Exploring patient participation in reducing health-care-related safety risks

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Exploring patient participation in reducing health-care-related safety risks 54 Fig . 4 .5 . Patient safety in France Ministry of Health HAS IGAS AFSSAPS InVS EFS EXECUTIVE BRANCH ABM DGS DGOS DREES ANSES INPES INCa » ABM is the Agency of Biomedicine » AFSSAPS is the French Health Products Safety Agency » ANSES is the French Agency for Food, Environmental and Occupational Health Safety » DGOS, Direction Générale de l’Offre de Soins, is in charge of the organization of health care (to ensure its quality, continuity and accessibility) and health care professionals’ training and activities » DGS, within the Ministry of Health, is the authority responsible for prevention and health safety policies » DREES is responsible for providing the general public, authorities and representatives with reliable data and analyses on demographic features and health and social policies » EFS is the French Blood Transfusion Organization » HAS is the French National Authority for Health and is in charge of health care organizations and accreditation of professionals, safety of procedures, safety recommendations and patient information » IGAS is the Interministerial Audit and Evaluation Office for Social and Health, Employment and Labour Policies; its role is to assist public players in making informed decisions » INCa is the French National Cancer Institute » INPES is the French National Institute for Prevention and Health Education, in charge of health education and prevention » InVS is the French National Institute for Public Health Surveillance Source: the authors, based on HAS data. body was set up, chaired by a representative of patients’ organizations, with the aim of influencing decision-making and policy-making processes, and a new health information web site is being developed. It is worth noting that patients’ common rights, including informed consent, provision of information and access to medical records, also apply to blood transfusion. Transfusion and haemovigilance organization in France The overall goal of haemovigilance is to increase the safety and quality of blood transfusion (Article R1221-22). According to Decree No. 2006-99 (1 February 2006) relating to the blood transfusion centres and haemovigilance and modifying the Public Health Code (Article R1221-24), the national haemovigilance system consists of: » AFSSAPS; » National Haemovigilance Commission; » regional haemovigilance coordinators (mentioned in Article R1221-32); » EFS and the CTSA; » National Institute for Public Health Surveillance; and » health care facilities and armed forces hospitals (haemovigilance correspondents), transfusion safety and haemovigilance committees or facility medical commission
Blood transfusion safety in France: developing tools to support patients subcommissions; under Article R1221-43, a haemovigilance correspondent in each health facility must declare all adverse reactions in transfusion recipients and serious transfusion incidents and collect information mentioned in articles R1221-40 and R1221-2. A simplified depiction of the transfusion and haemovigilance system at national, regional and local levels is shown in Fig. 4.6 (6). Fig . 4 .6 . Organization of transfusion and haemovigilance in France Ministry of Health National AFSSAPS Regional EFS and CTSH 18 blood transfusion centres National Haemovigilance Commission 29 regional haemovigilance coordinators Local 155 transfusion sites 1 600 health care centres Health care professionals The transfusion safety and haemovigilance committees, created in 1994, are responsible for improving transfusion safety through research and consequent recommendations. Their duties at local level are to improve safety for transfused patients, monitor the application of haemovigilance regulations and manage the training of staff members dealing with blood transfusion processes (10). Any health care professional who observes or becomes aware of an adverse effect or a serious incident must report it within eight hours. Analysis of haemovigilance data is carried out at national level. Regulatory aspects and legal tools supporting patient safety and the right to safety in France List of official legislative documents Law No. 2002-303 8 on patients’ rights and quality of the health system came into force in 2002. This law gives the right to every hospitalized individual over 18 years of age to name a trustworthy person who will back them during their stay and defines the right for patients to access their medical records. In relation to blood transfusion, the 11 January 2006 bill 9 (repealed on 1 October 2006) abolished the systematization of pre- and post-serological transfusion checks on LBP recipients. 8 Loi No. 2002-303 du 4 Mars 2002; see the list of legislation at the end of this chapter. 9 Circulaire DGS/DHOS/SD3/2006/11 du 11 Janvier 2006. National Institute for Public Health Surveillance Epidemiology of donors 55
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Exploring patient participation in
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ABSTRACT Patients’ rights have be
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iv Patient information: the link be
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vi LIST OF TABLES, FIGURES AND BOXE
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ACKNOWLEDGEMENTS The editors would
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LIST OF ABBREVIATIONS ABHR alcohol-
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FOREWORD Health is a social value a
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ChApTER 1. pATIENTS’ RIGhTS AND p
Page 17 and 18: Box 1 .1 . contd Reporting and Lear
Page 19 and 20: The causal mechanisms through which
Page 21 and 22: » be involved in routine monitorin
Page 23 and 24: elationships within the complex env
Page 25 and 26: ChApTER 2. pATIENTS’ RIGhTS AND p
Page 27 and 28: CoE Recommendation 2006/7 of the Co
Page 29 and 30: The 2005 United States act on patie
Page 31 and 32: The right to participate in policy-
Page 33 and 34: The right to participate in quality
Page 35 and 36: » engaging with patient representa
Page 37 and 38: hampered by the written and spoken
Page 39 and 40: prevents misunderstandings and shap
Page 41 and 42: Health care providers should nevert
Page 43 and 44: Recommendation 7 - Encourage the av
Page 45 and 46: 20. Constitution of the World Healt
Page 47 and 48: ChApTER 3. pATIENT pARTICIpATION IN
Page 49 and 50: awareness of the sociomedical burde
Page 51 and 52: Patient participation in hand hygie
Page 61 and 62: Blood transfusion safety in France:
Page 65 and 66: Box 4 .1 . Definitions of adverse e
Page 67: Fig . 4 .4 . Distribution of advers
Page 73 and 74: The heterogeneity of situations and
Page 83 and 84: Fig . 4 .12 . Patients’ response
Page 91 and 92: Patient safety, rights and medicati
Page 97 and 98: Fig . 5 .3 . Frequency with which d
Page 107 and 108: ChApTER 6. pATIENT pARTICIpATION IN
Page 109 and 110: Patient participation in elective s
Page 111 and 112: e desirable to have a special statu
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Patient participation in elective s
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» being involved in monitoring and
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Other studies on patient attitudes
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Information about patients’ exper
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available evidence suggests that in
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Adverse events Respondents from the
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Feeling safe Five per cent of hospi
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probability proportional to populat
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care professionals’ and patients
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group recommends that patient invol
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13. Hibbard JH et al. Can patients
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52. Triemstra M et al. Measuring cl
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2009 (http://www.bradfordresearch.n
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of a small-scale patient survey add
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Box 8 .2 . Curricula and CME Chapte
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is provided through interaction of
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Box 8 .4 . Patient education Chapte
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ANNEX 1. QUOTATIONS FROM INTERNATIO
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(2) When designing adverse event re
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17) If yes, do you think this was m
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Box A3 .1 . Reporting procedure Pat
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Box A3 .2 . contd Haemosiderosis Ha
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ANNEX 4. pATIENT QUESTIONNAIRE ABOU
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ANNEX 6. WhO pATIENT SAFETY pROGRAM
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especially those in intensive care.
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ANNEX 7. hANDOVER pROjECT Paul Bara
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(a) Provide new insight into the ro
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Johnson J, Barach P. Handovers of p
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Enhancing the patients’ role in p
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Enhancing the patients’ role in p
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