How to improve patient safety in intensive care units

There is a need for us, Norwegian physicians, to develop our patient safety knowledge, attitude, and practice. The components of this should include the notions that errors are common and many of them are preventable. Moreover, simple techniques can imply substantial impact on preventing errors or reducing their effects. We need a strong leadership directed towards patient safety, and we need to be convinced that our leaders and employers support us in our efforts to improve patient safety. Norwegian Medical Association stated in December 2006 that the work of patient safety is still in its starting phase in Norwegian healthcare system and included five suggestions for promoting patient safety. These suggestions are in accordance with the results of the extensive literature survey performed in this thesis. The suggestions were constructed by "cooperation, culture, professionalism, regulations, and technology". Co-operation between the medical profession, governmental authorities, and the public is of vital importance to achieve a high quality patient safety policy and practice. Without cooperation it is impossible to promote the culture of patient safety and professionalism. Continuous medical education and continuous professional development are cornerstones of professionalism that should be improved along with a well-defined adherent financing system. Regarding regulations we should take into consideration the experiences from other comparable countries and be open-minded to them. These experiences may include the Danish hospital accreditation program and the program of individual practitioner revalidation in the United Kingdom, both aiming for system changes for promoting patient safety. In connection with this thesis, we performed a limited survey of perceived concepts of patient safety among the physician-leaders of ICUs in the Norwegian university hospitals as well as those Norwegian physicians who are the members of European Society of Intensive Care Medicine. This survey illustrated that the great majority of physicians believe that it is necessary to improve patient safety in the ICUs. This is also in accordance with the statement from Norwegian Medical Association in 2006: "there is a lack of systems for nationwide dissemination and implementation of the achieved experiences and knowledge". It seems that promoting patient safety is primarily a question of culture and attitudes. It remains to see whether a change of attitudes and culture can be achieved without going through regulations