Prescribed measures to seek out 'reckless' hospital staff

Wallis Wang

Hospital Authority staff who incorrectly distribute medicines due to distractions or the desire to finish work early will be considered to have engaged in reckless conduct, the most severe form of staff accountability, according to the director of quality and safety, Michael Wong Lap-gate.

This follows an HA review committee's report proposing to establish a framework for determining staff accountability based on guidelines distinguishing between human error, at-risk behavior and reckless conduct.

The report suggests that the HA should develop an accountability framework for senior management to hold them responsible for patient safety.

But chairman of Hong Kong Patients' Voices Alex Lam Chi-yau said the HA report was more like "slogan-chanting."

Speaking on radio yesterday, Wong said recklessness is the most severe conduct among the three types of staff accountability.

"For example, a pharmacist is supposed to verify each of the six bottles of drugs for a patient with a scanner, but he only scans the first bottle six times to finish work quickly. In this case, he may give a wrong bottle to the patient," he said.

"We should eliminate factors that may lead to these dangerous behaviors, such as a doctor performing surgery while drunk, or a nurse distributing drugs while watching football games. These are clearly reckless conducts and the medics should be held accountable."

Wong added that each hospital's quality and safety department employs fewer staff members. Therefore, various departments in public hospitals should also be responsible for patient safety.

For example, if a patient falls inside a medical ward, the wards should review their own measures to prevent such an accident from happening, he said, adding that the quality and safety department should only be responsible for overall monitoring and assistance.

However, Lam said that the HA report paid lip service to staff mistakes that endanger lives by using words such as "strengthening, improving and optimizing."

He said the report failed to include a dismissal mechanism that would punish staffers who make serious mistakes.

"The HA chairman said earlier that there will be punishment for staffers' mistakes, but the authority will not consider firing them due to a manpower shortage. I have a bad feeling about this," Lam said.

"Without a dismissal mechanism for HA employees who make serious mistakes, the staffers will have their jobs saved no matter how wrong they are, as if they are holding an 'ultimate exemption'."

Lam added that the authority's senior management should also be held accountable if employees follow orders but accidents still occur.

He expressed concern that medics would conduct fewer medical procedures to avoid mishaps.

The report, which was released last Friday, proposed 31 recommendations for improvement.

Apart from enhancing accountability, it also urged the authority to strengthen governance by clarifying the roles, responsibilities and jurisdiction of different levels of staff, including defining the roles and objectives of the head office, hospital clusters and hospital departments.

Public hospitals should foster a culture of safety by prioritizing non-punitive reporting and creating a "speak-up" culture, the report said.