Patient Safety Needs Assessment in Ulaanbaatar Mongolia

Mongolian Public Health Professionals’ Association – Patient Safety Needs Assessment in Ulaanbaatar, Mongolia

In March 2010, Krista Patlovich, MPH visited Mongolia to discuss the issue of patient safety with various nurses, doctors, and hospital administrators from five urban hospitals in Ulaanbaatar (UB), and met with representatives of the Mongolian State Inspection Agency and the Hospital Accreditation Department. Krista is a research assistant in the department of medicine at the National University Hospital (NUH) in Singapore who traveled to UB on a voluntary basis under the auspice of NUH and the Flagstaff International Relief Effort (F.I.R.E.) in collaboration with the Mongolian Public Health Association. The purpose of the trip was to determine the current state of patient safety at hospitals in UB.

From these interchanges it is clear that Mongolian healthcare professionals are aware of the problems with patient safety in their hospitals and are equally as interested in their solutions. Like many countries, however, patient safety has not been a health care management priority until recently and to date only limited resources have been dedicated to this issue.

Fundamental findings:

1. Nearly all hospital and government agency staff encountered appear to be genuinely enthusiastic to work towards change, and support the development and implementation of standard procedures and protocols to mitigate patient safety issues. Currently, these agencies and some hospitals are initiating programs and processes to effect change.

2. Fundamental reporting systems are not in place, and unfortunately not even encouraged in some instances. The fear of being criticized (administrators) or of being punished (nurses and doctors) outweighs the pressure for patient safety program implementation. This issue can be addressed through leadership initiatives without budgetary impact.

3. Low cost, procedural steps such as implementing standardized system tools, such as patient chart inserts and patient identification indicators, were not observed to be available for use. The primary common frustration amongst the healthcare professionals is the present resource gap preventing progress forward.

4. Little data exists to assess and quantify patient safety needs, which is needed to serve as a baseline for use in setting priorities and measuring effectiveness of future programs. Specific areas to be addressed include:

       A. Patient Identification
       B. Standardizing Patient Charts
       C. Intra-staff Communication
       D. Patient Education
       E. Medication Safety
       F. Infection and Injection Control
       G. Medical Equipment

The questions remain: “How safe is our hospital?” and “Do we have the right policies and programs in place?” Healthcare institutions in Mongolia must understand the present state of patient safety in order to plan and implement changes for improvement. There is a true desire for change among Mongolia's healthcare workers, who are motivated and ready to be champions of patient safety in their respective facilities. They need the informational framework within which to do so and the leadership to ensure that patient safety is a management and institutional priority. A thorough needs assessment could serve to create the necessary baseline data.

Objectives of this needs assessment:

To understand the current social and environmental patient safety challenges Mongolian faces within their hospitals by conducting focus groups with doctors, nurses, health care administrators and patients;
To develop a recommendations and best practices patient safety manual based on findings from the needs assessment;
Advocate for larger scale changes including enforcement and implementation of recommendations and best practices which are identified in the manual.

For further information: Dr. P. Bolormaa, MD, MPH

Executive Director
Mongolian Public Health Professionals’ Association
Tel/Fax: 976-11-325190
E-mail: mphpa@magicnet.mn

http://www.mphpa.com