Japan patient safety guideline for Public Health Centers

Background: Safety of drugs, devices and procedures are a major concern all over the world. In Japan, safety related incidents have been increasing in the last two decades. Malpractice litigations are also rising. Purpose: The purpose of this study is to assess the function of Public Health Centers (PHC) and to develop a patient safety guideline for PHC in Japan. Method: A total of 31 model projects were implemented to improve measures for patient safety. These projects as well as their handbooks and manuals were categorized into five subjects as follows: I) Regular investigation, II) Patient safety consultation, III) Culture of patient safety and mutual information exchange, IV) Strengthening the preparedness against nosocomial infection or major accident and V) Education of the staff. To assess preventive strategies in PHC in Japan, a questionnaire survey was conducted in the years of 2008 and 2010, to compare the changes before and after the projects. Results: 1) 325/517 (62.9%) in 2008 and 308/494 (62.3%) in 2010 responded in a questionnaire survey. PHC needed more than 40 % improvement in strategies for patient safety was 29.1% in 2008 and 19.4% in 2010, which showed 9.7 points improvement. 2) A guideline was made based on these procedures. Conclusion: Japan patient safety guideline for PHC should be used to improve patient safety through PHC daily works of regular investigation, patient safety consultation, culturing mutual understanding among hospitals and patients or residents and supporting health care providers in a case of accident or nosocomial infection in 494 PHC jurisdictions in Japan.