Health Worker Safety: A Priority for Patient Safety

At the 72nd World Health Assembly in May 2019, Resolution WHA72.6 was universally agreed and established World Patient Safety Day. It is to be marked annually on 17 September, the second of which has recently passed. In light of the COVID-19 pandemic the WHO sought to recognise “the huge challenges and risks health workers are facing globally including health care associated infections, violence, stigma, psychological and emotional disturbances, illness and even death”. Therefore, the theme of World Patient Safety Day 2020 was Health Worker Safety: A Priority for Patient Safety, with the slogan “Safe health workers, Safe patients”, and a call for action to “Speak up for health worker safety!” It is undoubted that the COVID-19 pandemic has exerted unprecedented pressure on health systems worldwide, and is one the biggest infectious threats to face healthcare workers (HCWs), and humanity in general, in the past 100 years. The Amnesty International Report from September details the deaths of over 7,000 healthcare workers from COVID-19, with our near neighbours, the UK, recording the third highest number of HCW deaths after Mexico and the USA. At the time of the report it was recognised that the recorded deaths were likely to be a significant underestimate of the true figure. More recent calculations by the International Council of Nurses at the end of October indicate that, into the second surge, a more likely figure then was in excess of 20,000. In response to the first figure, Steve Cockburn (Head of Economic and Social Justice at Amnesty International) stated “For over seven thousand people to die while trying to save others is a crisis on a staggering scale. Every health worker has the right to be safe at work”. It is a tragedy that access to personal protective equipment and other infection prevention and control measures are limited in some healthcare environments. However, in our own relatively well resourced institutions, the global mortality of HCWs should serve as a sobering reminder of our continued vulnerability in the face of COVID-19. And it should encourage us to maintain compliance with, and adherence to, sensible PPE and infection control protocols. Health systems can only function with a healthy, skilled and motivated workforce - HCW safety is critical for the provision of safe care to patients. And as the WHO note, “working in stressful environments makes health workers more prone to errors which can lead to patient harm”. Thus, the theme for this issue of the CAI Safety Newsletter largely revolves around the relationship between HCW safety and patient safety. Detailing her experiences in Syria, Dr Francesca Holt describes her work in the most stressful of environments – how to keep yourself and your patient safe in a war, and the tragic compromises that this situation inevitably requires. On a much more local theme, Dr. Kevin Hore presents some of the material from his Masters dissertation on fatigue and anaesthesiologists, while Dr. Maeve McAllister reviews a controversial paper from the NEJM on shiftwork patterns in the PICU and medical error. Dr Aislinn Sherwin discusses the need for, and barriers to, open disclosure, including the need for doctors to feel psychologically safe in a just culture before they are likely to fully embrace a culture of candour. And finally, but not least, Drs Vinnie Wall and Oscar Duffy outline the first College Sustainable Anaesthesiology webinar, a matter that is of central importance to the health of all citizens, HCWs and patients alike.