Patient safety

Dr. Armando C. Crisostomo, Vice Chancellor for Research at UPMC talks about the importance of learning patient safety among medical students ( Photo by Ramir G. Cambiado)


A basic dictum in the practice of Medicine is Primum non nocere (First, do no harm). Health professionals, especially doctors, are mandated to have a good understanding of patient-safety principles and concepts even before seeing their first patient

By Gelyka Ruth R. Dumaraos

The University of the Philippines College of Medicine (UPMC) recently revisited the World Health Organization (WHO) Curriculum Guide on Patient Safety for Medical Schools and the current challenges in its implementation in the 2019 Patient Safety Congress held at the Philippine International Convention Center last March 28-29.

In a talk by Dr. Armando C. Crisostomo, Vice Chancellor for Research at UPMC, he highlighted the need to guide medical students in the evidence based teaching-learning strategies while these would-be doctors are still in medical schools.

The curriculum guide, which was published in 2009, was one of the concrete steps in pushing for patient safety, following the World Health Assembly resolution on patient safety in 2002, calling to reduce the harm on patients and their kins due to hospital errors.

Medical errors

Errors in the process of a treatment is caused by poor designed systems and other factors. With this, patient face consequences that can translate to unfortunate outcomes.

The lack of patient safety results to extended hospitalization stay or read-missions, nosocomial infections, lost income, decreased productivity, disability and unnecessary medical expenses. There are published studies highlighting the overwhelming evidence showing that significant numbers of patients are harmed due to safety breaches in their health care, either resulting in permanent injury, increased length of stay in hospitals or even death.

Medical students and other healthcare professionals need to understand how and why systems break down and why mistakes are made so they can act to prevent and learn from them

“An understanding of health-care errors also provides the basis for making improvements and implementing effective reporting systems,” WHO adds in its report. “Students will learn that a systems approach to errors, which seeks to understand all the underlying factors involved, is significantly better than a person approach, which seeks to blame people for individual mistakes.”

Dr. Crisostomo explained that the patient safety curriculum provides practical framework to identify systems-based defects and improve patient safety.

“It identifies hazards in patient care that pose risk to patient safety and to learn how to investigate an adverse event,” he said.

Human factor

To mitigate these potential harm, medical students are advised to understand the importance of the human factor in addressing patient safety. The guide says, “Human factors engineering will help students understand how people perform under different circumstances so that systems and products can be built to enhance performance.”

Using the human factor approach simplifies processes, standardizing procedures, providing backup when humans fail, improving communication, redesigning equipment and engendering a consciousness of behavioral, organizational and technological limitations that lead to error.


Notably, despite the curriculum being released over a decade ago, knowledge in patient safety has been getting bleak attention. For one, health providers have low recognition on the importance of integrating patient safety into the curriculum. There is also the lack of familiarity and reluctance of educators to teach patient safety principles.

“There is a continuing emphasis on education treatment rather than the prevention and the perceived role of teachers as the only information provider,” Dr. Crisostomo shared.

What helps in reaching out to medical students on patient safety are teaching innovation that makes it more appealing and relatable.

He cited the use of mobile apps gaming system called PASSED or Patient Safety in Surgical Education which enables users to engage in touch screen features with clinical scenarios extracted.

Engaging the whole health team

WHO stresses that while doctors play a major role in ensuring the patient’s health, the patient himself, as well as their carers, share the same duty.

The patient and his/her carers or family members play a role in ensuring safe health through helping in diagnosis, deciding about appropriate treatments, choosing an experienced and safe provider, ensuring that treatments are appropriately administered; and identifying adverse events and taking appropriate action.

Dr. Crisostomo highlighted that communication among the members of the health team is the key player in ensuring the patient’s safety until he resumes his daily, productive life.

“Human factors engineering will help students understand how people perform under different circumstances so that systems and products can be built to enhance performance”

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