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Opinions of Friday, 19 May 2006

Columnist: Akuoko, Kofi

Medical Mistakes in Ghana

Running Our Hospitals Better and Safer

Medical Mistakes in Ghana

The Daily Graphic reported on May 5, 2006 that a patient has sued three Korle-Bu doctors for an operation the doctors performed on the patient?s wrong leg. According to the Institute of Medicine (IOM), each year about 98,000 people die in USA hospitals due to medical errors. If this is the case in the richest nation on earth, a country that leads the world in medical science and research, then how many people die or injure in Ghana each year because of medical mistakes? What is the medical error rate in Ghana?

It is possible that someone you know has been injured or killed as a result of medical mistake. Each one of us faces the risk of being a victim of medical errors. Due to the high doctor to patient ratio, medical error rate in Ghana may be terrifyingly high. Worse yet, the Ghana Integrity Initiative (2006 Global Corruption Report) identified healthcare sector as one of the most corrupt institutions in Ghana.

Causes of Medical Errors

Can Doctors and Nurses be blamed for mistakes that kill or seriously harm patients each year in our hospitals? Doctors and Nurses are generally kind-hearted people, they have chosen their profession expressly to cure and comfort patients. They do not dress up each morning to go to work to kill or harm patients. If the primary intention for hospital is to cure and heal patients then why are so many patients killed or injured in the process of curing and healing them?

Medical mistakes result in part from complexities in hearthcare systems, which create confusion, uncertainty and ineffectiveness. Ambiguties in healthcare systems create many opportunities for medical errors. Drug administration and laboratory report processing are examples in healthcare system that are known to be error prone. A significant percentage of mistakes occurring in healthcare systems are due to medication errors. Let me use doctors? handwriting as an example, most people can not read the drug prescription doctors write. Patients assume, rightly or wrongly, that drug store Pharmacists are experts in reading doctors? poor handwriting. Only God knows how many patients have died or injured just because of doctors? poor handwritting! Next time your doctor writes a drug prescription for you, be polite and ask him/her to write it legible. To ensure the safety of patients, some hospitals no longer handwrite drug prescriptions: The process is computerized.

Money Is Not Always The Problem

Basically, there are four different approaches that can be used to improve healthcare quality: Put more money into the healthcare system; reorganize healthcare; strengthen management; or use quality methods designed specifically for continuous improvement. The focus of this paper is on the use of quality methods to improve healthcare.

In Ghana, putting money into our healthcare is the approach most people advocate for. The argument is that extra money could be used to increase doctors and nurses pay, buy more drugs and hospital equipments. I have no doubt that Ghana?s healthcare institutions are under-funded and extra funding is needed. However, our healthcare problems are not always lack of resources: Some of our resources are in the wrong hands or are wasted. I defined waste as anything other than the minimum amount of financial, human, and material resources which are absolutely essential to add value to healthcare. The Ghana Integrity Initiative 2006 report and the Daily Graphic report (May 5, 2006) show that our heathcare system is dangerous and ineffective. More of the same is not the best way to improve healthcare! Expanding on the existing ineffective healthcare system without fundamentally changing it is not the best use of our limited resources. We can make our hospitals safer and more effective by adopting innovative quality solutions.

The Innovative Quality Approaches

To run our hospitals safer and more effective we need to adopt quality approaches: Standard-based quality management; Team problem solving based on proven quality tools, concepts and principles; Quality assessment and regulation; and Patient and community participation.These quality approaches can be combined, however, it is important to test each approach to determine which one is most cost-effective and most likely to work in Ghana. The writer is aware of application of basic quality control measures at Korle-Bu and KATH hospitals. The use of rudimentary quality control measures will not produce world-class quality healthcare system. World-class hospitals use leading-edge quality methodologies such as Lean, Six Sigma, Malcolm Baldrige National Quality Award, and Toyota Production System (TPS) to save lives, increase patient satisfaction, eliminate waste, and improve quality and reliability of healthcare. If our healthcare institutions implement innovative quality solutions, it will make Ghana a center of medical excellence and will create health tourism, this will attract foreigners to Ghana to seek treatment. Healthcare quality is a top priority in Malaysia. Malaysia?s Health Minister, Dr. Chua, rightly observed that ?almost all nations around the world face shortage of doctors and allied healthcare staff and this is why it is important to have quality healthcare?. Each year Malaysia attracts about 100,000 foreign patients for medical treatment.

India has established world-class quality healthcare systems in practices such as cardiac care, cosmetic surgery, joint replacements, and dentistry. Medical tourism became India government policy when the finance minister called for India to become a "global health destination". According to a report by McKinsey Consultants and the Confederation of Indian Industry, India medical tourism industry could be generating revenues of about $2.1bn by 2012. Our Healthcare institutions must benchmark other countries for leading-edge quality approaches to improve our healthcare systems. The government must consider introducing National Health Quality Plan to provide a framework for our healthcare institutions to adopt and implement quality management systems.

About the writer: Kofi Akuoko, is a member of Ghana Quality Organization (www.ghanaquality.org). He can be contacted at kakuoko@ghanaquality.org

Views expressed by the author(s) do not necessarily reflect those of GhanaHomePage.