The Holiday Season and Patient Safety: Avoiding Medical Errors at the End of the Year

Donna Nicholson shares the WHO and the WHAT about global patient safety as well as some practical tips for the delivery of healthcare during the hectic holiday season.

Last fall, I was one of fifteen NCMGMA (North Carolina Medical Group Management Association) members who traveled to Switzerland and Italy to learn more about healthcare delivery outside of the United States. One of our first stops was with select leaders of the World Health Organization (WHO) in Geneva, Switzerland.

The WHO leaders were welcoming and gracious.  We discussed several global health initiatives, but as we approach the busy holiday season, I am reminded of one in particular: the WHO Global Patient Safety Challenge: Medication Without Harm.

If you aren’t familiar with the Global Patient Safety Challenge, it is an actionable component of the Global Patient Safety Action Plan 2021-2030.  The Plan focuses on policies and action implementation leading to eliminating avoidable harm in health care and ensuring the safety of clinical processes.

The four domains capturing initiatives are: the patient and the public; health and care workers; medicines as products; and systems and practices of medication within the three action areas: high-risk situations, polypharmacy, and transitions of care.

So how does all this relate to the holiday season? It is commonly known that one of the top drivers of clinical risk falls in the category of Medical Errors, including medication errors. 

According to the WHO, “Patient harm due to unsafe care is a leading cause of death and disability worldwide and most of this harm is avoidable. Harm due to medicines and therapeutic options account for nearly 50% of preventable harm in medical care.” The WHO further comments that, “Unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. Globally, the cost associated with medication errors has been estimated at $42 billion USD annually.”

What do we know about the delivery of healthcare during the holiday season?

• There are often staffing shortages and increased staffing fatigue.
• Shortages and fatigue can amplify the risk of mistakes.
• Mistakes can be manifested in poor documentation, abbreviated communication during transfers of care, errors in clinical judgement, errors in medication administration, shortcutting SOPs, etc.
• Communication with the patient, family members, and the care team can become strained due to overall stress.
• Compassion fatigue experienced by caregivers can escalate during the holidays.
• There is an increase in public accidents and visits to emergency departments.
• There is an increase in team member accidents.

This is just a short list of concerns those of you in patient care can face related to holiday stresses.

As a leader, here are some considerations:

• Organize staff scheduling with staggered schedules, prioritizing experienced staff, and offer flexibility in scheduling, if possible.
• Enhance communication not only with the care team but with the patient and family as well.
• Encourage open communication and the exchange of productive dialog.
• Do not skip steps in your SOPs regardless of potential time savings.
• Be visible and support your team. Monitor how things are going and be kind.
• Heed Patient Safety measures such as double-checking medications and holding safety huddles.
• Do not skimp on patient and family engagement.