Poorly ranked hospitals strained
Over-work and a shortage of manpower are probable reasons for some hospitals having a higher mortality rate than others for patients who have had emergency surgery, the Hospital Authority says.
The ranking was made in a report, the third such study published by the Surgical Outcomes Monitoring and Improvement Programme, which measured surgical performance in the city's 17 public hospitals with emergency facilities.
The report found that more than 23,000 operations were performed in those hospitals in the 12 months to the end of June last year. Of 5,167 urgent operations, 519 patients, or 10 per cent, died within 30 days, either because treatments failed or from complications.
There was no specific breakdown of the numbers of deaths that occurred in Yan Chai Hospital or Tseung Kwan O Hospital, which had the worst results on 30-day deaths.
It was the first year Tseung Kwan O topped the list and the third time for Yan Chai, despite most of their patients being classified as low-risk.
Monitoring programme director Dr Yuen Wai-cheung said Yan Chai emergency ward surgeons each treated 300 patients a year on average, compared with an average of 200 at the other hospitals.
'The hospital should look into whether a lack of manpower or hardware is the reason,' Yuen said yesterday.
Without naming Yan Chai, Dr Francis Mok Pik-tim, chairman of the Hospital Authority's co-ordinating committee (surgery), suggested the hospital had room for improvement in arranging emergency operations sooner, liaising with intensive care unit staff for post-op care and involving more senior specialists in emergency operations.
'For historical reasons, this hospital treats internal-bleeding patients in surgery wards, but this wastes manpower in the wards because these patients could also be treated equally well in the medicine department,' Mok said.
He suggested the hospital send patients to other hospitals for complicated operations so resources could be better allocated.
Yan Chai Hospital yesterday acknowledged the report and said it would implement the changes.
Dr Man Chi-wai , chief of services (surgery) at Tuen Mun Hospital, said the average waiting time for an emergency bed in the hospital was eight hours, compared with less than six hours for others.
Tuen Mun now had only two operating theatres for urgent surgery out of a total of 11, but it had to serve an area with a population of 1.1 million as Pok Oi Hospital in Yuen Long performed only elective and simpler surgery, Man said.
'More resources, including extra emergency beds, facilities and manpower are needed to cater for the population's needs,' he said.
Mok said: 'The report did not mean to pick on medical staff or indicate to patients that they should avoid those hospitals which perform the worst. It aims to point out the results of each hospital so they can make improvements accordingly.'