“Developing patient safety as medicine advances”: Interview with Prof. Dr. Rainer Haseneder

In September 2021, a new Certificate program will start at the TUM Institute for LifeLong Learning: “Focus on Patient Safety – how to actively shape change.” In this interview, Prof. Dr. Rainer Haseneder  who is part of the project team developing the program, explains what the “human factor” is all about, how Covid-19 has influenced the relevance of the topic, and why transferring concepts from aviation to the medical context can be particularly useful.

Dr. Haseneder, why is the topic of “patient safety” more relevant than ever?

Patient safety has become much more important in Germany in recent years, but there is still room for improvement in implementation. For example, it would be desirable to establish a comprehensive, deeply rooted patient safety culture in the respective organization. Patient safety must evolve with the progress of medicine, too: Treatment options are becoming more diverse and complex, which is of course a good thing. However, today’s high-tech procedures and processes are more prone to error than less complex medical interventions, and these changes must also be taken into account in terms of patient safety.

How do you think the Corona pandemic has influenced the issue?

The Corona pandemic demonstrated the importance of patient confidence in safe medical care. For example, during the first wave, significantly fewer sick non-Covid patients came to emergency rooms, in part despite having serious medical conditions, because they were afraid of contagion. Furthermore, the essential role employees play becomes more essential becomes clear. They must be given special protection: Every measure that increases the safety of patients also increases the safety of employees in the healthcare system: by preventing harm, the risk of them becoming “second victims” and suffering from psychological stress, for example, is reduced.

The new program focuses on the “human factor” – what does this mean?

The term “human factor” refers to all human characteristics – physical, psychological, cognitive, social – that influence human interaction with the environment and with social or technical systems. Evidence shows that a large proportion of errors that lead to patient harm result from “human factors.” Errors in technology or lack of medical expertise play a minor role. Accordingly, it makes sense that the greatest improvements in patient safety can be achieved through optimization in this area.

You talk about a change in perspective, toward a forward-looking approach to risks. Why is this so important in the medical context?

Previous approaches in the area of patient safety have been primarily characterized by reacting to errors in order to avoid them in the future. However, patient safety concerns much more than just avoiding errors and certain complications. Rather, patient safety must be understood as an inherent characteristic of teams and organizations. Only then, risks can be identified in a timely and proactive manner before they lead to error or harm.

In the program, concepts from aviation are transferred to the medical context. Can you explain that to us?

In aviation, which is a so-called “high reliability organization”, processes have been established for decades to make the system safer, e.g. checklists and simulation training. The usefulness of such measures to increase patient safety has been recognized in medicine, but they have not yet been established on a broad scale. Moreover, not all safety concepts and processes can be directly transferred to the healthcare context. Patients are always treated individually. In the Certificate program, participants get to know different concepts and the adaptations that are necessary to transfer them successfully.

To whom would you recommend the Certificate?

The Certificate program enables participants to initiate, establish and sustainably anchor patient safety projects as decision-makers or multipliers in their home organization. In this context, I recommend it for all employees in the healthcare sector who see themselves entrusted with such a task now or in the future.

Further information on the certificate program is available here.

Prof. Dr. med. Rainer Haseneder has been working at the Department of Anesthesiology and Intensive Care Medicine at the Technical University of Munich since 2002. He helped conceptualize the “Focus on Patient Safety” Certificate program and will be a lecturer.