6th World Patient Safety Day Conference

17 September, 2024, Budapest

On September 17, 2024, the Health Management Training Center and the NEVES Society jointly organized the VI. Patient Safety World Day Conference with significant professional and financial support from the World Health Organization (WHO). This year’s focus was on improving diagnostic safety.

The first block of the conference – Diagnostic safety in the WHO approach – was held in English. The WHO provided simultaneous interpretation for the presentations of the renowned foreign experts invited by the WHO.

Following the opening speeches of Haris Hajrulahovic, Head of the WHO Country Office in Hungary, Éva Belicza, former Head of the Department of Patient Safety at Semmelweis University, João Breda, Head of the WHO Athens office, and Dávid Becker, Deputy Director of the Heart and Vascular Center, the discussion turned to patient safety issues in the European region and the steps taken towards achieving high-quality, harm-free care.

Block 1: Moving towards high-quality care with no harm in the WHO European Region

Válter Fonseca, technical officer of the WHO’s Athens office responsible for quality of patient care and patient safety, focused on the importance of high-quality patient care and the need for health system transformation. He emphasized universal health coverage, which aims to ensure that everyone has access to high-quality health services without financial hardship. He also mentioned the WHO Global Patient Safety Report, which provides numerous recommendations for the European Region, such as increasing budgetary allocations for patient safety and providing greater legal protection for healthcare workers.

Meena Rafiq, primary care physician and leading clinical researcher at University College London and the University of Melbourne, presented on diagnostic errors in primary care. Such errors can lead to delayed, incorrect, or missed diagnoses, most commonly in cancer, cardiovascular disease, and infections. The speaker also noted that the multidimensional approach developed by the WHO can help improve diagnostic safety, such as by designing safe diagnostic processes, supporting healthcare workers’ decision-making, and involving patients.

Block 2: Diagnostic and Patient Safety from a Managerial Perspective

Barna Vásárhelyi, Director of the Institute of Laboratory Medicine at Semmelweis University, emphasized in his presentation that a significant portion of diagnostic decisions are based on laboratory test results. Therefore, it is crucial that these results are accurate and timely. He mentioned that approximately 8-10 million tests are performed annually at Semmelweis University, while the national figure could be close to 250 million, although exact statistics are not available. He also pointed out that many test requests are, unfortunately, unjustified, do not support clinical decisions, and, for example, provide redundant information. The speaker suggested that the availability of certain highly expensive, very specialized, or minimally informative tests should be restricted. Data management issues were also raised in the presentation, highlighting the need for the introduction of data protection protocols and the regular provision of data protection advice.

Daniel Bereczki, Director of the Neurology Clinic, presented a clinical audit of stroke care in his presentation. The audit involved a systematic and critical review and evaluation of professional activities in order to improve processes and thus enhance the quality of patient care. Between 2004 and 2020, cerebrovascular disorders accounted for more than half of cases in neurology departments nationwide, making this topic a suitable choice. The audit was conducted at three levels, relying on international, national, and local data sources. The process involved reviewing their own practices and comparing them to valid professional guidelines. The results of their study contributed to the regular analysis and improvement of their professional activities.

Attila Szijártó, Director of the Department of Surgery, Transplantation, and Gastroenterology (STéG) at Semmelweis University, presented the operation of the STéG, which is based on the professional organization of patient pathways and multidisciplinary teams. The nearly 500-member team, which includes 144 physicians, works in various workgroups, such as coloproctology, endocrine surgery, and transplantation. The clinic performs approximately 5,500 surgeries and 6,000 endoscopic examinations annually, and provides daily care for 350-400 outpatients. Multidisciplinary team meetings are held weekly, and psychological preparation training is available for patients before surgery. The clinic has achieved outstanding results: unified patient care, synergy, time savings, and excellent morbidity and mortality rates confirm the efficiency of the organization.

György Pápai, Medical Director of the National Ambulance Service (OMSZ), presented the steps the OMSZ is taking to ensure the safety of prehospital diagnosis and how it strives for continuous improvement. The OMSZ, as a state-funded organization, provides emergency patient care, ground and air ambulance services, based on strict legal and regulatory frameworks. The OMSZ’s developments include the introduction of the P1-P5 decision support protocol for emergency prioritization, which significantly improves the assessment of the severity of incoming emergency calls and the determination of actions to be taken. The OMSZ’s work is supported by structured training programs, regular developments, and continuous monitoring and evaluation systems, which contribute to high-quality patient care.

Emese Lenke Kádár, a general practitioner and winner of the Richter Prize, presented the communication opportunities available in general practice and the challenges faced. General practitioners have to deal with an unlimited influx of patients, while having limited access to diagnostic tools. They deal not only with health problems but also with social issues and have the opportunity to closely follow their patients. The speaker talked about the communication methods used in her practice, such as email communication, which can be used to prescribe medications, write referrals, and discuss test results. In addition, she also uses group communication methods, such as regularly sending newsletters to her patients about a particular common disease/symptom/misconception. As a result of renewed communication, the number of phone calls has decreased, allowing more attention to be paid to patients who appear in person, while patients have also become more aware of their own role. Overall, to improve the functioning of general practices, it is important to develop communication channels.

Block 3: The Role of Data and Artificial Intelligence in Diagnostics

Tamás Kováts, IT expert at the Health Management Training Center of Semmelweis University, gave a presentation on the possibilities of linking anamnestic data with artificial intelligence (AI). He demonstrated how the development of digital technologies is revolutionizing the processing of health data, thereby making medical decision-making more accurate, faster, and personalized. AI is already being successfully applied in various fields, such as imaging, drug research, and molecular diagnostics, where it can quickly and efficiently analyze large amounts of data. The opportunities offered by AI include identifying risk factors for diseases, making more accurate diagnoses, and selecting personalized treatments. In addition, it helps in planning the resources of the healthcare system and time management, and can increase efficiency.

Péter Pollner, associate professor at the Health Management Training Center of Semmelweis University, spoke about the role of machines in supporting safer diagnostics. Machine-supported decision-making results in consistent, multiple-checked decisions. Artificial intelligence (AI) is only as smart as we teach it, but it can handle an amount of data that humans cannot. Currently, AI support is being developed for CRC (colorectal cancer) screening. The goal is for the technology to become widely accepted and integrated into daily diagnostic routines.

Éva Belicza, former head of the Department of Patient Safety at the Health Management Training Center of Semmelweis University, presented a detailed overview of how data-driven analyses can contribute to improving diagnostic safety. She said that the basic data that can be used for the analyses include patients’ demographic characteristics, place of residence, time and place of care, as well as ICD, OENO, and surgical codes. She emphasized that data can primarily be used to measure the diagnostic process, rather than the accuracy of diagnoses. She highlighted that the results of research on diabetes and cancer show that data analyses provide a mirror of diagnostic activities at both the provider and system levels. Thanks to this, best practices and problem areas can be identified, and improving or deteriorating trends can be detected. The analyses show vulnerable population groups, such as those based on age or place of residence, and identify areas that require further, in-depth analysis. She further emphasized that based on the results, it is the responsibility of the providers and decision-makers involved to identify the causes and take the necessary corrective actions.

Zoltán Vida, Medical Director of Maros Outpatient Clinic, presented the safety challenges of radiological diagnostics and the possibilities for addressing them. He highlighted that the characteristics of radiology, such as the treatment of often personally unknown patients, technological requirements, and digitized workflows, carry special risks. The presentation focused on the critical role of imaging diagnostics in healthcare decision-making, which is crucial for the safe operation of healthcare providers. The identified risks included inadequate patient and physician information, inadequate examination preparation, and data management and identification errors. He emphasized the importance of cybersecurity, especially due to the rapid development of digitalization, which is particularly relevant for radiological systems. Finally, he emphasized that radiology will be able to achieve maximum safety if its processes are safe, if cybersecurity is developed consciously in parallel with digitalization developments, and if regulated, actively organized patient pathways ensure access to diagnostic services and the utilization of diagnostic results.

Lajos Benyó, head nurse of the Department of Anesthesiology and Intensive Care at the University of Szeged, presented the lessons learned from the „Standardized sampling device use” project implemented at the Institute. The aim of the project was to reduce the rate of pre-analytical errors in blood gas sampling from the previous 17% to below 3% by introducing a new sampling device. As a result of the 6-month project, implemented with the active participation of the department’s employees, the error rate was reduced to 0.044% by using the standardized sampling device, which, in addition to increasing safety, also resulted in significant cost savings. Subsequent measurements confirmed that the achieved results were maintained and even further reduced the error rate. Based on the international and domestic literature, they also examined the potential pitfalls of the POCT (point-of-care testing) area and compared them with the experiences gained at the University of Szeged. The project contributed to preparing the POCT system, which is not yet fully regulated in Hungary, for the certification process.

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