Page 169 - HA Convention 2015

Parallel Sessions

PS4.1 Patient Relations and Complaint Management 14:30 Theatre 2

The Myth of Patient Engagement Tuesday, 19 May
Lui SF, Wong ELY
Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong

Patient involvement, patient engagement, patient partnership and patient empowerment are a spectrum of process which
is believed to be important to achieve better outcome of patient care and patient relations. These overlapping terms can be
confusing to healthcare professionals and patients. Patient engagement (PE) can be categorised as two levels - individual
(patient) and public level (patients of a disease-group/population). PE on individual level may start from simply involve/
educate a patient to understand his/her own illness and to care for oneself, moving onto more advanced level - partnership
(working together) and empowerment (taking ownership of one’s care process, including to make appropriate adjustment
accordingly). To achieve this, it is necessary to escalate the engagement process step by step. Furthermore, it is important
for both parties to understand and agree on what PE is all about – key elements, activities, difficulties and improvement
measures.

The Jockey Club School of Public Health and Health Care of The Chinese University of Hong Kong conducted a survey on
PE for Hospital Authority in 2012/2013, aiming to explore the views and experiences of patients and staff on PE. While staff
and patients both believed that PE was important and could benefit healthcare, not all patients perceived PE as necessary
and some staff had concern on possible negative impact. Both parties shared common view on some of the essential
components of PE, but there were discrepancies on many aspects. Similarly, many PE activities reported by staff were not
perceived by patients. Key improvement measures proposed by staff and patients were: (1) to improve staff’s communication
skills with patients; (2) to reduce workload of healthcare staff; and (3) to change management style to enhance patient
engagement. The session will share some of the key findings of the survey.

PS4.2 Patient Relations and Complaint Management 14:30 Theatre 2

Medical Complaints and Disputes : A Patient-centred Model at The University of Hong Kong-Shenzhen Hospital HOSPITAL AUTHORITY CONVENTION 2015
Chu PCM 1, Hui CKM 1, Lai QQ 2, Wang HP 2, Wong RSK 2
1Department of Medicine, The University of Hong Kong-Shenzhen Hospital, PRC 167
2Patient Relation Office, The University of Hong Kong-Shenzhen Hospital, PRC

Medical complaints and disputes (MC&D) are increasingly prevalent in hospitals across China and occasionally led to
violence against hospital staff. Where fatalities have resulted from such conflicts, national and international attention are
drawn in the media, with growing levels of professional anxiety. One of the key issues is the lack of adequate communication
between doctors and patients, leading to a breakdown of trust, compliance and understanding about aspects of care in an
increasingly complex healthcare environment.

Most hospitals in China deal with MC&D through Hospital Medical Affairs Department with varying degrees of success. The
University of Hong Kong-Shenzhen Hospital (HKUSZH), set up in July 2012, adopted a different “reform” approach. From the
outset, a dedicated Patient Relations Office (PRO) was opened on the ground floor of the hospital to provide an open, direct
and immediately accessible point of contact for patients and relatives.

The PRO operates independently, and is directly accountable to the Deputy Hospital Chief Executive, who leads weekly
review meetings. This clear leadership enables all cases to be investigated immediately, effectively and empathetically. It
serves an important coordinating role between patients, staff, and external agencies (such as the municipal government,
insurance companies and legal advisors) in seeking satisfactory conflict resolution for all parties.

The PRO’s core aim is also aligned with the hospital’s mission in emphasising the need for patient communication and
engagement as a key area for continued quality improvement.

Since July 2012, the total number of MC&D received by our PRO team was 181 cases for 2012, 684 for 2013, and 719 for
2014. The overall MC&D rate for all outpatient was 0.44% in 2012, 0.24% in 2013 and 0.08% in 2014. The respective rate for
inpatient was 0.7% in 2013, and 0.32% in 2014, showing a significant yearly improvement against a background of rapidly
increasing daily clinical activities of 3,000 OPD attendances and 550 inpatient. Only 1.4% of cases led to compensation after
satisfactory conflict resolution.

These figures suggest that the PRO and its staff provide an effective and efficient way of dealing with MC&D before they
escalate. The empathy and engagement that the PRO staff established with the patient are particularly helpful in providing an
essential platform for communication, counselling and mediation for MC&D.