VietNamNet Bridge – Improving the quality of health treatment and examination as well as patient safety is a critical task for hospitals, as medical errors and hospital infections still occur at healthcare facilities in Viet Nam, especially provincial- and grassroots-level hospitals.

A doctor gives a check-up to a patient at Thai Nguyen Central General Hospital. Viet Nam needs to improve the quality of health treatment and examinations, especially at grassroots-level hospitals.

Last year, for example, doctors at Khanh Hoa General Hospital in Nha Trang waited too long to operate on a woman about to give birth. The woman, who had been in the hospital for five days, had shown signs of going into labour. The foetus died during the operation.

"The odds of medical error in a hospital are 1:10 and the odds of dying from a medical error are 1:300," said Dr Prabhu Vinayagam, managing director of Asia-Pacific region of Joint Commission International (JCI), which provides international accreditation, advisory services, publications and education programmes for healthcare facilities.

Vinayagam spoke at a conference last Saturday on quality management and patient safety held in HCM City and organised by the Ministry of Health and HCM City University Medical Centre.

Duong Huy Luong, deputy head of the hospital quality assurance division under the Department of Medical Examination and Treatment, said health facilities' poor management of quality improvement had resulted in too many errors and risks.

Moreover, hospitals that have decided to focus on quality assurance often do not know how to carry out procedures, and do not have the proper specialist on staff. They also may lack financing, Luong said.

Only 53.3 per cent of hospitals throughout the country have a division or team specialising in management and assurance of quality.

In 2013 the Ministry of Health issued criteria on quality assessment, Luong said.

In Viet Nam, two hospitals have JCI accreditation, VINMEC International Hospital in Ha Noi and Cao Thang Hospital in HCM City.

"Hospitals carry out activities to improve quality in order to provide safer healthcare services, and to satisfy patients and health officials," he added.

The ministry has also encouraged hospitals to ask organisations like JCI to conduct international quality assessments.

In the first quarter of next year, the ministry plans to publish the results of quality assessment at central- and city-level hospitals.

Vinayagam suggested that health facilities should also address standards of adherence and analysis, and collect available baseline quality data as required by quality monitoring standards.

Risk management, quality management, and facility safety should be included in one comprehensive data set, Vinayagam said.

Using the findings of baseline assessment, a detailed project plan should be created with assigned responsibilities, deliverables and timeframes.

The Health Ministry has provided guidelines and materials for quality assessment implementation and training for hospital staff.

Benefits

Dr Phan Thi Ngoc Linh, head of District 2 Hospital's quality assurance department, told Viet Nam News that effective quality management reduced costs and errors, which in turn attracted more patients.

Luong added that quality improvement activities, such as supervision of standard clinical pathways in An Giang Hospital, had helped reduce costs.

From September 2013 to September 2014, the hospital cut medicine costs from 72 per cent to 62 per cent, including costs for antibiotics, from VND60 billion to VND39 billion.

Spare funds from health insurance rose from VND18.5 billion to VND33 billion, he said.

Thu Duc General Hospital has also implemented quality improvement, including management of required clinical pathways with IT.

Supervision of drug interactions, particularly for patients that take multiple drugs, was also important, Luong said.

Dr and Assoc Professor Do Trong Hai, chief of HCM City University Medical Centre's quality assurance department, said the university had created a network and department of quality assurance in 2013, as required by the ministry.

"The increase in the number of patients at the hospital shows that quality has improved," he said.

In the past, around 4,000 outpatients visited each day. Today, it is 5,000-6,000, and beds at the hospital's new buildings are full.