How this Vietnam hospital is using feedback to boost safety

By Nurfilzah Rohaidi

Interview with Jonathan Carretas, Quality Management Manager, American International Hospital, Ho Chi Minh City.

American International Hospital in Ho Chi Minh City wants to encourage staff to report incidents without fear of being punished, according to Quality Management Manager Jonathan Carretas.

“If they report, it's not punitive. It's more of a learning session, that's why more staff are confident to report,” he explains to Hospital Insider. With this new online reporting system, there is an anonymous option so that staff can “write the report without telling their name, validate that, investigate the incident, and then we focus more on the system issue rather than the person”, he continues.

“Instead of having just a paper Incident Reporting System, which has many disadvantages, we have just worked with our IT and we developed our own online Incident Reporting System to make sure it's anonymous,” says Carretas.

The number of incident reports that the hospital receives has quadrupled since this system was put in place. “In the last quarter of last year, on average, the total number is around 23 - and now we receive more than 100 incident reports per month,” he explains. “It's increasing for the first time and it helps the awareness of the staff.” The most common incidents that arise include errors in communication during patient handover from one care team to another, Carretas notes.

At the recent Hospital Management Asia 2019 conference, Carretas shared his perspectives on modern healthcare risk management. It can be split up into two approaches: the first is reactive risk management, where “the incident happened, and your system has some flaws. You focus more on how to prevent the same thing from happening again with some action plans,” Carretas says. This type of anonymous incident reporting takes the form of the first approach.

The second approach is proactive risk management, where “we anticipate some of the risks or some possible harms that may happen to an organisation, by doing a risk assessment and figure out how to prevent them and to mitigate”, he explains. For both approaches, technology is crucial. “For example, the registration processes, turnaround time, waiting time and our electronic medical records.”

The hospital is innovating to digitise various processes, so that they can “get the data, and then monitor the turnaround time, and at the same time, evaluate our performance”, according to Carretas. It has also developed its own Google-like document management system, he adds: “You just search, all the policies, procedures, accreditation are there.”

The next step in the hospital’s journey towards better safety is a patient safety culture survey by a US healthcare accreditation government agency, that the hospital hopes to complete in the coming years.

This patient safety survey will allow the hospital to “get that baseline assessment from the safety perception of the staff,” he explains. The findings will inform the hospital’s efforts to develop safety action plans. And aside from that, international accreditation is a priority: “We will be getting JCI, target by next year,” says Carretas.

Evidence-based care is another key aspect in this journey towards better patient safety. The hospital uses evidence-based care tools from solutions provider Wolters Kluwer, which helps care teams to cut the risk of “sentinel event issues”, for instance. This term refers to unanticipated events in a healthcare setting that can lead to death or serious physical or psychological injury to a patient or patients, but which are not related to the natural course of the patient’s illness.

These solutions are key to helping doctors decide on the strongest evidence-based course of action for their patients, which goes a long way in reducing medical errors, according to Carretas.

Data-driven transformation and staff empowerment are just two ways that any hospital can boost patient safety, which means better healthcare services all around.