Conception of the formation of the strategy for the prevention of the defects in provision of medical care in the national health care system

Abstract

Objective: The aim of the work was to draw attention of the community to the problem of potentially preventable harm to the patients in health care institutions and to determine the main directions in the formation of the system for provision of patients’ safety. Material and methods: We performed the analysis of the international experience and the best practices of separate countries on the creation of a safer health care system for the patients. We studied a regulatory framework of the Ministry of Public Health of Ukraine on the formation of the quality management system for medical care. One of its main tasks is to ensure the safety of medical services. We evaluated the state of patients’ safety in domestic hospitals. Results and discussion: It was established that, at the political level, there was a lack of attention to the problem of patients’ safety, ignoring of the international experience and the experience of separate countries in prevention of unintended harm to the patients, underestimation of the risks of the processes of health care system reform to the patients’ safety, which led to a multiple increase of the in-patient mortality in recent years. To a large extent, this is due to a rapid increase in the level of postoperative mortality (in separate public health institutions 30 and more times greater) and, as a result, there is an increase in the risk of death of the adult population during in-patient medical care from 1.0 • 10-2 to 1.4 • 10-2. In domestic hospitals, the prevalence of indictment culture with an emphasis on the punishment of medical workers who made mistakes in providing of medical care, rather than a search of the root causes of the problem, has been revealed. Directions, approaches and tools for the prevention of the defects in medical care and their consequences have been proposed.