Patient safety in primary health care: Time for national action

The field of patient safety emerged following research showing that a large number of harmful, but potentially preventable, incidents occur in hospitals,¹ and following a number of high profile inquiries into incidents at specific hospitals.² These origins mean that the focus of much of the early patient safety work was limited to issues that were particularly relevant for acute care settings; there was little examination of the patient safety risks that exist in primary health care.

In Australia, however, most health care is provided in primary care settings. Given the size and importance of this sector, it is essential that attention is paid to ensuring that the care provided in this sector is safe, and that risks of unnecessary harm associated with the delivery of health care are minimised.

There are a large number of organisations that have a role in quality and safety in primary health care in Australia, and many initiatives are in place to improve care in this sector. One of these organisations is the Australian Commission on Safety and Quality in Health Care, which was established in 2005 to lead and coordinate improvements in safety and quality nationally.

The Commission’s remit is across the continuum of health care, including primary and acute care, in both the public and private sectors. Many of the Commission’s existing programs are relevant to primary health care, and the Commission is now keen to build on this by focusing specifically on patient safety issues in this sector.

The Commission will shortly be releasing a discussion paper about patient safety in primary care in Australia. Patient safety relates to the reduction of unnecessary harm, and is distinct from the broader definitions of quality.³ Although the evidence base and research methods in this field are still developing, it is clear that there are significant patient safety risks in primary health care, and that patients may experience considerable harm from the errors and incidents that occur in these settings.⁴ The Commission wants to raise awareness of these issues, stimulate discussion, and support coordinated national action on patient safety in primary care. In the context of current health reforms, there are opportunities to build on the systems and programs that already exist to further improve the safety and quality of primary health care in Australia.

More information on the Australian Commission on Safety and Quality in Health Care can be found on their webstie: <www.safetyandquality.gov.au/>

References

1. Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD. (1995). The Quality in Australian Health Care Study. Medical Journal of Australia. 163:458-71.
2. Faunce TA, Bolsin SNC. (2004). Three Australian whistleblowing sagas: Lessons for internal and external regulation. Medical Journal of Australia. 181(1):44-7.
3. Runciman W, Hibbert P, Thomson R, Van Der Schaaf T, Sherman H, Lewalle P. (2009). Towards an International Classification for Patient Safety: Key concepts and terms. International Journal for Quality in Health Care. 21(1):18-26.
4. Pearson A, Aromataris E. (2009). Patient Safety in Primary Healthcare: A Review of the Literature. Adelaide: Joanna Briggs Institute. <www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/com-pubs_PrimaryCare-con/$File/26889-Literature-Review.PDF>