'Culture change' for hospitals

PUBLISHED : Friday, 20 February, 2009, 12:00am
UPDATED : Friday, 20 February, 2009, 12:00am

The Hospital Authority needed 'cultural reforms' so staff would no longer be 'rule-bound', and would always remember their mission was to serve patients and the public, its chief executive said.

In an interview with the South China Morning Post, Shane Solomon pledged to introduce changes at the 50,000-employee authority to improve staff-patient relations and patient-centred care.

His comments came after the authority released two controversial reports on Tuesday - one on the loss of a baby's body at Pamela Youde Nethersole Eastern Hospital and another on the failure of Caritas Medical Centre staff to deal promptly with a heart attack patient at the centre's entrance.

An investigation found a mortuary technician at Eastern Hospital lied about the incident. The technician was sacked yesterday.

The boy's mother said on Wednesday that she could not accept the report, which failed to locate the body or explain how it had been lost.

'I can sympathise with her reaction, as nothing can comfort her until she can have the answers. She has every right to express her anger,' Mr Solomon said.

'The frustrating thing is how can we get the answer? I am annoyed that people have lied ... I am also annoyed that we cannot find the answer.'

Mr Solomon said he had visited the mortuary and tried to find clues. 'I have been there, I looked at it. I talked to the mortuary staff ... I have received inaccurate answers to my questions.'

He said he was shocked that the mortuary technician had lied about when he last saw the body and when its loss was reported.

'I couldn't believe it. This is a lie with serious consequences. It is damaging to the reputation of the HA. I know that the rest of the HA is not like that, it is not a typical incident. It, in some ways, damages the good work of other staff.'

He said the authority was willing to pay compensation to the parents, but he understood that nothing could truly compensate them for their suffering

Mr Solomon admitted the authority needed to improve its staff culture.

'The culture we want is that we have to be responsive to the patients as our first thought,' he said. 'People are rule-bound, procedure-bound. They are afraid that if they don't follow the procedures, they will get into trouble. [This was] the problem with the response of the receptionist at the Caritas Medical Centre [who told the son of the man having a heart attack to dial 999 for an ambulance]. From previous experience, she felt she knew what was expected of her ... She worked at a bank before and had customer service training, and while she wanted to respond, she thought that if she did not follow the procedure of staying at her counter, she could get into trouble.'

In the mortuary incident, the baby's body was put into a large storage tray. Then the body of a man was put in with the baby's body as no other tray was big enough, he said. A mortuary assistant faced two conflicting guidelines - not to put two bodies in a tray before storage capacity had been reached and a warning to staff not to relocate bodies.

'The lesson I want staff to learn from the two cases is that if you don't respond to patients, then you are more likely to get into trouble,' Mr Solomon said.

The authority would, in the coming year, enhance staff training and also work towards creating a 'just culture' so hospital staff would feel safe to face up to mistakes.

'If you punish everyone for any kind of mistake, people may go underground, they will hide things, they will lie,' he said. 'The culture we want is open, honest and learning without fear.'