Reflection on Patient Safety – Pre-Arrival Day 1

There were multiple experiences I had prior to medical school that piqued my interest in patient safety.  One of the first ones I had was when I met a patient suffering from hallucinations as a hospital volunteer in high school.  The woman had advanced schizophrenia with all the tell-tale signs pointing to her diagnosis:  disorganized muttering, a monotonous voice when doing so, small scars along her wrists, and a blank stare off into a distant nowhere.  Speaking with the nurses revealed the patient’s tumultuous 3-day history ending with her being pinned and restrained to the bed after she attacked a junior nurse spontaneously.  Items that posed any risk to the patient’s well-being had to be removed, be it butter knives or shaving equipment.  One could argue that there were positives that existed with this system in place.  After all, removing any hardware or sharp objects in the room was beneficial to the patient’s well-being, esp. with her past history of self-harm due to her intense visual hallucinations.  But it left me wondering if her environment otherwise led to any major relief therapeutically.  After all, beneath the catatonia and paranoia was still a person.  One in dire need of help with systematic placements that may have been contributing to her mental and emotional unwellness instead of relieving it.

The other patient safety experiences I had concerned the effect that waiting times had on patients getting appropriate care.  I have had shadowing experiences in the UK and India where, despite the vast differences that exist with both health care systems, patients have universally had to wait for extraordinarily long time periods to received proper care for something that could have been handled sooner.  “Mary” in the UK, for example, was an elderly woman I spoke with who waited to get her cataracts fixed for 4 months.  All the while, she was struggling to drive to work and was falling over cracks in the sidewalk that she wasn’t able to see as clearly.  Later on, “Shruti” in India also waited in the ER to get someone to look at her after she experienced head trauma from a motor vehicle accident.  Her head had dried blood on it and the bandages she had on were from her home; it took her 6 hours to see someone in the busy hospital I interned at.  Both seemed like egregious situations that left these people in progressively worse-off situations than they would have been if they were treated immediately.

All of this doesn’t even account for what administrative or organizational changes could have been done to make sure patients like them were still kept safe.  There is a very real level of danger that patients face at the hands of their disease and the society around them.  These impactful moments are why I want to attend the Academy for Emerging Leaders in Patient Safety:  to brainstorm solutions for maintaining patient safety with my cohort, to educate myself inter-professionally on what is being improved upon, and to become a better advocate for patients that suffer at the hands of medical error or trauma from it.  Making sure that patients stay safe should not result in a contentious battle between removing patient autonomy or letting patients’ ailments run rampant.