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医院管理局二○○八年研讨大会─「创优立新为民康」
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下稿代医院管理局发出︰
超过三千名本地和来自国内及海外的医护人员及学者，出席今、明（五月五日及六日）连续两日举行的医院管理局二○○八年研讨大会，就促进市民健康互相交流经验和意见，深入探讨医护专业发展的趋势及方向。
医管局研讨大会今年的主题为「创优立新为民康」，由本地及国际知名学者和医护专业人员分享和讨论下列课题：
─ 医疗融资选择
─ 推广健康管理
─ 持续优质医疗
─ 创新临床技术
─ 革新医护工作
医管局二○○八年研讨大会开幕典礼于今日（五月五日）上午举行，主礼嘉宾包括国家生部王国强副部长、政务司司长唐英年、食物及生局局长周一岳医生、医管局主席胡定旭及医管局行政总裁苏利民。
胡定旭在致欢迎辞时重申今年研讨大会的主题为「创优立新为民康」，正好配合政府于两个月前推出第一阶段的医疗改革咨询，这个改革可以带领我们的医疗体系进入新的一页。
胡先生指出：「在目前阶段，我们正整理来自员工、医院管治委员会成员、病人组织及其他相关人士的意见，就医疗融资及改革向政府作出建议。」
他相信无论前面的路怎样走，医管局也必须有一支干练而长远可持的专业团队。「我们已为医生建立新的专业晋升架构，以及推行医生工时改革的先导措施。目前，我们正为护士的专业晋升模式作最后定案。」
胡先生在总结发言时感谢政府承诺届2011／12年度，把医疗经费占政府经常开支的比例，从目前的百分之十五增加至百分之十七。
医管局行政总裁苏利民在开幕典礼上发表题为「茫茫人海，医院管理局位置何在？」的主题演讲时，谈及改革措施对医管局的影响，医管局怎样做才可以在改革后保持优势，继续为病人以至整个社会提供有价值的服务。
苏利民指出，医疗改革咨询文件详述香港医疗体系两种不平衡的情况︰首先是过份偏重急症治疗，忽略预防及基健护理；其次是过份倚赖公营医院体系。
「因此，医疗改革应可为医管局减少需求，并为将来建造更稳定的财政基础。」他续称。
他认为即使达致更合理的公私营平衡，医管局将来在提供医院服务方面，仍会担任龙头的角色，「医管局应继续为病人及社会提供有价值的服务，以及一个全面的安全网。」
他相信医管局应协助病人无论使用医管局或私营的服务，都会有更多的选择。
「在未来的医疗融资领域，医管局应考虑为购有医疗储蓄或保险愿意多付的病人，提供核心循证医疗服务以外的新选择。」他更预见将来出现更多公私营的合作计划，为病人提供更多的簇新服务。
「医管局必须继续为病人和社会提供『平靓正』的服务，」他认为「对病人的价值」有四方面值得深思。首两方面与专业和临床才能有关，而另外两方面则属于我们关顾病人的范畴。
第一方面是「首先，不要造成伤害?，苏利民指出，医管局已实施「严重医疗事故通报系统」，规定公立医院必须呈报九项引致严重伤害或死亡的事件，而且相信这些事故大多可以避免。「我们的目的是将事件披露以汲取教训，防止类似事件再于局内发生。?
第二方面为「推行保证质素的计划及制度?，他向听众指出医管局正不断推出各项质素计划，以提升服务质素及病人安全，包括：
＊ 推行「洁手护民康运动?，减少院内感染
＊ 实施「三核五对」程序，减少药物出错
＊ 各医院进行医疗审核，监察病人的治疗成效
＊ 率先就病理化验指令采用二维条形码扫描科技，减少识别病人身份的错误
＊ 致力为各医院争取国际认可的质素检定
＊ 使用计算机输入住院病人的药物指令
＊ 更新设备
第三方面是要致力增加培训及挽留员工，特别是医生和护士，使他们有合理的工作量，和有更多时间与病人沟通。
最后，苏利民吁请员工「易地而处，为病人的最佳利益设想」。「我们的最终任务是让病人痊愈返家，重回小区过健康正常生活。如果不能做到，我们仍应致力为病人纾缓压力、减轻痛楚，协助家属接受病人生命进入另一阶段。」
他补充说所谓「易地而处」，也包括明了在治理过程中，可能有很多医管局医生、私家医生及非政府机构参与，因此，确保当中的联系和协调顺畅是十分重要的。「由于长期病患者不断增加，连贯协调的护理将会日益重要。」
为确保对社会的价值，医管局将需继续有效地管理其资源，当中涉及：
＊ 维持市民健康，支持他们在小区生活
＊ 善用信息科技推行自动化
＊ 进行人力资源改革。护士不应做文员胜任的工作，护士及专职医疗人员可担当更多高技能工作，例如独立主理诊所
＊ 引入「疾病组合为本」的新拨款制度，令病人量与工作量成正比
＊ 利用大宗购买药物、医疗物品及设备，继续争取更大经济效益
＊ 将管理的间接成本减至最低，资源集中用在前线
苏利民总结时指出，医管局今年工作计划的主题是「健壮团队?臻健服务?，「缔造社会价值，应讲求更灵活有效的运作和贯彻团队分工，而不是强迫前线人员承担不合理的工作量。?
完
２００８年５月５日（星期一）
香港时间１７时０３分
Hospital Authority Convention 2008 - "A New Era of Patient Care"
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The following is issued on behalf of the Hospital Authority:
More than 3,000 experts and professionals from Hong Kong, the Mainland as well as the international healthcare sector gathered at the two-day annual Hospital Authority (HA) Convention 2008 which is being held today (May 5) and tomorrow (May 6) to share innovative ideas for improvement of the health of the community and also help shape the direction of healthcare development in the years to come.
The main theme of this year's HA Convention is "A New Era of Patient Care", which is underpinned by the following sub-themes:
- Healthcare Funding Options
- Patient Satisfaction and Engagement
- Quality Patient Care
- Clinical Innovations
- Impact of Work Reform
The HA Convention 2008 was officially opened by the Vice-Minister of Health, Dr Wang Guoqiang; the Chief Secretary for Administration, Mr Henry Tang; and the Secretary for Food & Health, Dr York Chow this morning at the Hong Kong Convention and Exhibition Centre. Accompanying the Vice-Minister, the Chief Secretary and the Secretary for Food and Health at the Opening Ceremony were HA chairman, Mr Anthony Wu, and the Chief Executive, Mr Shane Solomon.
In his welcoming address, Mr Wu echoed the theme of the Convention "A New Era of Patient Care" and remarked that launching the first phase of the consultation exercise on healthcare reform two months ago marked the beginning of a new chapter in Hong Kong's healthcare system.
"Meanwhile, we are consolidating the views expressed by our staff, Hospital Governing Committee members, patient groups and other stakeholders for our response to the Government on the healthcare reform proposals."
Mr Wu also said that regardless of the way forward, the Hospital Authority could not do without a strong and sustainable workforce, "we put in place a new career progression structure for our doctors and launched a number of pilot programmes of Doctor Work Reform. Currently we are finalising a career progression model for our nurses."
Mr Wu thanked the Government for pledging to increase the recurrent expenditure on healthcare from the present 15% to 17% in 2011-12.
In delivering his Keynote Speech "Where in the World is the Hospital Authority?", the authority's Chief Executive, Mr Shane Solomon expressed his views on how reform initiatives will impact on the Hospital Authority and what it must do to have a strong place in whatever reform environment was created, and that was to continue providing value to the patient and value to society.
He pointed out that the Healthcare Reform Consultation Document detailed two imbalances in Hong Kong’s healthcare system: first, too much emphasis on acute curative care, and not enough on prevention and primary care; second, too much reliance on the public hospital system.
"So the impact of healthcare reform should be to reduce demand on HA and create a more stable funding base for the future," he said.
Mr Solomon perceived that even with a better public-private balance, the authority would still have a central role in the future, "The Hospital Authority should continue to be good value for the patient and the society, providing the universal safety net."
He believed that the future HA should help patients have more choices, both within HA and within the private sector.
"In the future world of healthcare financing, HA should consider offering some new choices above its core evidence-based service offering for those willing to pay more, maybe using their medical savings account or their insurance cover," he said, adding that more public-private partnerships would emerge to create new choices.
"HA must continue to be 'good value' for the patient and for society." He said HA should focus on four dimensions of "value to the patient". "The first two are about our professional and clinical competence. The other two are about our caring dimension."
In explaining the first dimension "First, Do No Harm", Mr Solomon said that HA introduced the Sentinel Event Reporting System which had nine events that caused serious harm or death, and were believed to be largely preventable. "Our purpose is to disclose so we can learn how to prevent these incidents from happening right across HA," he said.
In the second dimension, "introduce quality programmes and systems", he reminded the audience that there were a number of quality programmes emerging in place in HA to improve quality and patient safety, which include:
- the "Clean Hands for Health" campaign to reduce hospital acquired infections
- the 3 checks 5 rights programme to reduce medication errors
- clinical audits to monitor patient outcomes in different hospitals
- 2-D bar coding to reduce patient identification errors, initially in ordering pathology tests
- moving towards internationally recognised hospital accreditation
- inpatient medication order entry
- modernising equipment
The third dimension is the need to train and retain additional staff particularly doctors and nurses, so that there are more reasonable workloads and more time for communication.
Lastly, Mr Solomon appealed to staff to "sit in the patient's seat, and imagine what is best for them".
"Our mission is ultimately to return people home to live a healthy and normal life in the community. If we cannot do that, then we should turn our efforts to palliation, pain control, and helping the family accept the patient’s next journey."
He said that sitting in the patient's seat meant understanding that they may have many HA doctors, private doctors and NGOs involved in their care, so making sure the links between them are smooth was important, "as chronic conditions increase, such continuity of care will become more important."
In ensuring that HA's service is value for the society, HA will need to continue managing its resources as well. This will involve:
- Keeping people healthy and supporting them to be able to live in the community.
- Embracing information technology and automation.
- Reforming our workforce. Nurses should not be doing jobs that clerks can do. But nurses and allied health professionals can do more highly skilled jobs, such as independent practice clinics.
- Introducing a new casemix funding system that ties workload to patient load.
- Continuing to use our economy of scale for purchasing of drugs, medical supplies, and equipment.
- Keeping management overheads to a minimum, so resources are directed to the frontline.
In his concluding remarks, Mr Solomon highlighted the motto of HA's annual plan this year: "Strong Team.SMART Care."
"Achieving value for society should be about working smarter and as teams, not forcing front-line colleagues to have unreasonable workloads," he said.
Ends/Monday, May 5, 2008
Issued at HKT 17:02
