Safety concerns

Medication safety is crucial to prevent avoidable harm in healthcare

Safety concerns


he Institute of Medicine (IOM) released its landmark report, To Err Is Human, in 1999. It reported that as many as 98,000 people die in hospitals every year as a result of preventable medical errors.

One of the main conclusions of the report was that most errors are not a result of the incompetence of healthcare professionals but rather a result of systems and processes that fail to prevent error. A comprehensive strategy for reducing preventable medical errors was introduced, and a goal was set to reduce the errors by 50 per cent over five years. This could, however, not be achieved. The perceived reason was the lack of an empowering culture for individuals to speak up without a fear of consequences when there is a potential safety breach.

Every person around the world, at some point in their life, takes medications to prevent or treat illness. While receiving medical treatment, the issues related to medication safety play a crucial role. Sometimes the medicines cause serious harm if incorrectly stored, prescribed, dispensed, administered or monitored insufficiently. This leads to a serious condition that may convert into a life threat. Unsafe medication practices and medication errors are a leading cause of avoidable harm in healthcare across the world.

There is a need to understand the science of safety and human factors while administering medicines. To err is human, yet we all must understand and own that. Once we do, we can collaboratively create a consistent culture of safety across the healthcare range.

The ongoing Covid-19 pandemic has significantly intensified the risk of medication errors and associated medication-related harm. It is in this context that medication safety has been selected as the theme for this year’s World Patient Safety Day, with the slogan: Medication without Harm.

A campaign by WHO titled Global Patient Safety Challenges reaffirms the objectives to call on stakeholders to prioritise and take early action in key areas associated with significant patient harm due to unsafe medication practices. These include high-risk situations, transition of care, poly-pharmacy, look-alike, sound-alike medicines and self-medication. The campaign will provide a special focus on the implications of the Covid-19 pandemic for medication safety, considering the serious disruption in the provision of health services.

Recent studies indicate that mainly low-to-middle-income nations record over 134 million cases of patient harm after receiving medical care. This results in about 2.6 million deaths annually. High-income nations have relatively lower numbers, with one in 10 suffering further complications after receiving medical care. Globally, more than 1 million patients die each year from post-surgical complications.

Medication errors occur when weak medication systems and/ or human factors such as fatigue, poor environmental conditions or staff shortages affect prescribing, transcribing, dispensing, administering and monitoring practices, which can then result in severe harm, i.e. disability and even death.

Many low and middle-income countries have developed their own national accreditation and standards for regulating and improving the quality of healthcare services. The Punjab Healthcare Commission, as a regulatory body, has been ensuring patient safety in public and private healthcare establishments (HCEs) since 2013, working towards high-quality and safe healthcare services. The commission focuses on institutionalising mechanisms at HCEs that reduce the risk of preventable harm to patients. A Minimum Service Delivery Standards (MSDS) has been developed to achieve this objective for 12 types of HCEs. Under a comprehensive and internationally recognised framework, the standards encompass all aspects of service delivery, including patient safety.

Recent floods in Pakistan have made a bad situation worse. This is another health challenge after the Covid-19. The spread of waterborne diseases among thousands of flood victims demanded more health facilities with the availability of relevant medicines. Moreover, most births in Pakistan happen at home, and we realise that almost one million homes have been destroyed. In such a situation, expecting women do not know where they will deliver their babies and in what kind of health conditions. This opens a new episode of patient safety procedures, including medication safety, at large.

In many developing countries, medicines are easily available without prescription. This results in many adverse outcomes, especially bacterial resistance. Insufficient healthcare services and socioeconomic factors result in an increased proportion of self-medication compared to drugs prescribed by physicians. The role of pharmacists is two-pronged in this regard. On one hand, they are responsible for ensuring proper storage and error-free delivery of medication. On the other, they must be watchful of counteracting medications being prescribed to a patient.

Self-medication would be safe if a person has proper and adequate familiarity with dosage, efficacy and side effects. However, limited knowledge can cause serious side effects, such as allergic reactions, skin problems and bacterial resistance. In less advanced countries, such as Pakistan and India, people have very limited knowledge regarding risks associated with self-medication. This leads to a high prevalence rate and the emergence of new cases of antibiotic resistance.

Medication errors occur when weak medication systems and/ or human factors such as fatigue, poor environmental conditions or staff shortages affect prescribing, transcribing, dispensing, administering and monitoring practices, which can then result in severe harm, i.e. disability and even death. Multiple interventions to address the frequency and impact of medication errors have been developed by the WHO and other healthcare institutions.

Engaging key stakeholders and partners in the efforts to prevent medication errors and reduce medication-related harm to empower patients and families is a positive solution to this problem. The improvement level of patient safety has a direct bearing on the number of lives saved and disabilities prevented to general and hospitalised patients. In the present time where the medical science has reached the pinnacle of success, patient safety cannot be left unwatched.

The writer is a playwright and freelance journalist and can be reached at and his blogging site:

Safety concerns