Safety in Dutch hospitals improved

Patient safety in Dutch hospitals has improved. The incidence of potentially preventable adverse events and potentially preventable hospital deaths has decreased significantly in recent years, according to large-scale record review study by NIVEL and EMGO⁺/VUmc in Dutch hospitals.

Program leader professor Cordula Wagner, PhD (NIVEL/EMGO⁺): “This is a very encouraging result. We do not expect that the potentially preventable adverse events can be reduced to zero in a highly complex environment like a hospital. Compared to studies in other countries, the Netherlands is one of the relatively better performing countries.”

National safety campaign
In 2008, hospitals started the implementation of the national patient safety campaign for hospitals Prevent harm, work safely (‘Voorkom schade, werk veilig’). Almost all hospitals have participated. This program, which was completed in 2012, focused on the implementation of safety management systems (‘veiligheidsmanagementsystemen’) and improvement programs on different themes, e.g. prevention of infections, targeted screening of vulnerable elderly, and additional checks when administering high-risk medications. Besides this patient safety campaign, the Dutch Health Care Inspectorate (IGZ) paid extra attention to various security risks, including the surgical process.

Continuous improvement
"When hospitals continue on the same path, further improvements are possible", Cordula Wagner said. "At the moment not all the themes from the national safety campaign have been fully implemented in all hospitals. This third Dutch adverse event study also found issues that need further improvement, such as the use of anticoagulation in patients undergoing surgery and periodic training of health professionals in the application of medical equipment and devices. The national safety campaign is ideally an open learning system of continuous assessment and improvement, which must continuously develop in order to anticipate new risks and to continue the management of existing risks”.

Record review study to assess adverse events
The record review study Monitoring adverse events in Dutch hospitals (‘Monitor Zorggerelateerde Schade’) focused on the incidence, nature, severity, causes and consequences of healthcare-related adverse events, potentially preventable adverse events and potentially preventable hospital deaths. For the study, more than 4.000 patient records from 20 hospitals were examined. Academic, clinical and general hospitals throughout the Netherlands participated in this study. The researchers are very grateful to the hospital staff involved, for their openness and willingness to participate in the study. 

Funding
Ministry of Health, Welfare and Sport
 
Collaborating partner
EMGO+/VUmc