External accreditation may head off further medical blunders All hospitals in Hong Kong will have their standards assessed by a common accreditation system under a proposal to improve the quality of health-care services. A recently commissioned report for the Hospital Authority concluded that Hong Kong needs an accreditation system on hospital services. The proposal comes amid a litany of medical blunders in public hospitals in the city. At present, the 44 public hospitals are only subject to internal assessments, while the 12 private hospitals have joined the Trent Accreditation Scheme, developed in Britain. Under the scheme, teams of surveyors comprising various health-care professionals visit the hospitals every two years to audit services ranging from medical equipment and hospital management to staff training and service standards for each department. They also make recommendations for improvements. The Hospital Authority's consultancy report said Hong Kong's public hospitals should first join an external hospitals accreditation system. In the long run, the city should establish its own accreditation board, it said. The authority is looking at the possibility of joining one of the major hospital accreditation bodies, including the Australian Council on Healthcare Standards (ACHS) and the Joint Commission in the United States. A delegation led by the authority's chief executive Shane Solomon will visit Australia at the end of this month to learn more about ACHS. The delegates, including representatives from private hospitals, will also meet officials from the government-run Australian Commission on Safety and Quality in Health Care to exchange views on patient safety and handling of medical incidents. The commission's scheme measures 300 areas of quality performance. A senior authority source said the current practice of internal audits was 'unsatisfactory'. 'We need to compare with other health-care organisations using an international standard. Patients also expect a common standard for all public and private hospitals in Hong Kong,' the source said. 'We also agree that in the long run, Hong Kong needs its own accreditation board.' The source said the external accreditation would first be run in several public hospitals and then extended to all. In the wake of a series of medical blunders recently, the authority has pledged to improve patient safety and clinical governance. In August the authority introduced a new sentinel events reporting system in which public hospitals will have to report serious medical blunders within 24 hours. The authority source said having a hospital accreditation system would further boost public confidence in health-care services. Medical legislator Kwok Ka-ki said the public hospitals' self-examination had failed. 'An external accreditation body will be more independent and more credible. And we need a commonly agreed standard for all hospitals. A third party can also give new ideas,' Dr Kwok said, adding that the body should be a non-profit-making group with fair charges. But a public hospitals executive called on the authority to think twice. 'Bringing in external accreditation will mean we have to spend perhaps millions of dollars a year on an outsider who may not know Hong Kong hospitals very well,' the executive said.