Teamwork essential to safety of Hong Kong patients
Medical Council decision to ban surgeon from practising for six months after death of elderly man has been severely criticised and the Hospital Authority reaction should be welcomed
As the disciplinary regulator of doctors as well as the body responsible for their registration to practise, the Medical Council is no stranger to criticism of its handling of complaints about medical blunders.
Typically they come from patients or their families and often concern the long wait for hearings of complaints as well as dissatisfaction about outcomes.
It is highly unusual, however, for the city’s medical groups and unions to join in dissent from one of the council’s rulings on a serious medical blunder.
This sets the case of specialist Dr Wong Cheuk-yi apart. The council found Wong guilty of two charges of professional misconduct in an incident that led to the death of an elderly man, and banned him from practising for six months.
The 73-year-old patient died at Kowloon Hospital in November 2011 after his only source of air, an opening in his windpipe created by a tracheostomy, was blocked by gauze taped down on its edges by nurses.
Wong was ruled to have failed to take proper steps to prevent the patient’s permanent incision being treated or managed as if it were temporary, and to have failed to alert or instruct nursing or other medical staff that it was permanent and should be left open.
Three nurses involved in the case were found guilty of professional misconduct in 2016 and banned from practising for a month, while nine of their colleagues were cleared.
The medical groups claimed the six-month ban on Wong reflected “disproportionate” responsibilities for a surgical blunder. They urged the Medical Council and the Hospital Authority to clearly define the roles of doctors and nurses.
They rejected any suggestion that doctors should monitor nurses’ performance or shoulder unlimited responsibility because it could lead to distrust between the two parties. They have a point.
Teamwork and trust are critical elements of patient care, especially in the handover of care.
This case should prompt reflection on the interdependence of doctors’ and nurses’ roles. It could be good therefore that the Hospital Authority has agreed to issue guidelines to clarify them, so long as these rules do not inhibit teamwork or communication that are integral to patient safety.