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SINGAPORE: Many developed nations do it: Hire healthcare workers from abroad. This is the reason why language and cultural barriers are now the biggest challenges to patient safety.
In Singapore, the National Healthcare Group (NHG) has come up with ways to address these and other issues, making its safety standards comparable with those in the United States, according to Dr Joseph Cooke, the chief officer of patient safety at the New York Presbyterian Hospital Weill Cornell Medical Centre.
At the National University Hospital (NUH), for example, pictorial books that capture common complaints and patient requests are being used to help nurses communicate more effectively.
The books come in nine languages — English, Malay, Burmese, Chinese, Japanese, Tagalog, Thai, Tamil and Vietnamese.
Unfettered communication between medical staff and patients is not the only aspect of patient safety, though. Being sensitive to workers from different cultural backgrounds seems to be essential, too, said Dr Cooke.
The hospital's most recent initiative to boost safety standards was the introduction of colour-coded charts in February, which use visual cues to help the medical team stay alert to patients' vital statistics.
According to NUH patient safety officer Sophia Ang, who initiated the colour-coded charts at the hospital, there has been an increase in awareness among staff on safety issues compared to the past few years.
Said Dr Ang: "The nurses like this interesting concept as the colours help trigger their visual senses, alerting them to the patients' vital statistics."
At Alexandra Hospital, which also has its own colour-coded tools, there is also a safety committee that looks at issues and recommends improvements.
Dr Harvey V Fineberg, president of the Institute of Medicine (US) and Provost of Harvard University, who visited NUH recently, was impressed by the standard of patient safety here.
"Hand-cleansing facilities were literally in every room. That may seem rather overdone, but in fact, the problem of infection in hospital is often a problem of carriage of infection from one patient to another by health workers," he told TODAY.
He added that one of the most common problems concerning patient safety is the error made when prescribing and delivering medicine.
"At every step along the way — from the decision, to the order, to the processing, to the drug delivery, to the actual administration and to the patient — there is a chance for error," he said, adding that computerised order entry can help to avoid reading error.
NHG to introduce new medication admin system
The NHG has been looking into this issue since February and will be introducing an electronic medication administration system at Tan Tock Seng Hospital and NUH come June, ensuring that the right medicine in the right dosage is administered.
Dr Cooke noted that with scientific advancements and the increasing use of technology in the sector, it is important for hospital staff to stay vigilant as healthcare becomes more complex. Technology, for one, is not error-free, he cautioned.
Dr Cooke, a specialist in the management of critical illness, hinted at a possible collaboration between Singapore and the US with regard to education on patient safety.
He added that he was impressed with the commitment of healthcare workers here in upholding patient safety standards.
"In the race to be safe, we must not lose sight of the essential fabric holding everything together — the physician and patient," said Dr Cooke, who listed other challenges that health institutions might generally face, such as the need to stress patient safety to medical students.
At the Yong Loo Lin School of Medicine here, "students learn issues on patient safety such as infection control and how to recognise those at risk of falls, as well as fundamentals such as drug allergies and the need to wash their hands prior to every job", said a third-year medical student. - TODAY/ra
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