FV Hospital putting the case straight

It is now working towards a higher recognition. However, its quality was questioned in recent weeks in the aftermath of death of 57-year-old Hanoi patient Mai Trung Kien, who was brought to FV with symptoms of appendicitis, underwent an appendectomy and later died. FV Hospital CEO Jean-Marcel Guillon shares with VIR some of his thoughts about the case and healthcare at FV.

What lessons has FV Hospital learned from the Mai Trung Kien case?

More than three months after the death of the patient and based on an objective review of the medical facts provided in the medical records of FV Hospital and Tam Duc Hospital, the ad hoc professional council organised by the Ministry of Health re-established the truth and concluded that this patient died due to a heart attack and a bleeding, with the bleeding not being due to the surgery, but being due to the medication the patient was taking for his heart.

As we have admitted from the outset, FV Hospital’s diagnosis of the bleeding was late, but the professional council confirmed that the cardiac problems made this diagnosis extremely difficult and that FV Hospital accurately diagnosed the heart problems and gave the right treatment. While the mistake of FV Hospital did not directly cause the death of this patient, it serves to remind us how complex the practice of medicine is, especially for patients at high-risk of death.

During these three months a large number of unsubstantiated claims have been made against us. Remember that we are prevented, due to patient-confidentiality obligations, from defending ourselves by way of the media, and we should not be unfairly penalized for this.

We firmly believe that a single complaint procedure for medical matters, as prescribed under the Law on Medical Examination and Treatment, is the only correct forum for medical complaints because a professional council is (1) the only forum where a medical establishment is permitted to disclose medical facts about its patients, and so is able to defend itself against untrue and misleading allegations and (2) the only forum where independent medical professionals judge their peers based on medical facts, not speculation.

The Ministry of Health’s Medical Services Administration Department requested FV to organise a study, an in-depth review, to correct the individuals and teams who had made professional, technical mistakes in medical examination and treatment of patient Mai Trung Kien. How did FV do this?

We have reviewed our risk-priority protocols to try to ensure that, in a patient with many risk factors, one symptom does not mask another, and multiple symptoms are balanced by priority of risk.

The Medical Services Administration Department requested FV to report the review to the department by November 26, 2012. What are the main points of the report?

The ad hoc professional council stated that “the patient was adequately monitored and examined during the treatment process from admission until death, however we have reminded doctors to write down in the medical records even fuller details of their visits to patients. We are considering performing at our laboratory a highly specialised coagulation test (quantification of anti-factor Xa) which is not performed in Ho Chi Minh City.

We revised the policy “Notification of Laboratory Critical Results” to make sure that doctors will be automatically informed verbally and very quickly if haemoglobin levels decrease even if the decrease has not reached any critical level. FVH is considering how it can proceed with an autopsy when the current law only allows for autopsies with the consent of the patient’s family and most families are unwilling to agree to an autopsy

Will FV continue to accept high-risk patients for treatment? Why?

FV Hospital’s vision is to be a leading medical provider in Asia. In line with this we will continue to accept high-risk patients for treatment, even if, in doing so, we risk extremely adverse media coverage.

In the wake of the Mai Trung Kien case and the adverse publicity, what is FV doing to minimise risks of losing its reputation?

Since 2003, FV Hospital has treated almost 350,000 patients and has a world-class 0.1133 per cent overall surgical mortality rate, and a 93.5 per cent average ‘good-excellent’ inpatient satisfaction level. Many success stories have received a lot of attention  but it seems that the media and the public have forgotten them. Our objective is to work even harder to restore our reputation and gain back our patients’ trust. FV Hospital and its 900-plus staff and doctors are committed to delivering the highest level of patient care.

FV was the first hospital in Vietnam to be accredited by an international organisation, the French Haute Autorité de Santé (HAS), in 2007. What is the significance of this recognition? Why does FV need recognition from the Joint Commission International, which FV expects to achieve soon?

Accreditation provides a visible commitment by an organisation to improve the safety and quality of patient care, to ensure a safe care environment, and to continually work to reduce risks to patients and staff. Accreditation is one of the most, if not the most, effective quality evaluation and management tools. The accreditation process is designed to create a culture of safety and quality within an organisation, like FV Hospital, that strives to continually improve patient care processes and results.

FV Hospital is pursuing a recognition by the Joint Commission International, considered the global leader in hospital accreditation. Essentially, our aim is to achieve and maintain the best quality medical and non-medical services. Leading the effort in total quality management at FV are the Quality Assurance Department and Patient Services Department.

The former is in charge of medical aspects focusing on patient safety and improved outcomes, while the latter oversees non-medical aspects, such as the appointment and performance of a customer service officer who assists patients and acts upon his or her needs and requests.