Hospitals eager for external vetting

PUBLISHED : Tuesday, 13 October, 2009, 12:00am
UPDATED : Tuesday, 13 October, 2009, 12:00am

Five public and three private hospitals in Hong Kong will for the first time undergo the same external accreditation early next year in a government effort to standardise the quality of medical care.

This is three more than the five originally envisaged to kick-start the scheme - aimed at setting uniform standards for public and private institutions - and was increased after hospitals showed 'encouraging' enthusiasm for joining in.

But the exercise will not require hospitals to make public their serious incidents or blunders.

Secretary for Food and Health Dr York Chow Yat-ngok has said the government wants to see all hospitals accredited with the same standards in the long run. On Sunday he said the government was reviewing whether public and private hospitals should use the same guidelines in public reporting of medical incidents.

His comment came after a woman died of a rare condition following an emergency Caesarean section on Saturday at Baptist Hospital.

The Hospital Authority has tendered out external accreditations to the Australian Council on Healthcare Standards (ACHS), an international hospital accreditation agency.

The assessments will look at patient safety, services outcomes, patient records, handling of medical incidents and training. The council will bestow one of five grades - from 'little achievement' to 'outstanding achievement'.

The authority's director for quality and safety, Dr Leung Pak-yin, said yesterday that the responses from public and private hospitals to the scheme were 'encouraging'.

Previously the authority planned to choose three among five shortlisted public hospitals for the external accreditation. Leung said now all five would join as the hospitals were keen to participate. He said the ACHS had trained 30 Hong Kong hospital surveyors, who would jointly conduct the mock survey with the Australian surveyors early next year.

The participants are Queen Mary, Pamela Youde Nethersole Eastern, Tuen Mun and Queen Elizabeth hospitals, and Caritas Medical Centre.

Three private hospitals, instead of two as earlier proposed, will join. The Hong Kong Sanatorium and Hospital will be the first to undergo a formal accreditation in December, followed by Baptist and Union hospitals.

Leung said the accreditation would require hospitals to set up systems to share and learn from medical incidents, but there was no specific requirement on reporting such incidents.

At present, the Hospital Authority issues regular reports of serious events to the public. Private hospitals are required to report incidents to the Department of Health but the department does not issue any regular public information.

Hong Kong Sanatorium and Hospital medical superintendent Dr Walton Li Wai-tat said an ACHS team would survey the hospital for five days in December for official accreditation. 'We already had a mock survey three years ago and now we are ready for an official survey,' he said.

But Li said it would be 'counterproductive' for the government to ask all private hospitals to make their medical incidents public. 'It will only lead to defensive medicine. Medical staff may not be willing to take up high-risk jobs because of the fear of being sued. Now private hospitals report incidents to the Department of Health, it is up to the department to report to the public or not.'

Private Hospitals' Association president Dr Alan Lau Kwok-lam said the private hospitals' current reporting system was very good and there was no need for a change.

Baptist Hospital chief executive Dr Raymond Chen Chung-i said the hospital wanted to improve its quality of care continuously through the external accreditation.

The vice-chairman of the Alliance for Patients' Mutual Help Organisations, Cheung Tak-hai, said external accreditation could help uphold the quality of medical care. The group has called on the Hospital Authority to appoint more patients' representatives to the governing boards of public hospitals.

The eight participating hospitals would first undergo a mock survey by early next year, followed by formal assessments for accreditation in about two years.