03 July 2007

Allow local professionals to implement quality systems


I NOTED the letter by P. George of Johor Baru,"Seek world-class recognition" (NST June 29).

He advocates government and private hospitals seeking recognition from the Joint Commission International (JCI), a hospital accreditation body based in the United States.

He seems to imply that in hospitals with such accreditation, cases of apparent medical negligence may be reduced.

Hospitals are dangerous places. Welcome announcements to a hospital may sound like this: "Welcome to Hospital XYZ. There is a two per cent chance that you may acquire a life-threatening infection during your stay in this hospital.

"There is a one per cent chance that your baby may be admitted after delivery etc, etc". Frightening but true in some hospitals!
It is impossible to estimate the frequency of medical mistakes, but there can be no doubt that mistakes are more common than most of us realise.

The only published information available comes from the US.

A study conducted in California in 1974 concluded that three million hospital admissions led to 140,000 injuries, giving an incidence of 4.7 per cent.

Another review (Harvard Medical Practice Study, 1990) conducted in New York concluded that 2.7 million hospital admissions led to 98,600 adverse events, giving an incidence rate of 3.7 per cent.

With five million hospital admissions a year in England alone, this might mean almost 200,000 medical accidents in English hospitals.

In Australia, 16.6 per cent of hospital admissions had an associated adverse event.

The medical profession in Malaysia has also realised that we need to learn from our mistakes and, more importantly, prevent similar events from occurring in hospitals.

Hospitals have been urged to set up quality and audit systems and institutionalise them by applying for accreditation and ISO certification.

Malaysia has its own Malaysian Society for Quality in Health (MSQH), the only body that is recognised to carry out hospital accreditation.

It is a vigorous and thorough exercise which checks that hospitals have systems in place that emphasise patient safety and medical audits.

The exercise is based on international standards with local modifications.

The MSQH is affiliated to the International Society for Quality in Health (ISQua) and is now in the process of forming ASQua (the Asian equivalent).

It is to be noted that Singapore does not have its own national accrediting body and that is why it depends on JCI for hospital accreditation.

Eighty-eight Malaysian hospitals have undergone the first cycle accreditation survey (each cycle is three years). Thirty-five hospitals are into the second cycle and seven are in the third cycle.

The Health Ministry has emphasised that only accredited hospitals will take part in health tourism promotions.

We need not look far to ensure that our hospitals are safe and not ailing.

Let us support our own professional bodies in their efforts at accreditation and implementing quality systems. We should support local solutions for local problems.

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