The hospitals where risk of post-operative death is highest

Ageing Queen Elizabeth in Kowloon told it must improve survival rates for elective and emergency surgery; Kwong Wah also cited

PUBLISHED : Sunday, 20 January, 2013, 12:00am
UPDATED : Sunday, 20 January, 2013, 3:50am

Queen Elizabeth Hospital has to improve its surgical services, the Hospital Authority said yesterday as it released its annual report on the outcomes of operations.

The hospital at King's Park in Kowloon was listed among the public hospitals with the highest risk-adjusted mortality rates in both elective and emergency operations, the Surgical Outcomes Monitoring and Improvement Programme report revealed.

While programme director Dr Yuen Wai-cheung declined to disclose individual hospitals' mortality rates, the report stated that out of 24,244 patients who underwent surgery in the city's public hospitals last year, 608 died within 30 days after their operation. The crude mortality rate - before it is adjusted for operation risks - was 2.5 per cent, slightly lower than the 2.8 per cent in 2011.

Nearly 80 per cent of the operations performed were elective and the rest were emergency ones.

The crude mortality rate for elective operations last year was 0.7 per cent, the same as the previous year, while that of emergency operations was 9.1 per cent, lower than 2011's 9.9 per cent.

Out of 17 public hospitals examined in the report, Queen Elizabeth and Kwong Wah Hospital in Yau Ma Tei had the highest risk-adjusted mortality rates in elective operations. Those with the highest such rates for emergency operations were Queen Elizabeth, United Hospital and Tuen Mun Hospital.

Dr Yuen said hospitals' mortality rates had to be adjusted for the risks involved, as surgery outcomes could be affected by patients' pre-existing health conditions and the severity of their diseases. The adjustment was essential for a fair and meaningful comparison, he stressed.

"Every hospital faces different problems, but in general, they are [issues regarding] manpower, facilities and co-ordination between departments," said Dr Alexander Chiu, the Hospital Authority's chief manager for quality and standards.

Queen Elizabeth, which was included for the first time in the authority's list of hospitals that have to improve, said that because it was a designated trauma centre and major transfer centre in the central Kowloon hospital network, the condition of patients it received was usually serious or complicated.

The hospital also said it had had a heavy workload and a manpower shortage. In 2011 and last year, its staff attrition rates for doctors, specialist doctors and nurses were 11, 14 and 15 per cent, respectively.

Factors that may have limited the outcomes of its operations also included its ageing facilities, said the hospital, which was built 50 years ago. It said it would work on improving the environment in its surgical wards, strengthen its intensive care unit services and recruit more manpower.

Kwong Wah Hospital said it would strengthen co-operation between departments and enhance medical staff training.

Such reports have been compiled annually since 2008