Policy: Managing Patient Safety Incidents in South Africa

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This policy describes a national standardised system for managing patient safety incidents to ensure that health facilities, district offices, provincial offices and the national office respond effectively to patient safety incidents.

According to the document, all health facility must have a system in place to manage patient safety incidents according to following principles:

Ensuring a just culture: Staff members reporting patient safety incidents should be free from fear of victimisation. A just culture supports a learning organisation that investigates incidents instead of blaming individuals;
Confidentiality: Identities of patients, reporters or institutions should be kept anonymous and should only be known to staff directly involved in the management of a patient safety incident;
Timeliness: Reports should be analysed promptly. Once the organisation is notified of a patient safety incident, investigation should be conducted immediately;
Responsiveness: Participating organisations commit to the immediate implementation of recommendations;
Openness about failures: Patients and their families or support persons should be offered an apology and told what went wrong and why; and
An emphasis on learning: The system is oriented towards learning from mistakes and consistently employs improvement methods for achieving this. The police also notes that all sub-district and district Patient Safety Committees must identify a designated Patient Safety champion in all clinics and health centres. These committees should be assisted by Provinicial Patient Safety Committees.

The policy then continues by outlining terms of references for such committees before outlining procedures for recording and classifying incidents as well as feeding back investigation outcomes. The policy also includes a tool kit to allow health workers to assess facility risk factor and collect statistics about reported incidents.

Download the policy: Final Draft National Policy to Manage Patient Safety Incidents in South Africa