Patient Experience in Latin America: Challenges and Opportunities to Ensure Safety

Healthcare is an essential part of our lives, aimed at preventing diseases, treating conditions, and improving our quality of life. However, in this noble effort to care for our health, healthcare systems can sometimes make errors that result in harm to patients. These errors not only cause physical and emotional suffering but also negatively impact people's trust in the healthcare system. In Latin America and around the world, patient safety has become a critical issue requiring urgent attention. In this blog, we will explore the current landscape of patient safety in Latin America, addressing common challenges and the solutions that organisations can implement to ensure optimal care.

Where Are We in Latin America?

Patient safety is a topic that cannot be overlooked. Harm to patients occurs even in advanced healthcare systems due to increasing complexity and the possibility of human errors. Process errors, lack of communication, and the absence of active patient involvement can be underlying factors in these issues. It is crucial to recognize that solely blaming the active provider does not address latent system errors. Instead of expecting individual perfection, it is necessary to create a safe environment with well-designed systems. This is where a shared and transparent safety culture comes into play, an essential component for preventing and improving healthcare errors.

Patient Safety: What Does It Mean?

Patient safety is not just an abstract concept but a concrete focus in healthcare. As healthcare systems become more complex, the likelihood of risks and errors associated with healthcare increases. The purpose of patient safety is simple yet fundamental: to prevent and reduce hazards, errors, and harm that patients may face during their healthcare. The foundation of this initiative is continuous learning from mistakes and adverse events to continuously improve and evolve.

Latin America: Confronting the Burden of Healthcare-Related Harm

Millions of patients in Latin America experience harm or even die due to unsafe healthcare. The situation is alarming, with examples including medication errors, healthcare-associated infections, and risky surgical procedures. Unsafe practices such as unsafe injections and misdiagnoses contribute to this burden. These problems not only jeopardize patient safety but also affect the overall quality of healthcare in the region.

The Data Speaks for itself 

• Medication errors result in an annual cost of approximately $42 billion worldwide. Healthcare-associated infections affect 7-10% of hospitalised patients. 

• Up to 25% of surgical patients experience complications, with one million surgical patients dying annually. 

• Unsafe injection practices lead to 9.2 million years of disability-adjusted life lost. 

• Diagnostic errors affect 5% of adults in outpatient care, with more than half of them potentially causing serious harm. 

• Errors in radiation and septicemia cause preventable harm and deaths.

• Venous thromboembolism is responsible for common and preventable harm.

Transformative Technology: Improving Patient Safety

In the digital age, technology plays a crucial role in healthcare improvement. Implementing patient safety and quality systems can make a difference. Through specialised software, effective audits can be conducted, and accreditations of high standards like those of the Joint Commission International (JCI) can be tracked. These systems not only monitor quality but also identify areas for improvement and prevent future incidents.

MEG: Offering Solutions

Through MEG, we present effective solutions to address common challenges in patient safety in the medical field:

1. Medication Management: We offer the Antibiotic Administration Survey to address common errors in medication administration.

2. Surgical Errors: To prevent surgical errors, responsible for 10% of preventable harm, we provide efficient access to the World Health Organization's Surgical Safety Checklist, available digitally in the context of Safe Surgery for Latin America and Spain.

3. Healthcare-Associated Infections: In response to healthcare-associated infections, accounting for 0.14% of cases, we implement measures to reduce antibiotic resistance and control infections in the medical field.

4. Sepsis: Sepsis is a critical concern, with approximately 23.6% of cases occurring in hospitals. We offer specialized audits in infection prevention and control to address this issue.

Looking to the Future

The data confirms that patient safety is a critical priority in Latin America and globally. Preventing and reducing adverse events in healthcare is possible through effective strategies and global collaboration. Our ultimate goal is to ensure that every patient receives safe and high-quality care. Through awareness, a focus on vulnerable groups, robust health policies, a safety culture, and ongoing research, we can move towards a future where patient safety is constant. The adoption of advanced technologies, such as audit and tracking software, will be crucial for continuously improving the quality and safety of care provided. Ultimately, we all play an important role in this process, from healthcare professionals to informed patients, collaborating to achieve optimal and safe care for patients.

Sources:

1. World Health Organization (WHO). Patient Safety. https://www.who.int/en/news-room/fact-sheets/detail/patient-safety. Accessed September 11, 2023.

2. IBEAS Study. IBEAS: A Pioneer Study on Patient Safety in Latin America: Towards Safer Hospital Care. May 4, 2011. https://www.who.int/publications/i/item/WHO-IER-PSP-2010.3

5 Tips for Digital Transformation in Type IV and Type II Hospitals

The digital transformation of hospitals is essential to enhance efficiency, improve patient care, and stay ahead in a rapidly evolving healthcare environment. Whether it's a large Type IV hospital with more than 300 beds or a mid-sized Type II facility with 60 to 150 beds, understanding the specific needs and challenges of each hospital type is crucial for a successful transition. Here are some key tips to guide the digital transformation process for these types of hospitals.

1. Technology Selection and Risk Management

Choose technologies tailored to the hospital's size and complexity, considering both current infrastructure and future needs.

• Type IV Hospitals: A Type IV hospital, with over 300 beds and a wide range of services, should implement a comprehensive hospital management system that integrates all departments, enhancing coordination and streamlining operations across the board. This might include systems that manage patient records, inventory, scheduling, and more.

• Type II Hospitals: For a Type II hospital with 60 to 150 beds, a modular system is ideal. This allows the hospital to start with essential components, such as document management, and gradually expand as needed. This approach ensures that the hospital can scale its digital capabilities in line with its growth.

2. Risk Assessment

Conduct thorough risk assessments before implementing new technologies, tailored to the hospital's scale and type.

• Type IV Hospitals: Before rolling out a new digital system across the entire hospital, consider piloting it in a specific unit to ensure compatibility with existing systems and to avoid data loss. This step allows for any necessary adjustments before a full-scale implementation.

• Type II Hospitals: For a Type II hospital, assess the risks associated with integrating a patient management system. A pilot test in a high-traffic area, such as the emergency department, can provide valuable insights into the system’s effectiveness and highlight any potential issues.

3. Enhancing Operational Efficiency

Adopt digital solutions that streamline internal processes and boost operational efficiency, customized to the hospital's specific needs.

• Type IV Hospitals: Implement a real-time inventory management system to track and optimize the use of medical supplies and medications across various departments. For instance, integrating a pharmacy management system can significantly improve resource allocation and reduce waste.

• Type II Hospitals: Introducing a hand hygiene auditing system or an incident risk management tool can reduce administrative burdens and improve patient flow management. These systems are particularly beneficial in hospitals with moderate patient volumes, where efficiency is crucial.

4. Patient Safety and Risk Management

Leverage advanced technologies to enhance patient safety, ensuring staff are trained to follow digital safety protocols.

• Type IV Hospitals: Utilize detailed dashboards, heat maps, and issue-tracking features to identify and prioritize risks, plan interventions, and monitor progress. These tools are vital in large hospitals where managing a high volume of patients and data can be challenging.

• Type II Hospitals: A pharmacy monitoring system with automated alerts for medication administration can significantly reduce errors and enhance patient safety, especially in critical care units. These systems help maintain high safety standards even in smaller hospital settings.

5. Training and Education

Provide ongoing training for staff on new technologies and safety protocols to ensure a smooth transition.

• Type IV Hospitals: Offer comprehensive training workshops and online resources for all hospital staff on using the new hospital management system and understanding cybersecurity protocols. Continuous education is essential in large institutions to ensure that all employees are proficient with new systems.

• Type II Hospitals: Implement targeted training sessions for administrative and clinical staff on using electronic medical records (EMRs) and scheduling tools. These sessions should be practical and focused on day-to-day operations to help staff adapt quickly to the new systems.

"The tool allowed us to evaluate more processes, involve more teams, and focus more efficiently on critical points, making our efforts more effective."

-Dr. Hugo Siu, Director of Quality, Anglo Americana Clinic, Peru.

Conclusion

Digital transformation in hospitals, whether large Type IV facilities or smaller Type II institutions, requires careful planning, risk management, and ongoing education. By selecting appropriate technologies, conducting thorough risk assessments, enhancing operational efficiency, prioritising patient safety, and investing in staff training, hospitals can successfully navigate the challenges of digital transformation. This process not only improves patient outcomes but also positions hospitals to meet future healthcare demands with agility and resilience.

Enhancing Patient Safety: Insights and Solutions from an Expert in Health Quality

In an enlightening interview, a seasoned professional, Mauricio Petri, an expert in Patient Safety and Quality, shared his extensive journey through various industries, including automotive and healthcare, and his current focus on digital transformation in health. With over two decades of experience, he has made significant strides in integrating his expertise in quality management into improving patient safety and hospital management.

Insights into Patient Safety Challenges

The primary challenge facing patient care is accessibility. High accessibility without quality is akin to having low accessibility. Effective healthcare starts with accessible primary care, which lays the foundation for preventive measures and early diagnosis. However, improving accessibility alone isn't enough; quality must be maintained throughout the care process. This involves not only digital advancements but also enhancements in overall service processes.

Factors Influencing Patient Experience

Several factors affect patient care, including the time dedicated to patient interaction and the quality of communication. Studies emphasise the importance of empathy, communication, and the management of patient expectations. The gap between patient expectations and actual care can lead to dissatisfaction. Effective communication and managing expectations are crucial in providing a positive patient experience.

Explore our Patient Experience Software here!

Improving Communication and Patient Involvement

Efforts to enhance patient communication include proactive feedback systems and patient involvement in decision-making. Engaging patients in designing care processes helps align services with their needs. For instance, working with patient groups in Chile has shown the benefits of incorporating patient feedback into process design.

"High accessibility without quality is the same as having low accessibility. So, the second important point after accessibility is quality."

"The way to incorporate these tools is to create a digital space where the patient, during their care flow and journey, can quickly provide their experience in real-time."

-Mauricio Petri, Expert in Quality and Patient Safety, Business Development in Latin America & Spain at MEG

The Role of Digital Transformation

Digital transformation is evolving, with a focus on electronic health records and incident reporting. However, the next step involves using digital tools to capture patient experiences in real-time. By integrating digital surveys and feedback mechanisms during care, healthcare providers can quickly address issues and improve the patient experience. This approach allows for immediate adjustments and better coordination between care teams.

Conclusion

The integration of digital tools for real-time patient feedback represents a significant advancement in improving patient safety and care quality. By addressing accessibility, communication, and leveraging technology, healthcare providers can enhance the overall patient experience. The ongoing efforts to innovate and involve patients in their care journey are crucial steps toward achieving better outcomes and safer healthcare environments.

Streamline patient safety and compliance with MEG’s LFPSE-Compliant Risk Management System.

Breaking Down the Barriers: Tackling Healthcare Data Migration Challenges

According to Gartner, 83% of data migration projects fail, with over half exceeding their allocated budgets. And in a heavily regulated industry like healthcare, where providers manage vast amounts of complex data across various sources, formats, and systems, data migration presents its own set of unique challenges.

Ensuring data integrity, preserving patient records, maintaining uninterrupted care delivery, and complying with regulatory standards all depend on successful data migration. So, how can healthcare organisations achieve seamless data migration while upgrading their digital infrastructure? Whether transitioning from legacy systems to advanced solutions, merging operations, or enhancing compliance with updated regulations, this blog post explores common challenges and how we at MEG overcome them with our industry expertise and best practices.

Key Challenges in Healthcare Data Migration

1. Data Integrity

The Challenge

Ensuring the accuracy and consistency of data during migration is a significant challenge due to the wide range of structured and unstructured healthcare data across multiple sources, different data models, and data quality issues such as missing, outdated, or inaccurate information. Inconsistent or poor-quality data can lead to errors that impact patient care and overall operational efficiency.

The Solution

At MEG, we use a three-step approach to ensure data integrity. This includes:

1. Data Standardisation: Using standardised data formats, field names, and coding schemes to maintain consistency across systems is an effective method to eliminate incorrect and missing data, streamline the migration process and ensure compatibility across systems. Establishing data governance policies and procedures helps enforce standardisation practices and maintain data quality over time.

2. Data Cleansing: Conducting a thorough analysis of the data to be migrated to the new system helps identify inconsistencies, duplicates, or errors within the dataset. Addressing these issues early on minimises the risk of data corruption or loss during migration.

3. Data Audit: Conducting a thorough inventory of all existing data sources, formats, and structures allows healthcare organisations to identify potential challenges, such as data inconsistencies, outdated or incompatible systems, and duplicate data that could negatively impact the migration process well in advance.

2. Interoperability

The Challenge

Different healthcare systems use different data formats and standards, making interoperability a significant hurdle.

The Solution

To ensure compatibility and interoperability between the source and target systems, we recommend developing robust data mapping and transformation procedures that allow different data formats and standards to be accurately integrated.

Data mapping ensures that data fields in the source system (in our case, the existing Quality Management System) correspond accurately to the fields in the destination system (MEG). It involves analysing both the source and target systems, transforming data into the required formats, and ensuring accurate field mapping between systems. This is also where data is converted into the required format or structure. This can involve simple transformations like date formats (e.g., changing MM/DD/YYYY to YYYY-MM-DD) or more complex transformations like combining multiple fields into one.

3. Data Security and Compliance

The Challenge

Healthcare data contains sensitive patient information such as personal identifiers, medical history, and diagnoses and is subject to strict privacy regulations like HIPAA and GDPR. Ensuring compliance with these governance frameworks and preventing data exposure, loss, or corruption during migration is often a challenge.

The Solution

To overcome this, MEG implements the following measures across all data migration projects:

• Clients are encouraged to self-evaluate their internal data, and the MEG implementation team guides them through the best practices for data preparation. This process often involves consolidating data from various formats and sources, such as paper records, Excel spreadsheets, and legacy software databases, into a single secure source.

• Clear data retention policies that dictate how long different types of data should be retained and when they can be safely archived or deleted to ensure data privacy, security, and adherence to legal and regulatory requirements.

• Strong encryption methods and password-protected zip files to protect data during transfer

• Stringent access controls to ensure only authorised personnel can access the data

• Frequently checking and documenting compliance with relevant regulations throughout the migration process

4. Downtime and Disruption

The Challenge

In some cases, data migration of large amounts of data can cause system downtime, affecting healthcare operations and patient care.

The Solution

Some best practices that can be implemented to avoid this include:

• Phased Migration: Performing the migration in smaller, manageable phases allows organisations to identify and address potential issues early on, reducing the overall risk of data loss, corruption, or system downtime. Each phase serves as a learning opportunity to refine processes and mitigate potential problems in subsequent phases.

• Backups: Maintaining backups of all data before and during the migration process allows you to implement rollback procedures to revert to the previous state in case of critical failures or data loss during migration.

• Testing: Setting up dedicated test environments that mirror the production environment allows for thorough testing of migration processes without impacting live operations. This enables organisations to identify and address issues in a controlled environment before deploying changes to production.

Conclusion

Healthcare data migration is a complex but necessary undertaking for modernising healthcare systems and improving patient care. By understanding the challenges and implementing effective strategies to address them, organisations can break down the barriers to successful data migration, ensure compliance and security, and pave the way for a more efficient, integrated, and patient-centric healthcare environment.

To know more about successful healthcare data migration, check out our whitepaper, "Mastering Healthcare Data Migration: Challenges, Best Practices, and the MEG Approach".

Interview with Dr Magaly Blas, researcher and epidemiologist

Technological Advances in Maternal Health in the Amazon: The Case of Mamás del Río

In the heart of the Amazon rainforest, where roads become rivers and distances are measured in days of navigation, Mamás del Río emerges as a beacon of hope for communities facing limited medical care. Led by Dr Magaly Blas, with extensive experience in epidemiology and public health, this program has proven to be an innovative model for improving maternal and neonatal health through technology adapted to challenging environments. This article explores how the program has integrated technology to enhance care in rural and indigenous areas, highlighting the importance of public-private partnerships in this process.

CHECK THE FULL VIDEO INTERVIEW HERE

In this video, Dr Magaly Blas, an epidemiologist, introduces Mamás del Río, a program improving maternal and neonatal health in the Peruvian and Colombian Amazon. The program empowers community health workers with tablets for educational content and monitoring tools, transforming healthcare in remote areas.

CC are in English and many other languages.

Dr. Magaly Blas and Mamás del Río

Dr Magaly Blas is a physician from the Universidad Peruana Cayetano Heredia, with a master's and a doctorate in epidemiology from the University of Washington. She currently leads the Mamás del Río program, which aims to improve maternal and neonatal health in remote and indigenous communities in the Peruvian and Colombian Amazon. Besides directing the program, Dr Blas also plays a crucial role as head of the Political Advocacy Secretariat in Medicine and Public Health at the Medical College of Peru.

Using Technology to Improve Maternal and Newborn Health

Mamás del Río has implemented technology directly into the hands of community health workers, who play a vital role in their isolated communities. Each community worker receives a tablet that serves as an educational and monitoring tool. This tablet contains "digital stories," interactive narratives created in collaboration with the communities themselves, addressing specific maternal and neonatal health topics. During home visits, the tablet guides the workers on danger signs during childbirth and promotes safe childbirth practices, using multimedia content that deeply resonates with the local communities.

“We equip our community health workers with tablets that contain interactive educational content and monitoring tools. This not only facilitates education on maternal and neonatal care but also allows continuous health monitoring in communities where access to health centres is limited. We have demonstrated that it is possible to adapt technological tools to function without an internet connection, ensuring that critical information reaches even the most remote communities.”

Examples of Public-Private Collaborations

Strategic collaborations with public and private entities have been fundamental to the success of Mamás del Río. Under Dr. Blas’s leadership, the program has established strong partnerships with the Ministry of Health and regional governments, as well as support from the Ministries of Foreign Affairs of Peru and Colombia. This partnership has facilitated the expansion of the program along the border, significantly improving access to healthcare in previously inaccessible areas. Additionally, the program has received funding from the Inter-American Development Bank and Grand Challenges Canada, which have supported key scaling and impact assessment initiatives.

“We work in close partnership with the Ministry of Health and regional governments, as well as international organisations, to scale the program and ensure its long-term sustainability.”

Research Methods and Impact Evaluation

Mamás del Río has used rigorous research methods to evaluate the impact of its interventions on maternal and neonatal health. Studies have been conducted before and after the program in selected communities, using repeated censuses to measure changes in health indicators. The results of these studies have been published in specialised journals, such as The Lancet Regional Health Americas, highlighting significant improvements in newborn care, the promotion of breastfeeding, and increased institutional deliveries.

“These results not only validate our strategy but also reinforce our commitment to continue innovating and adapting technologies to address the unique challenges faced by Amazonian communities.”

New Ideas from Collaborations

Successful collaborations have led to new initiatives within Mamás del Río. For instance, an innovative approach is being developed to address teenage pregnancy, a growing concern in the communities served by the program. Dr Lisa Lebita Woodson has worked on this line to understand why teenage pregnancy occurs and how to address it. Additionally, community empowerment has been strengthened through the creation of the Association of Indigenous Community Health Workers (AACOSIL), a platform that promotes local leadership and participation in health-related decision-making.

“Our goal is to ensure that every mother and child in the Amazon has equitable access to safe and effective healthcare.”

- Dr. Magaly Blas, Epidemiologist and Researcher, Director of Mamás del Río

With the right combination of technology, collaboration, and commitment, Mamás del Río has shown that it is possible to significantly improve maternal and neonatal care in the most remote and vulnerable regions of the continent. Despite initial challenges such as technology training and limited connectivity infrastructure, the program has implemented effective solutions in remote environments without constant internet access. The offline-operating application has facilitated adoption by community workers, allowing them to access essential educational resources and monitoring tools.

In conclusion, under the direction of Dr. Magaly Blas, Mamás del Río highlights the crucial importance of technological innovation and strategic partnerships in improving maternal and neonatal health in remote areas. Through public-private collaboration, the program has not only transformed lives and strengthened communities but also established a replicable model for regions with similar challenges. Continuous commitment to research and rigorous evaluation remains essential to guide future interventions and ensure a lasting impact on public health, thereby improving patient safety and quality in healthcare systems.