Introduction

The Patient Safety Council of Malaysia was formally established in January 2003 following a Malaysian Cabinet directive to ensure that the  rakyat  receive safe health care. The formation of the Patient Safety Council of Malaysia has been formalised by the Malaysian Cabinet following the recommendations of the Honourable Minister of Health on 29^th January 2003.  This council is  chaired by the Director- General of Health Malaysia and will advise the Honourable Minister of Health on the situation of preventable adverse events as well as the measures taken to overcome them, in an effort to promote systemic improvements in the safety and quality of healthcare in Malaysia..

In the  July 5, 2000 issue of the Journal of the American Medical Association (JAMA) Dr. Lucian Leape wrote that “The transforming insight for medicine from human factors research is that errors are rarely due to personal failings, inadequacies and carelessness. Rather, they result from defects in the design and conditions of medical work that lead careful, competent, caring physicians and nurses to make mistakes that are often no different from the simple mistakes people make every day, but which have devastating consequences  for patients. Errors result from faulty systems and  not from faulty people. So, it is the systems that must be fixed. Errors are excusable; ignoring them is not”.

It must be emphasised that quality improvement efforts should never be equated with a fault-finding missions. Looking for defects in healthcare is to identify the reasons or critical areas where the fault  is likely to occur and all efforts are targeted to overcome them. Thus the basis of ‘ Quality –  as doing the right thing right the first time and doing it better the next’ must be  supported and upheld. So must a just and learning culture lead to a culture of safety in the Malaysian health care system.

By having the National Patient Safety Council lead the Patient Safety agenda in Malaysia, it is hoped that all healthcare workers will take the lead to ensure that  all necessary measures are taken give  patient safety top priority. Minimising and ultimately eliminating preventable adverse events in patient care is our ultimate goal.