Holistic approach to tackle growing NCDs threat

Rokiah Mahmud

As Brunei is facing the growing threat of non-communicable diseases (NCDs) the country will undoubtedly experience increased pressure on healthcare demands which have many downstream effects, Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar said at the opening ceremony of the Internal Medicine Symposium 2019.

He said for example NCDs lead to more hospital admissions with acute medical presentations such as heart attacks and strokes. Patients with a heart attack or stroke will often have other comorbidities. The minister said, “The modern day clinics should not focus on treating only an organ specific problem but should approach the patient in a more holistic manner and treat the entire patient as a whole.”

He added, “General internal medicine remains a cornerstone in our clinical practice as we encounter more and more patients with increasingly complex diseases involving multiple organs.

“Healthcare professionals face a tough challenge to keep-up-to-date with the latest practices in various medical sub-specialities. However, it is our duty to continue developing and enhancing our clinical knowledge and skills to keep up with the ever-changing landscape in internal medicine, ultimately to provide the best patient care and outcomes.

“Similarly, it is also our task to perform our duties in ways that maintain and continue to patient safety and overall quality of care.

“We cannot afford to cite ‘we trained this way back then’ as a way to justify our standards and quality of care now because something as simple and mundane as failing to identify your patients correctly or illegible writing and incorrect documentation might be our downfall in this era of patients’ rights, ‘doctor Google’ and medicolegal.

“There is a need to keep abreast with best practices in quality and patient safety if we want to keep up with patients’ expectations and patients’ trust.

Minister of Health Dato Seri Setia Dr Haji Mohd Isham bin Haji Jaafar launches the Internal Medicine Symposium 2019. PHOTOS: BAHYIAH BAKIR

“Admittedly, the health industry is now well known as a highly reliable organisation as compared to the airline or nuclear industries. According to a study by Johns Hopkins in 2016, more than 250,000 people in the United States die every year because of medical errors making it the third leading cause of death after heart disease and cancer.

“In relation to this, the Ministry of Health (MoH) is continuously adopting and innovating relevant practices from reliable organisations, especially those concerning patient safety.

“One on-going initiative happening now is the MoH Incident Reporting System. This was first started in February this year by the Quality Governance and Innovation Office with a current implementation coverage of 80 per cent and over 1,200 submissions thus far.

“The overall objectives of the system are to improve patient safety and to promote safety culture. By providing a platform for reporting, we want to encourage people to be able to report freely in a safe environment, without assigning blame or promoting blaming culture.

“Ultimately, the incident reporting system promotes transparency and helps identify processes that have gaps or needs of improvement.

“What we have learned so far from the system is that we do have errors but what is more encouraging is that doctors are active at submitting incident reports and pharmacists are good at self-reporting and they bear the burden of correcting mistakes made by others.

“Our challenge will always be the follow-up action, meeting expectations and maintaining safety culture. Alhamdulillah, we have been able to rectify some issues and Insya Allah plans are already in the pipeline for the others.

“In addition to this, the MoH established the National Quality and Patient Safety Committee (NQPSC) in July 2018 tasked with the responsibility of identifying key priority areas, endorsing and monitoring patients’ safety agendas based on quality and patient safety programmes, build organisational capacity, provide oversight and evaluate implementation of patient safety initiatives.”

The minister saidto achieve this objective, Patient Safety Units are established in all healthcare facilities in Brunei Darussalam to facilitate all patient safety initiatives and quality improvement programmes from a patient safety perspective; build staff capacity in patient safety; and facilitate involvement of patients and relevant stakeholders in improving health care safety.

The minister encouraged all to support the initiatives and treat them as a learning and improvement tool to enhance health-care services.