The European Alliance for Access to Safe Medicines (EAASM) along with the members of the European Collaborative Action on Medication Errors and Traceability (ECAMET), organised a Parliament roundtable debate (held virtually) on “Preventing Medication Errors across European Hospitals to protect Patient Safety”, bringing together high-profile speakers from the European institutions, international organisations, and health NGOs.
The meeting represented the launch of a comprehensive White Paper on the urgent need to reduce medication errors in hospitals to prevent patient and second victim harm. The document gathers the results of a Pan-European survey on medication errors and traceability, conducted amongst 317 European hospitals, with the aim to discuss areas of improvement, and thus stimulate policymaker’s attention to intensify and implement actions to address this major patient safety issue. EAASM Executive Director Mike Isles kicked off the discussions outlining the serious consequences medication errors can bring about, not only for patients but also for the second victims, such as healthcare professionals. Medication errors can occur at any stage of the medication use process, namely during prescription, transcription, preparation, dispensing, administration and/or monitoring.
The webinar’s host MEP Tomislav Sokol (Croatia, European People’s Party), stressed that before the outbreak of the Covid-19 crisis, healthcare topics had been marginalised in public debates among the EU institutions. Healthcare was perceived as a national competence primarily, even though Member States do not have financial instruments or legal frameworks suitable for the scope, as there are currently at the European level. Differences in terms of medical performances reflected on medication errors, and are caused by different financial resources, a diverse state of health infrastructure and equipment of health personnel. Currently, thanks to the Cohesion Fund and the new budgetary program for health, it is possible to invest within healthcare systems. MEP Sokol outlined the need of data sharing and welcomed the upcoming Commission proposal on the European Health Data Space, to be adopted in May 2022.
Dr. Neelam Dhingra, Unit Head of WHO Patient Safety Flagship, pointed out that unsafe medication practices and medication errors are a leading cause of avoidable harm in healthcare systems across the world. Medication related harm represents 50% of all preventable harm in medical care, with prescribing and monitoring errors contributing to the highest sources. The cost associated with medication errors has been estimated globally at 42 billion dollars annually, not counting lost wages and productivity. It is in this context that ‘Medication Safety’ has been selected as the theme for World Patient Safety Day 2022, with the slogan ‘Medication Without Harm’.
Another valuable contribution was made by Dr. Neda Milevska-Kostova, Board Vice-Chair of the International Alliance of Patients’ Organisations (IAPO), who raised the patient voice during the meeting. Patients are often considered as end users of the healthcare service, feeling both the negative and positive aspects of healthcare, from diagnosis to follow-up. Dr. Neda called for greater interaction and engagement with patients in the continuum of care, in order to identify, reduce and prevent occurring patient harm across the healthcare systems. In 2020, IAPO established IAPO Patients for Patient Safety (P4PS) Observatory as a single-point global platform for gathering and analyzing patients’ expertise and experience that would feed into the national, regional and global policies aimed at improving safety and quality of care for patients by the patients, with the final goal to build patient-centered healthcare worldwide.
Dr. Peter Walsh, Chief Executive of Action against Medical Accidents (AvMA), put emphasis on the need to ensure absolute transparency, openness, and honesty towards patients. Moreover, the need of a solid regulatory framework has been perceived as a crucial step towards detecting, preventing and reducing the incidence of medication errors.
Mr. Ian Lindsley, Secretary of the European Biosafety Network (EBN), explained how medication errors impact a person’s psychological health. Anxiety is identified as the main mental health disorder that nurses suffered during the COVID pandemic, leading to chronic worse workplace stress. And 30% of the nurses with mental health and psychosocial disorders have been involved in medication errors or adverse events. Nurses, as second victims, have not received any professional or adequate psychological therapy.
Mr. Richard Price, Head of Policy at the European Cancer Organisation (ECCO), regretted the EU’s lack of action in this area, especially since medication errors in the oncology sector can cost patients their lives. Additionally, he shared the call to educate the workforce properly on safety issues.
Prof. Maurizio Cecconi, President of the European Society of Intensive Care Medicine (ESICM) contributed to the debate by referring to and applauding the work done by intensive care units, particularly after the outbreak of the Covid-19 pandemic. He warned about the need to increase the number of intensive care beds in Europe considering Europe’s ageing population. Hence, the need to promote a culture of risk prevention and risk mitigation.
In her closing remarks, MEP Dr. Joëlle Mélin (Identity and Democracy, France) outlined the reasons behind the delay in the prevention and treatment of medication errors and hazards across hospitals. Emphasis must be placed on training and remuneration commensurate with responsibilities; it should never be forgotten that any medication taken involves a chain of responsibilities from which no one can escape. MEP Mélin highlighted that « even with increased automation, digitalisation and robotisation of service operations, the human factor will hopefully remain a fundamental pillar of patient care ».
Institutional and cultural inadequacies have been also mentioned. The fact that only 20% of hospitals allow access to their medication error track record is not acceptable in this modern age where transparency is becoming more and more expected. This is ethically unacceptable, especially for patients.
Overall, the experts agreed on the importance of a cultural change within the medical environment. A transparent communication, greater involvement of governments in providing technological support, have been recurrent threads in the keynote speeches.
The reports reveals many positive aspects within hospitals across Europe whilst at the same pointing to areas that would benefit greatly from development in terms of funding, training and implementation of traceability systems.
The recent White Paper highlights the need to:
- Establishing a culture of safety
- Create strategies to improve communication
- Raise awareness and organising regular multi-disciplinary training meetings
- Systematically use accreditation/certification systems
- Introduce technological tools
In line with these recommendations, the ECAMET Alliance calls on European and national health authorities to commit to:
- Include medication safety in the Pharmaceutical Strategy for Europe, in the EU general pharmaceutical legislation and in Europe’s Beating Cancer Plan through medication traceability systems in a healthcare setting to minimise medication errors.
- Prioritise strategic investments in medication traceability systems in the EU4Health program to minimise medication errors.
- Foster the development and implementation of ECDC guidelines and key indicators on medication errors in EU healthcare settings.
- Facilitate the systematic exchange of best practices between healthcare providers both at European and national levels to reduce medication errors in healthcare setting.