New measures aim to prevent blunders in public hospitals

PUBLISHED : Tuesday, 22 September, 2009, 12:00am
UPDATED : Tuesday, 22 September, 2009, 12:00am

The Hospital Authority yesterday announced six ways it aims to raise its game after a series of medical blunders that have hit public confidence in the health care system.

But unions and patient groups said they were worried that the new measures would increase pressure on frontline medical workers and might, therefore, make service quality worse.

Authority chief executive Shane Solomon said at a board meeting that hospital staff would be consulted about the measures over the next three months.

The authority will widen the definition of events that would need to be reported publicly. In the past, only blunders resulting in a patient's death or permanent harm were made public. Now all mistakes that could result in serious harm to a patient would be reported, even if no harm actually occurred.

The authority said it would also enhance peer review and patient feedback. Doctors and administrators would inspect wards and 'listen to the concerns of frontline staff', said the authority's director of quality and safety, Dr Leung Pak-yin.

Drug prescription and dispensing will be improved over the next year. Measures include replacing loose tablets with blister packs and removing high-risk medications from wards.

To reduce incorrect identification of patients, bar-code and radio- frequency identification (RFID) systems will be introduced in hospitals over the next four years. RFID tags, used in packaging to catch shoplifters, will be used to identify babies and corpses.

Solomon also promised to reduce doctors' and nurses' workloads. Doctors' working hours would be cut. More nurses would be trained and 1,200 would enter the workforce next year. Guidelines and procedures for nurses would be simplified.

A unified policy on staff disciplinary procedures will be introduced throughout the groups of hospitals under the authority.

An independent committee will investigate serious mistakes. Hospital groups will review minor blunders, but recommendations for disciplinary action will be reviewed centrally.

A patient group said the six measures took patients' demands for more transparency into consideration but ignored the likelihood the steps would increase the pressure on frontline staff. Cheung Tak-hai, chairman of the Alliance for Patients' Mutual Help Organisations, said that if medical staff had to follow more rules and report more mistakes, their work quality might suffer.

Dr Adrian Tse Yiu-cheong, chairman of the Frontline Doctors' Union, said the measures failed to deal with the main problem - long working hours and heavy workloads.

He said having doctors conduct patient-safety inspections might not reduce blunders and could increase the chance of them occurring. 'With so many people watching us working, of course we will be very stressed,' he said. That might encourage colleagues to follow guidelines blindly and inflexibly.

Tse said that instead of making vague promises to reduce doctors' working hours, the authority should work to retain more doctors, especially senior specialists, by improving working conditions.

Six ways to prevent further blunders

Broaden criteria so more errors are reported

Conduct patient safety rounds in wards, revamp complaints system, carry out satisfaction polls

Improve drug prescription and dispensing procedures

Use 2D bar codes and radio-frequency identification

Reduce doctors' and nurses' workloads

Unify disciplinary actions across different clusters

Source: Hospital Authority