Following the misconduct of the anesthetic technician at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) earlier this month, the ministry has rolled out the Hospital Management and Administration Transformation (HMAT) initiative in all hospitals and Basic Health Unit (BHU) grade I in the country.

HMAT is a management tool to improve management efficiency and accountability in the clinical setting including medical ethics and medico-legal components.

Health minister Tandin Wangchuk said that besides installing more CCTV cameras in the hospital to deter such incidents, the JDWNRH management is also considering random drug testing for staff working in high-risk units at the hospital.

He said that incidences, like the recent case involving an anesthetic technician at the national referral hospital in Thimphu, although isolated, would be deterred.

“This will be done through reinforcement of mandating all health professionals to comply with the standards and professional code of conduct,” he said in a written statement.

To further enhance the quality of care and patient safety, lyonpo said the ministry is continuously reviewing and re-sensitising on 5S – CQI (sort, set, shine, standard, sustain-continuous quality improvement), which have been implemented across all health facilities.

“This initiative enhances the design and delivery of health services to achieve optimum patient outcome and safety,” he said. “All SoPs and clinical practice guidelines need to be reviewed and continuously validated to adapt to changing settings and clinical requirements.”

The ministry has also initiated implementing the Bhutan Health Standard for Quality Assurance (BHSQA) in hospitals across the country. BHSQA looks at standardising clinical practices and processes for better quality and outcome of care.

Currently, 10 hospitals including two regional referral hospitals and the national referral hospital are implementing the standard.

Lyonpo said the initiative would be gradually rolled out to all health facilities in the country. “These tools and strategies define the scope of health professionals to undertake clinical tasks within an appropriate setting and standard procedure so that patient safety is ensured.”

On what kind of measures will be put in place in terms of access to controlled drugs by the health staff, he said all hospitals have a system in place to limit access to controlled drugs by keeping the drugs under strict lock and key. “Only few ward and operation theatres (OT) in-charges have access to controlled drugs.”

There is an existing process on access to and use of controlled drugs including maintaining proper inventory of the expired and damaged drugs and storing it under lock and key. The hospital will translate the process into written SoPs and strengthen monitoring, supervision and compliance.

“The ministry and the hospital have reminded all health professionals to strictly abide by the professional code of conduct including the access to controlled drugs, the danger of misuse of the controlled drugs and its administrative and legal consequences,” the minister said.

The hospital has also asked its staff to report if any of the OT staff behave abnormally or if they suspect misuse of controlled drugs.

Dechen Tshomo