Improving Patient Safety

Could such a campaign that urges the public to ask if the doctor has washed his hands be held in Israel? It's hard to believe.

"Bacteria spread fast, and there could be 4-6 million of those nasty little things on your hands right now. Get rid of them. Clean your hands."

These words are part of the educational materials in the Clean Your Hands campaign being conducted by Britain's National Patient Safety Agency (NPSA), which was founded four years ago by the U.K. National Health Service. The campaign began in September 2004 among employees at dozens of hospitals in Britain.

The information campaign is designed to encourage medical staff at the hospitals to be more strict about washing their hands, in an attempt to reduce the number of patients who are harmed - and sometimes even killed - by serious infections originating inside the hospitals.

The campaign is based on findings indicating that it is possible to significantly reduce the infection rate in hospitals if the medical staff keep their hands clean and sterile. The campaign's slogan is, "A whole world in your hands."

This unusual campaign is aimed not only at the medical staff, but also at the patients, in order to advise them on how to overcome their inhibitions and dare to ask the medical teams treating them if they have washed their hands.

Contrary to the fears of NPSA executives, the initiative has been received with great understanding among most of the employees, and the information campaign has succeeded in influencing the behavior of the medical personnel.

The hygiene campaign was presented by the heads of the NPSA at the annual Patient Safety Congress of the American National Patient Safety Foundation, held in early May in Orlando, Florida. NPSA representatives did not hesitate to admit that some of the reasons for the campaign stemmed from extensive media coverage (which they deemed "sensational") of the problems of infection in British hospitals, and the fact that patient safety has become a political issue that gained considerable attention in the party platforms and the recent election campaign in Britain. The lectures given at the Orlando congress took place on the day after the elections in Britain, and the speakers proudly mentioned that the NPSA was founded with the encouragement of Prime Minister Tony Blair.

The lectures at the congress showed that many states and organizations in the West are making an intensive national and governmental effort to protect patient safety, to combat medical negligence and to improve the quality of medical care. One particularly surprising and fascinating lecture was given by Dr. Mamphela Ramphele of South Africa, who was among the leaders of the anti-apartheid movement in her country.

As former managing director of the World Bank, Ramphele was responsible for managing its human development activities in the areas of education, health, nutrition and social protection. She made an original comparison between the character of the struggle waged against racism in South Africa and the current struggle for improved patient safety and better quality medical services worldwide.

Ramphele noted that both instances involve groups with tremendous power; in the case of the medical system this refers to the medical establishment, which in most countries is considered the strongest group - which is often unrestrained and unsupervised. These groups are in no hurry to relinquish their power and authority in favor of the challenges posed by the struggle for the improvement of the quality of medical care, challenges that include preventing negligence during medical treatment.

These groups are also not interested in the recruitment of the patients and their families to the important campaign for better-quality health care, which is part of the traditional social struggle for equality for all. Ramphele stressed that such public campaigns demand that the patient's voice be heard and called for a leadership with a strong ethical base and vision.

Could such a campaign that urges the public to ask if the doctor has washed his hands be held in Israel? It's hard to believe. In Israel, there is no significant public campaign for improved medical care and the protection of patient safety, and the Health Ministry, which should lead such a campaign, shirks its governmental obligations and often capitulates to the dictates of the medical organizations, while forgoing better health services.

Apart from scattered activities in a few hospitals and health maintenance organization clinics, the Health Ministry does not make a concerted governmental effort to improve the quality of medicine, and the public suffers the consequences every single day.