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The following is issued on behalf of the Hospital Authority:
The 25th issue of "HA Risk Alert" was published today (April 27) by the Hospital Authority (HA) as a risk management and communication initiative to further strengthen the reporting and monitoring of medical incidents in public hospitals.
In the foreword of the latest issue, the HA Chief Pharmacist, Ms Anna Lee, notes that evidence-based clinical practice, effective medication use, proactive risk management as well as an open and transparent safety culture are ranked top priority in safeguarding patient safety worldwide. She said that in HA's quality journey, the Pharmacy Service is being improved continuously to maintain a safe and efficient drug delivery process to meet public expectations.
The reported sentinel events analysed in this issue included two fatal medical incidents, one case of wrong side procedure performed, and two cases of retained segment of consumables. It also highlights the key learning points on three patient suicide cases in the reported period. Among the 23 reported serious untoward events, there were 21 medication incidents and two cases of patient misidentification. Subsequent to in- depth root cause analyses investigation, recommendations were made and are shared in this publication to avoid similar events in future.
The publication also presented the top reported incidents of the Advanced Incident Reporting System in the last two quarters of 2011.
The publication has been distributed to all healthcare professionals in public hospitals for continuous quality improvement. It can also be accessed by the public at www.ha.org.hk/riskalert .
"HA Risk Alert" is published quarterly and posted on the HA website every last working Friday in the month of January, April, July and October. The next issue will be published on July 27, 2012.
Ends/Friday, April 27, 2012
Issued at HKT 17:11
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