Robin Gauld is Head of Department, Professor of Health Policy and Director of the Centre for Health Systems in the Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Professor Bryony Dean Franklin is Director of the Centre for Medication Safety and Service Quality (CMSSQ), a joint research unit between Imperial College Healthcare NHS Trust and UCL School of Pharmacy, where Bryony is Professor of Medication Safety.
As a Section Editor of Safety in Health, what do you expect from the new journal?
Robin Gauld (RG): Creating a new journal is always a major challenge but it is also critically important in the field of safety in health. This is an area of very real importance today for health care professionals, managers, and policy makers.
It is arguably even more important for patients as the harm and suffering they experience from mistakes and unsafe care fall largely on them. There are huge costs: physical, emotional, and financial. I’m excited at the creation of Safety in Health and thrilled to see the first articles printed.
As Section Editor for Patient Safety, I’m particularly pleased we are able to build an outlet for focusing on the patient and to be the natural first port of call for research in the field. I’m hoping to see article submissions which focus on a broad range of patient safety questions and concerns, from initiatives aimed at improving safety and reducing harm, through to studies showing the impact of error and harm on patients. These might be informed by quantitative, qualitative or mixed methods.
Bryony Dean Franklin (BDF): I am very excited to see a new journal publishing work relating to patient safety, and see this as reflection of the growing recognition of this important area. I look forward to seeing high quality research and commentary, with an international and multi-disciplinary perspective.
Studying medication errors is your field of expertise, what are the biggest problems in the medication process?
BDF: The biggest problems seem to relate to communication – whether between patients, carers and healthcare professionals, between different individual health care professionals, or between healthcare sectors.
Other problems involve specific high risk drugs which are complex to use and/or have a low therapeutic index.
What are the global trends to overcome medication errors?
In looking to address any problem, the temptation is often to focus on individual parts of the bigger system.
Bryony Dean Franklin
BDF: To overcome these problems, we need solutions that: span healthcare sectors, involve different health care professional groups, and involve patients and their carers. In looking to address any problem, the temptation is often to focus on individual parts of the bigger system. This is partly driven by necessity as we need to break things down into manageable chunks. However there are two problems with this approach.
First, we risk shifting problems from one area to another. Second, there is the very real possibility that we make one very small part of the system work well, while the stages before and after it still function badly. As most processes are only as good as the weakest link, this is potentially wasted effort.
We are each only likely to be experts on one small part of the bigger picture and so need collaboration with a wide range of relevant stakeholders, including patients and carers. I am sure researchers in Safety in Health are up for this challenge!
Studying a broad range of quality and safety aspects in healthcare, what are the biggest issues in this field for the future?
Placing patients at the centre of all initiatives to improve the quality and safety of care is central to a fundamental change in how services are organized and delivered.
RG: There are a range of issues that will define the future of quality and safety in healthcare. Perhaps the biggest of these is the redefining of roles in healthcare that is presently underway to varying degrees in different parts of the world and in different services.
Placing patients at the centre of all initiatives to improve the quality and safety of care is central to a fundamental change in how services are organized and delivered – through the eyes and experiences of patients – as well as to how professionals are trained.
Based on this principle, healthcare of the future will look very different from what it does today.