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Following is a question by the Hon Abraham Shek and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (April 9):
Question:
Last month, two children sought medical treatment from the Accident and Emergency Department (A&E Department) of Tuen Mun Hospital, but their condition deteriorated drastically and they died subsequently. Also, another medical incident took place in the same hospital in November last year in which the labels of the blood samples of two patients were mixed up by medical staff, resulting in the patients concerned receiving inappropriate treatment. In this connection, will the Government inform this Council whether it knows:
(a) how the doctor-to-patient ratio of New Territories West Hospital Cluster, to which Tuen Mun Hospital belongs, compares with those of other hospital clusters;
(b) if the Hospital Authority has compared the figures of medical incidents in hospitals under various hospital clusters in recent years, so as to find out the reasons why the figures of such incidents in certain clusters are on the high side, and on the basis of such figures, require the hospitals concerned to make improvements or render necessary assistance to them; if so, of the details; if not, the reasons for that; and
(c) if the arrangement for experienced doctors to serve as duty doctors at the A&E Department of public hospitals will be strengthened; if so, of the details; if not, the reasons for that?
Reply:
Madam President,
(a) The ratio of doctors to in-patient discharges and deaths of various hospital clusters under the Hospital Authority (HA) is set out in the table at Annex.
(b) HA has all along attached great importance to the quality of its services and patient safety. An established system and guidelines have been put in place for conducting clinical audits and dealing with medical incidents. HA launched the Advanced Incident Reporting System (AIRS) in 2006, which is an electronic information system that enables hospital clusters to make immediate reports of medical incidents to the HA Head Office. To further enhance patient safety, HA has implemented in October 2007 a Sentinel Event Policy to standardise the practice and procedures for handling sentinel events in all hospital clusters, thereby strengthening the reporting, management and monitoring of sentinel events in public hospitals. Under the new reporting policy, hospital clusters are required to report via the AIRS any medical incidents classified as sentinel events within 24 hours upon awareness of their occurrence. They should at the same time handle the incident promptly in accordance with the established procedures so as to minimise the harm caused to the patient and the impact of the incident as far as possible, and provide support to the staff involved in the incident. The HA Head Office is responsible for monitoring and coordinating the handling of sentinel events and implementation of initiatives for promoting patient safety at an organisational level. HA will also take the initiative to disseminate information related to the sentinel events in order to enhance operational transparency and mutual trust between patients and hospitals.
On the other hand, HA will take thorough follow up action on the sentinel events and investigate their causes and improve the relevant systems and work procedures where necessary, with a view to avoiding recurrence of similar incidents in future. Through the training provided by HA and the bi-monthly "Risk Alert" newsletter published by HA, the staff of different cluster could make reference to and draw on the experience in handling sentinel events.
(c) As at January 31, 2008, the number of doctors serving in Accident & Emergency (A&E) Departments in public hospitals is 413. About 30% of them are at the rank of Consultant/Associate Consultant/Senior Medical Officer. Provisional data for 2007-08 show that the overall wastage rate of HA's doctors at the rank of Senior Medical Officer and above was around 7.4%, while that of doctors at the rank of Senior Medical Officer and above in the A&E Departments was only about 1%. At the same time, the professional standard of A&E doctors has been improving in recent years, with the percentage of A&E doctors with fellowship in the Hong Kong Academy of Medicine increased from 33% in 2003 to 50% in January 2008. We therefore believe that experienced doctors to provide service at the A&E Departments are adequately provided with. HA will regularly review the relevant staffing arrangement, and flexibly deploy manpower to maintain the service standard of A&E Departments.
Ends/Wednesday, April 9, 2008
Issued at HKT 15:39
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