Currently, the quality of health services has touched upon the issue of patient safety. The issue of service quality and patient safety is increasingly growing to become a serious public health problem. Although there is the natural risk due to their illness, the risk due to unexpected cases would exacerbate the patient's condition.
Recent publications in the U.S. in 2011 showed 1 in 3 patients who were hospitalized suffered unexpected cases. The most common types were medication errors, surgery mistakes and procedures, as well as nosocomial infections. "Moreover, the study at 10 hospitals in North Carolina found similar results. One in four hospitalized patients had unexpected cases, 63% of these can actually be prevented and it turns out that reduction efforts in developed countries is quite slow," says Prof. dr. Adi Utarini, M.Sc., M.P.H., Ph.D. in her inaugural speech as Professor of the Faculty of Medicine at UGM Senate Hall on Monday (25/7).
Meanwhile in Indonesia, according to Utarini, patient safety has become a serious concern. From her study of hospitalized patients in 15 hospitals with 4,500 medical records show various unexpected cases records, i.e. 8.0% to 98.2% for diagnostic errors and 4.1% to 91.6% for medication errors. Since then, the evidence regarding patient safety in Indonesia is even more increasing. "So, the slogan 'buy one, get one free' does not entirely wrong considering the high rates of unexpected case in medical action in the hospital," said Utarini.
On that occasion, Utarini also mentioned about the complexity of the health care regulatory system. She took the example of statistical data showing the risk of death from unexpected case in the U.S. reaching 30,000 times higher than the risk of aircraft accidents. Therefore, serious reform on efforts are needed in a systematic way to create a high level of patient safety. Without them all, quality services and patient safety is just a dream.
The lecturer of the Department of Public Health UGM Faculty of Medicine explained that the health care regulatory system is complex. In Indonesia, quality of services and patient safety is mentioned explicitly in the Health Law No. 36/2009, among others, through medical doctor competency test, quality control, service according to standard and medical audit. Meanwhile, in Indonesia socialization and training of quality and patient safety have been carried out actively by the government and other institutions since 2005. After five years, health care profession and hospitals began to open themselves and recognize the importance of quality and patient safety. The term medical errors no longer causes resistance.
Utarini conveys the present of co-regulatory strategy that describes the cooperation between the internal and external regulators (e.g., health profession organizations, hospital associations, and other health care industry). Reviews, disciplinary procedures, and establishment of the board/advisory committee consisting of several elements of external regulator are the example of co-regulation, whereas meta-regulation strategy is a strategy that involves external regulatory institution to ensure compliance of self-regulation to the standard. Meta-regulation mechanisms, among others, are performed through external clinical audits, mandatory report of patient safety and hospital performance indicators. "Here, the role of the supervisory board is very important in the quality of care and patient safety as the core business of a hospital," the woman born in Yogyakarta, June 4, 1965 said.
Meta-regulation strategy is expected to increase the effectiveness of internal and independent regulation. Although widely adopted in Indonesia, the potential of the strategy can be developed, among others, through the role of the Indonesia Hospital Supervisory Board and the Hospital Patient Safety Committee at the central level. Hospital Supervisory Board can monitor the compliance of supervisory board in performing supervisory functions, while the Hospital Patient Safety Committee can ensure the hospital patient safety teams to perform the intended functions.