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* This presentation is prepared by the author in one’s personal capacity for the purpose ofacademic exchange and does not represent the views of his/her organisations on the topicdiscussed.A Case ofUntrained AcupuncturistJournal Club / Grand Round Meetingin Administrative MedicineDr Albert Lo28 Aug 2004Dr Albert Lo 1The CaseA patient’s relative complained via the press media that ajunior doctor practised acupuncture without undergoing propertraining in your hospital. Acupuncture was not an approvedintervention procedure in the hospital and the hospitalmanagement was not aware that acupuncture has beenpractised.Please outline, as the chief executive of the hospital, the actionsthat you will take after receiving the complaint.Dr Albert Lo 2Problem identification‣ Standard / quality of care‣ Practice of CAM in hospitalDay 1OperationalFact finding‣ Chief of Service to conduct• Doctor• Circumstances• Damage to patient• Other cases involved‣ Medico-legal implicationDr Albert Lo 3‣ Patient Relation Officer to conduct• Complaint already filed?Dr Albert Lo 4Medico-legalDay 1‣ File notification to Corporate LegalCounsel (to be followed by details)Public affairs‣ Notify Corporate Public Affair Division‣ Send holding reply to pressDr Albert Lo 5Day 2 (am)Operational‣ Facts ascertained‣ Stop ongoing practice‣ Determine line to takeMedico-legal‣ File supplementary information‣ Direct communication with Legal Counsel toagree on line to take / content in reply topressDr Albert Lo 6

OperationalDay 2 (pm)‣ Chief of Service and Patient Relation Officerinterviewed patients and relatives(complainant)‣ Reveal the facts‣ Apology‣ Personal damage to be handled by corporateinsurance companyPublic AffairsDay 2 (pm)‣ Reply to press• The fact• Discussed with the complainantDr Albert Lo 7Dr Albert Lo 8GovernanceDay 2 (am / pm)‣ Inform Chairman of HospitalGoverning Committee‣ Copy reply letter to Chairmanbefore releasing to pressDr Albert Lo 9Within 1 weekOperational‣ Communicate with hospital staff to re-affirmthe policyHuman Resources‣ Start disciplinary proceedingRisk Management‣ Review acupuncture and other CAMpractice in hospitals‣ Gather opinions to prepare for futureamendment of the policyDr Albert Lo 10Within WeeksGovernance‣ Bring up to Hospital GoverningCommittee meeting• Facts• Remedial actions / change inpolicy• Disciplinary actionsDr Albert Lo 11Practice of CAM in hospital‣ Legislation and control‣ Professional competence andqualification‣ Corporate policy, including medicolegalaspect‣ Clinical benefits and risk for aspecific treatment modality on adisease condition‣ Supervision, accountability andquality assuranceDr Albert Lo 12

Core competencies involved‣ Quality improvement and risk management• Manage risk with appropriate systemand measures• Manage medico-legal cases andminimize risk through risk management• Address complaints fairly and withtransparencyCore competencies involved‣ Analysis and decision making• Apply knowledge and skills in riskmanagement and control to makingdecisions under uncertainties‣ Strategic thinking, policy development andimplementation• Develop plan to put policy / strategy intooperation or to implement programmeDr Albert Lo 13Dr Albert Lo 14