When Dr Christiaan Barnard and his colleagues performed the first successful human heart transplant in 1967, teamwork before, during and after surgery would have been key to extending the boundaries of medicine. Like other life-saving advances, the operation is now routine. It is to be expected that we would have become blasé about it, except when it affects someone close to us.
But the teamwork required and priority of patient safety remain anything but routine. We are reminded of this by the findings of an investigation into a potential tragedy at Queen Mary Hospital in May, when a woman patient was given a mismatched heart. Happily the 58-year-old recipient has not rejected the organ and is expected to be sent home in a month.
A panel formed by the Hospital Authority found multiple reasons for the blunder without holding any single person responsible. It cited lack of information and communication in the heart transplant service, and a lack of manpower, specialist training and proper role delineation.
Pending a sweeping reorganisation of the authority’s transplant protocols, an information system that automatically verifies compatibility between heart donors and recipients will be set up in three to six months as an interim measure.
It is nearly four years since the authority sent special teams into public hospital wards to monitor compliance with patient-safety guidelines. This followed a spate of medical blunders involving repetition of the same kinds of mistakes in routine procedures. One hospital chief blamed lack of teamwork and co-operation among frontline staff. Such lack of communication opens the door to mistakes, of which the heart-transplant blunder is the latest example. That said, not many have surfaced in recent times. A policy of openness and transparency – revealing incidents promptly along with remedial action – seems to have reinforced patient safety. We trust it will be maintained for the sake of public confidence.
Source: scmp.com