Hospitals seek 'just' system of discipline

PUBLISHED : Monday, 29 June, 2009, 12:00am
UPDATED : Monday, 29 June, 2009, 12:00am

The system for disciplining public hospital staff is being reviewed to make it more 'just', the Hospital Authority chief executive said.

The authority was reviewing the system because the existing grounds for punishing staff were too broad and unclear, Shane Solomon said.

The authority's punishments of hospital staff over medical incidents have been controversial. While patients' rights activists complain that some disciplinary actions are too lenient, some frontline doctors are frustrated that the authority has failed to hold senior management responsible.

The chief of the emergency room at the Caritas Medical Centre, Ng Fu, has launched a judicial review against the authority's disciplining of him after the death of a man outside the hospital in December. Dr Ng said the authority had not given him a fair chance to defend himself.

The authority's previous proposal to sack staff who lose patients' data drew strong opposition from frontline staff, who described the policy as too harsh. The proposal failed to gain approval from the board.

Mr Solomon said the review aimed to create a 'just culture', so staff would be open about mistakes. He said failure to report a mistake was more serious than making one.

Under the new system, there were 'layers of responses' to different kinds of incidents, such as the loss of patient data.

Mr Solomon said a cultural change was needed to make staff more responsive to their patients' needs, instead of blindly following guidelines. 'We have to change the management style, to encourage people to take risks and respond to patients, even if it will be against the guidelines,' he said.

Mr Solomon, who started a second three-year contract in March, said his main tasks during his first term were to improve staff morale and balance the authority's budget.

The main task of his second term was to improve the quality of service, such as by minimising medication errors, cutting waiting times and introducing external hospital accreditation.

To reduce medication mistakes, in two years doctors will start using a bedside electronic system to prescribe drugs. It will send prescriptions electronically to pharmacy departments to prevent mistakes arising from illegible handwriting. The authority will also go filmless in radiological services in three years, which will lead to very fast and accurate results.

Meanwhile, the authority has completed a review of the seven hospitals' cluster system. Each cluster will create a post of quality improvement programme co-ordinator, whose role will be to monitor the quality of service and find ways to improve it.

Each cluster will create seven posts of 'cluster clinical stream co-ordinators' to take care of services development and planning in their own areas: medical services, surgical services, nursing, diagnostic services, mental health, primary and community care and allied health services.

Hong Kong Public Doctors' Association president Ho Pak-leung said the authority should improve the transparency of the disciplinary process and make sure senior managers share responsibilities with frontline staff.