NUH's clinical care processes 'appropriate' but communication can be improved: Janil Puthucheary on case of woman who lost baby

NUH has reviewed their processes and since implemented these improvements.

Ashley Tan | April 05, 2022, 01:46 PM

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Senior Minister of State for Health Janil Puthucheary addressed the case of the pregnant woman who allegedly lost her baby at the National University Hospital (NUH)'s Emergency Department (ED) on Apr. 5 in Parliament.

Members of Parliament (MPs) Ng Ling Ling, Edward Chia, Wan Rizal and Non-Constituency Member of Parliament Hazel Poa filed questions on the matter.

Janil offered his deepest condolences to the family, and shared that the couple has had discussions with the NUH team.

The case has since been closed, with the husband of the pregnant woman acknowledging in a Facebook post that his wife might not have lost the baby at NUH's ED.

He also clarified that that nurses did indeed check on his wife at intervals, and she was not left at the ED unattended for two hours as opposed to his initial claim.

Clinical care processes are "appropriate"

Janil confirmed the husband's statement, and revealed that NUH has investigated the matter "thoroughly", and reviewed their processes in consultation with the Ministry of Health (MOH) and the Director of Medical Services.

NUH's clinical care processes are "appropriate", Janil said.

However, there were some areas for "improved communications" and the coordination of transfers between the ED and the delivery suite. NUH has since implemented these improvements.

Janil added that due to Covid-19, EDs at public hospitals have faced high demand and healthcare workers have been working continuously to attend to all patients.

"All patients will triaged based on presenting history, symptoms and clinical parameters, so that those with life threatening conditions are prioritised. No patient will be denied care," he said.

Janil also thanked healthcare workers for their professionalism and dedication in caring for all their patients.

How can hospitals improve the provision of information?

Edward Chia, who shared that the couple are Zhenghua residents within his Holland-Bukit Timah GRC, also elaborated further that the husband revealed it was never his intention to cause any blame to the hospital or to healthcare workers.

Chia said:

"His intention was to really seek answers for the two hours of wait time that he and his wife experienced at the A&E. And it was so...because he was unable to seek answers or any response over a period of five days.

And this included the time when his wife was being treated at a high dependency ward. He finally got a response from a patient care officer when his post went viral."

Chia subsequently asked about how hospitals can improve the provision of information to patients and their families:

"Therefore I'd like to ask SMS following this incident, with the objective of improving protocols, would MOH be assessing how hospitals should improve the provision of critical information to patients in a timely manner with empathy?

I do believe that with greater transparency, this will strengthen the trust Singaporeans already have with our health care institutions."

Lessons will be learned and shared across healthcare system

Janil reiterated that NUH's clinical care processes had been "appropriate", and did not contribute to the outcome of what happened.

The NUH team looked through how they performed their communication and how they provided information that was available to reassure and inform the couple, Janil shared.

"Indeed, there were ways in which they can improve, they recognise this and they already instituted changes to their processes to make sure that information is provided in a timely manner. And done so in a way that is more acceptable, I think, to the patients and their families."

This review of NUH's processes was done in consultation with MOH and the Director of Medical Services, and the "lessons will be learned and shared across our healthcare system".

The best protection for healthcare workers

Following the initial backlash against healthcare workers after the incident came to light, MP Wan Rizal also rose to ask how these workers can be protected in the future should such incidents occur again.

"Adverse incidents will happen in these complex and high risk, high intensity situations. And when they do, everybody feels bad," Janil replied. "Anybody hearing about it feels a loss, feels sympathy."

Although healthcare workers might worry about whether they have made any errors upon hearing about such incidents, Janil shared that all allegations and comments need to be investigated.

This is the hospital's duty to the patients and the families they care for, so processes should be investigated.

Counselling and support available for healthcare workers

The best protection for healthcare workers, Janil opined, is therefore a "quick and thorough establishing of the facts that are involved", and this should be carried out in a way that "involves the healthcare worker systematically and professionally".

Healthcare workers are aware of these processes, but such cases might still be draining for them.

As such, counselling and psychological support is available for workers within the system, Janil said.

Ultimately, it would be most helpful if the public refrains from speculating about the case, Janil added:

"At root, however, it would be helpful if when allegations and incidents are raised, that these are based on facts rather than speculation."

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Top photo from Mee Pok Tah / FB and MCI / YouTube