A unique collaboration between space scientists and healthcare professionals is set to take the country closer to the goal of “error-free” healthcare. The first step in this direction is Health Quest, a new set of guidelines for critical care units and emergency departments―where a single mistake can cost a life―in hospitals across the country. These guidelines are the result of a joint effort between experts in space technology at Indian Space Research Organisation (ISRO), and healthcare professionals from organisations such as the Association of Healthcare Providers India (AHPI), Consortium of Accredited Healthcare Organisations, National Accreditation Board for Hospitals and Healthcare Providers, Society for Emergency Medicine, India (SEMI), and the Indian Society for Critical Care (ISCCM).
Data from developed countries suggests that nine out of every 100 patients who are hospitalised encounter medical error-related events. However, similar data from the country is not available, even as experts reckon the numbers would be higher. “When I discussed concerns about human and equipment error with Dr K. Kasturirangan, former chairman, ISRO, he said that the errors were unacceptable, and that healthcare institutions should be akin to the launch of a space vehicle, where there's no room for error. So we thought of this unique idea of adopting the best practices from ISRO for the two units of emergency departments and critical care,” Dr Alexander Thomas, president, AHPI told THE WEEK.
To reduce errors and improve patient outcomes, certain systems are followed in hospitals all over the globe, said Dr J.V. Peter, professor and head of medical intensive care, Christian Medical College, Vellore. Checklists are maintained, and hierarchies among staff and standard operating protocols are followed to minimise errors. In India, too, a need to define certain processes was felt, and ISRO's zero error technology provided a good model to emulate.
However, as Peter explains, there are differences between hospitals and space stations―unlike machines which can be 'çloned', every individual is unique genetically and in their response to illness. Hence, treatment needs to be individualised. Also, unlike in space technology, domain experts in medicine are expected to possess knowledge from other specialties too. “So we took only certain principles of design, conformance and performance from space technology, that could be incorporated in healthcare systems,” said Peter.
The guidelines designed hence define the minimum standards of equipment in these units, address aspects of manpower, and define norms around quality such as keeping device-associated infections under control, among other processes. When compared with hospitals in India, however, transparency around infection rates and death rates in critical care units is an issue, said Peter.
Many of ISRO's best practices―for instance, conducting surprise audits―might help ensure that processes are followed, said Peter. Now, the guidelines will be circulated through the network hospitals associated with AHPI, SEMI and ISCCM.
If the rate of medical errors is reduced by even 1-2 per cent―because of this project being in the initial stages―it will still create a significant, positive impact on the effectiveness of patient care and safety in the country.