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Health Literacy & Patient Safety
Dr Nikhil D Datar
MD DNB FCPS FICOG LLB DGO DHA •Consultant Gynaecologist: Nanawati Hospital & Hinduja Healthcare Surgical•Director Datar Nursing Home ( Malad) & Yashada Maternity & Surgical Home( Goregaon)
•Founder President : Patient Safety Alliance.
Are YOU at risk?
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AS A PATIENT:Safe, transparent, evidence based, “patient centric” medical care
AS A DOCTOR:Perceived negligence is responsible for 85% of medico-legal cases.
True story
• Patient NOT disclosing that she has undergone a major surgery in the past
Victims of medical accidents
WHO
• “Unintended medical harm” 8th common cause of deaths
• 50% deaths are preventable• Patients are the most important stake holders
Is Health care “patient centric?”
• Doctors adopt highly paternalistic attitude, see informed consent as waste of valuable and scarce time. (Sanwal etal J R Soc Med 1996,89 196-98)
• 40% patients could not understand basic instructions such as take tablet on empty stomach, 60% could not understand standards consent document.(Williams etal JAMA. 1995;274:1677-1682)
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Those with limited health literacy are more likely to:
• Skip preventive measures• Require hospital admissions• Use services designed to treat complications
than services used to prevent complications• Feel shameful & vulnerable• Spend more money• Feel unsatisfied (http://www.health.gov/communication/literacy/quickguide/
factsliteracy.htm)
The “Gap”
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Bridging the gapCase Studies:
• Patient Safety Alliance• “Be alert… Be safe” workshops by PSA• PSA tools• Project “Digital Consents”
Patient Safety Alliance
• Empowering patients• Supporting healthcare professionals
to reduce medical harm.
Education & activism in Health policy and law
“Be Alert… Be Safe” workshop
• Interactive 2 hour workshop• Topics:
– Why errors occur?– Effective consultation with the doctor– How to prevent medication errors– Infection control: role of patients– Internet for authentic health information– Legal recourse against HCP
PSA Tools
• Effective consultation• History that helps• Medication card• Check list for hospital admission
Case study : Digital Consents
• Multi lingual, audio visual, interactive patient information and consenting tool using IT
Process mapping
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DAY 1 : 730 – 750 PM DAY 2 : 930 AM
DAY 2 : 10 30 AM BETWEEN 930 – 1030 AM
Addressing the gap
• What information is sufficient?• How much to disclose?• How to do so without frightening the patient?• How to document the communication• How to get over the language barrier?• How to give this kind of time?• How to improve patient recall?• How to improve patient experience?
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Benefits of Digital consents
• Brings transparency and fairness• Shared decisions and shared risks• Ensures that sufficient information is given
every time• More effective, less time consuming• Protects medico-legally
सर्वे� स�खि�नः सन्तु� , सर्वे� सन्तु� निनःरा�मयः
• Do join us at www.patientsafetyalliance.in
