and is vital for the preservation of society and national security. Reforming of the health care system requires the adaptation of classic approach and search for new methods of adequate health care management on a scientific basis. As we are talking about direct impact on human health, patience safety is particularly important in this case. The ensuring of patience safety is achieved primarily through the use of clinical interventions with maximum efficiency and minimum risk for the patient, which is the basis of evidence-based medical practice.
The report of the U.S. Institute of Medicine, “To err is human: Building a safer health system” (1999) stated that in the U.S. hospitals, medical treatment errors result in death of 44 – 98 thousand people every year. The working group on quality patient care organization “Hospitals for Europe” has reported that in 2000, one in ten European hospitals’ patients suffered from preventable harm or adverse effects of treatment. In 2004, the 57th World Health Assembly considered a proposal for building an international alliance to improve the situation in the field of patient safety as a global initiative.
The resolution of typically the problem of patient safety needs a comprehensive approach that includes an evaluation of almost all vital activities. It is now proved that the quality associated with life of patients features an independent predictive value and does not have more accurate criteria with regard to determining the status regarding the patient during therapy than indicators of general somatic status.
Health care care should be risk-free, effective, timely, qualified, plus patient-centered. Consequently, the wide-spread introduction of measures targeted at improving safety associated with patients is of particular medical and practical interest. Execution of a comprehensive system of treatment for making sure patient safety in clinics can improve clinical performance and cost-effectiveness of the diagnostic and treatment method.
Parameters reflecting the underlying negative indicators of diagnostic and treatment procedure may increase the effectiveness of monitoring the safety o in the hospital patients. Integrated safety criterion allows measuring the stage of patient safety, strategy further improvement of analysis and treatment process to be able to assess overall trends inside patient safety and of its comparative quantitative evaluation in different parts of a multi-hospital setting.
Elimination of any kind of possible defects in corporation of the hospital and work of medical personnel, problems of medical interventions plus complications associated with typically the behavior of the patient and staff can also improve patient safety. Amplification, rise of treatment and diagnostic process when implementing a great integrated approach to patient security in hospital is not really accompanied by a considerable increase in workload for personnel but , on the opposite, increases the number associated with staff which is totally satisfied with their job.
The main factors distracting the safety of patients in hospital include medical interventions, psychological conflicts and dissatisfaction of patients with the quality of medical care. At the heart of preventive measures to ensure the safety of patients are the introduction of evidence of medical practice, industrial technology management with quality of care, and informing and training patients.
Monitoring of patients around the hospital showed that for the evaluation of patient safety, integrated criterion of security can be used founded on the basis of inverse negative indices, ranked in order of their clinical significance: in-hospital mortality, non-fatal adverse outcomes, complications of medical interventions, intra-hospital infections, dissatisfied patients, the presence of psychological conflicts and medical personnel interested in the elimination of organizational defects.
Economic efficiency evaluation consists of saving funds allocated to facility of obligatory medical insurance (savings rate) by reducing the average length of treatment and increase of clinical effectiveness. Cost-effectiveness of a comprehensive system to ensure patient safety in the hospital is to reduce the actual average cost of treatment per patient. To achieve some significant reduction in the cost of the diagnostic and treatment process, increase in the frequency of positive outcomes, decrease in the average duration of treatment, and some significant changes are necessary.
Reducing the negative effects of the organization of medical and diagnostic process is accompanied by increased access to quality patient care due to the increase in the number of patients with stable bed turnover, the number of days of bed occupancy in a year, shorter hospital stay, the increasing number of tools and laboratory studies per patient per year (Institute of Medicine, 2012).
Implementation of an integrated system for patient safety leads to the intensification of labor and reduced employee turnover. Increase of the overall satisfaction of medical staff of the quality of diagnostic and treatment process, the number of associates, innovations, personal activity of health workers in the management of quality also increases the proportion of staff trained specialization and improvement of their qualification.
Implementation of a comprehensive system to ensure patient safety in a multidisciplinary hospital reduces the frequency of psychological conflict between the medical staff and the patient or his/her relatives, which helps to reduce cases of unjustified increase in terms of hospital treatment and non-patients on therapeutic and diagnostic procedures (Youngberg & Hatlie, 2004).
During the intensive care treatment, advanced monitoring is needed for ensuring patience safety: monitoring of cardiovascular, respiratory and nervous systems, liver, kidney, gastrointestinal tract, blood, homeostasis as well as energy, water, electrolyte and acid-base balance. Equally important is the intensive surveillance of the ongoing treatment interventions and their outcomes. The important role plays external and internal monitoring of microbiological status and the use of prognostic criteria.
Clinical monitoring (observation of clinical signs and symptoms and quality data) is no less important than the quantitative indicators obtained by using sophisticated equipment. Monitoring provides a timely evaluation of the circulatory function of the heart, vascular tone, blood volume and the overall adequacy of the blood supply of vital organs (Tingle & Bark, 2011).