A specialised course for doctors and hospital staff focusing on how a critically ill or injured patient should be handled could bring down the rate of death due to medical negligence by 50%, claim the experts. A study by the Harvard University last year showed that nearly 50,00,000 deaths occur in India annually due to medical errors triggered by lack of practical knowledge among the doctors and nurses to handle patients when brought to the hospital.
“The Acute Critical Care Course(ACCC), developed in the early 80’s in Europe has come as a boon for medical institutions abroad by reducing the death rate of patients by nearly 10% even in serious health complications including sepsis,” said Ajay Sharma, a transplant specialist and consultant at the Royal Liverpool University Hospital in the U.K.
The main aim of ACCC is to train the medical specialists and surgeons of various specialisation such as surgical, gynaecology, orthopaedics and emergency to suspect and identify patients at a risk of deterioration, he added. This two-day course has become mandatory for surgical trainees both in the U.S. and the U.K., which annually lose over 400,000 and 98,000 patients respectively due to medical errors.
According to Dr Sharma, implementing the course in Indian hospitals, especially in the rural areas can bring down the mortality rates due to medical negligence by nearly 50%. “Most of the new doctors are not well-versed in identifying and managing unexpected adverse events which have an enormous impact on the outcome of a patient’s health,” said Sharma.
“The ACCC is an opportunity to practice these issues and challenges while helping in honing the technical and non-technical skills of the individual in a simulated environment,” he added.
Mr Sharma and his team have trained medical specialists at various Indian hospitals in ACCC since 2012 when the course was introduced in India.
Former director of All India Institute of Medical Sciences (AIIMS) and a fellow at the Royal College of Surgeons of Edinburg, M.C. Misra said ACCC is specially designed for those hospitals where doctors do not have practical knowledge about handling patients that require critical care. The course includes imparting training to the new and existing doctors of a hospital receiving critical care patients either on a high fidelity simulation or preserved dead bodies to make them understand the crucial steps to prevent errors.
Misra is one of the pioneers who push for the implementation of ACCC in Indian hospitals. “The deteriorating health of most of the patients can be identified well in time if the residents are trained in how to use simple principles of applied physiology. Timely steps are much more effective than last-minute heroic measures,” he added.
Geeta Shetty from the University of Birmingham in the U.K. agreed to this by saying that, “This course takes care of prevention of small mistakes that make it life-threatening for the patient, be it administering IV fluids in patients, minor surgeries or anything else.”
“In many cases of medical negligence in India, delay in taking care of breathing leads to organ dysfunction and poorer outcome even if given the best treatment,” she added.
Though this is a great move, experts say that ACCC has not spread far and wide in India with only 450 doctors across the country completing the course. They add that the death toll could have been much lower if adequate medical arrangements were available in hospitals and the staffers were trained well. But even the major hospitals, mostly in the rural areas continue to ignore that though most of the medical error cases causing death are reported at tier 2 and tier 3 cities where the concept of critical care does not exist.


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