By Nick Graves
I was delighted to be invited to attend the Second Global Ministerial Summit (G20) on Patient Safety in Bonn, Germany, on 29–30 March this year. Sponsored by the World Health Organization, the Summit brought together ministers and senior officials from more than 50 states. Significant guests included Margaret Chan, Director General of WHO; Sir Liam Donaldson, a former Chief Medical Officer for England; and 20 ministers for health (and their entourages) waiting to hear our ideas for improving patient safety.
Day one involved six concurrent workshops on economics, global patient safety, big data, control of infections, diagnostic and treatment safety, and medication safety. We all presented to each other, debated our best points, and finished the day with a list of policy preferences and good ideas for the ministers to take away.
As part of the workshop on infection control, I presented on how cost-effectiveness data can inform policy for the control of healthcare associated infections. The advice from this workshop, overall, was that we still lose a vast quantum of costs to preventable infections. For instance, sepsis is a major killer in hospitals, yet simple screening can reduce it. Indeed, NSW was held up as a world leader on this issue, having recently implemented the SEPSIS KILLS program, which showed a linear decrease in mortality from 19.3% in 2009–2011 to 14.1% in 2013. Then there’s the rise of antimicrobial resistance: this must be addressed urgently – with known effective interventions – and taken seriously by policy-makers. We also discussed standardised national surveillance systems for infections – something Australia fails at – and the need to both strengthen these systems and use them to assess and influence hospitals. Most importantly, as this was my moment in the sun – we determined that new programmes must be evaluated as good value for money. Finally, we agreed increasing the public’s awareness of sepsis and infections and resistance is important.
If I were to be negative and cynical I would suggest that this was a particularly extravagant way to get to where we got to. The information output was useful, but could have taken a smaller group of people less time to generate. I don’t however want to sound like Nigel Farage and spend my time ripping into European bureaucrats; I am sure there are many other benefits to assembling a good group of experts and policy-makers to debate these issues. In the grand scheme of things, a two-day meeting is negligible. On a personal note, I made wonderful connection with academics from European CDC and enjoyed spending time with Dr Petra Gastmeier, a colleague from the German infection control community. I also bumped into my colleague Jeffrey Braithwaite from the Australian Institute of Health Innovation.
What I learned is that everyone likes talking about challenges – that part is easy. Rolling up your sleeves and solving them is much harder. In all places – local and international – it seems we do more talking than solving.
I love Germany. The people are friendly and enjoy helping you – the hospitality is tremendous. Germans are the straightest talkers. In fact, my driver from the hotel said, very firmly, “You should have worn a business suit… Your smart casual outfit is inadequate.”