Re­spect­ing pa­tient rights

The Jakarta Post - JPlus - - Between The Lines -

“Pa­tients who come to ‘sur­ren­der them­selves’ to a hos­pi­tal have rights-one of which is ac­cess to the best med­i­cal ser­vice,” ac­cord­ing to Dr. Andry, the chief op­er­at­ing of­fi­cer of the Siloam Hos­pi­tals Group.

Re­spect­ing those rights is a con­stant fo­cus of the man­age­ment of the Siloam Hos­pi­tals Group as it keeps grow­ing.

Go­ing to a hos­pi­tal for med­i­cal treat­ment means that a pa­tient has en­gaged with the hos­pi­tal in a legally pro­tected ther­a­peu­tic trans­ac­tion, he said, adding that doc­tors and other health­care providers al­ways had to be aware of the things that pa­tients did not know.

“On one hand, pa­tients lack knowl­edge about the med­i­cal in­ter­ven­tions that a doc­tor might con­duct. On the other hand, the doc­tors have com­pe­tency in their re­spec­tive med­i­cal fields,” he says. “Legally speak­ing, doc­tors have an obli­ga­tion to give pa­tients enough med­i­cal knowl­edge so that they fully un­der­stand about the in­tended med­i­cal in­ter­ven­tion.”

As an ex­am­ple, Andry cites the hy­po­thet­i­cal case of a pa­tient un­der­go­ing an ap­pen­dec­tomy. “Prior to the op­er­a­tion, the pa­tient should ex­er­cise their right to ob­tain in­for­ma­tion on the op­er­a­tion un­til they un­der­stand it and give in­formed con­sent.”

If there is a lan­guage bar­rier, the pa­tient still has right to be ad­e­quately in­formed and would be al­lowed to have a rel­a­tive to help fa­cil­i­tate un­der­stand­ing. At Siloam, there are mul­ti­lin­gual nurses and doc­tors who are ready to fill this role for the pa­tients, as well. “In­formed con­sent is sig­nif­i­cant so as to avoid the pos­si­bil­ity of fil­ing suits by ei­ther the pa­tient or the fam­ily, or by the doc­tor in case the op­er­a­tion does not run as planned,” he says. At Siloam, doc­tors are re­quired to have good com­mu­ni­ca­tion skills as well as well-de­vel­oped senses of pro­fes­sion­al­ism, hon­esty, dis­ci­pline and team­work.

A hos­pi­tal can­not sim­ply aim for prof­its, he adds: A hos­pi­tal must pri­or­i­tize its so­cial func­tions: Of­fer­ing ex­cel­lence and max­i­miz­ing the wel­fare of its pa­tients.


Siloam In­ter­na­tional Hos­pi­tals of­fers in­ter­na­tion­ally rec­og­nized qual­ity ser­vice, ac­cord­ing to Andry. “The word ‘in­ter­na­tional’ has been used to en­sure that there is a health­care bench­mark with pa­ram­e­ters to which we can refer to as far as qual­ity med­i­cal ser­vice is con­cerned.”

That’s why the man­age­ment of the Siloam Hos­pi­tals Group has adopted the six-point “In­ter­na­tional Pa­tient Safety Goals”: Iden­ti­fy­ing pa­tients cor­rectly; good com­mu­ni­ca­tions; im­prov­ing safety for high-alert med­i­ca­tions; mak­ing sure that the right pa­tient is at the right lo­ca­tion for the right pro­ce­dure; en­sur­ing staff wash their hands; and avoid­ing pa­tient falls.

By ad­her­ing to these prin­ci­ples, mis­takes re­lated to med­i­cal care can be pre­vented, Andry says.

“In re­la­tion to iden­ti­fi­ca­tion, for ex­am­ple, a lab­o­ra­tory worker will first iden­tify the pa­tient’s name, date and place of birth. Oth­er­wise, the worker may ac­ci­den­tally take that blood of some­one else that has the same name,” he says. “If this hap­pens, it might lead to tak­ing the wrong blood sam­ple, an in­cor­rect di­ag­no­sis and a bad pre­scrip­tion. Iden­ti­fi­ca­tion is there­fore very crit­i­cal.”

Hand wash­ing is also im­por­tant, he says, adding that about 20,000 deaths a year across the globe can sim­ply be at­trib­uted to health­care work­ers or oth­ers on the team who do not fre­quently wash their hands.

“When you are al­lowed to en­ter an ICU, the first thing you should do is wash your hands, in­stead of tak­ing off your shoes or wear­ing a spe­cial uni­form,” he says.

To cul­ti­vate a cul­ture that re­spects the In­ter­na­tional Pa­tient Safety Goals, the man­age­ment of the Siloam Hos­pi­tals Group re­quires new em­ploy­ees to at­tend a three-month ori­en­ta­tion pro­gram, while nurses and doc­tors must for­mally de­velop their skills on a re­cur­ring ba­sis.

“Would-be nurses who join an ap­pren­tice­ship pro­gram are pro­hib­ited from at­tend­ing [pa­tients] or the un­su­per­vised ad­min­is­tra­tion of any ser­vices to a pa­tient un­til they com­plete the pro­gram, be­cause en­sur­ing a pa­tient’s safety is of ul­ti­mate im­por­tance to us,” Andry says.

In ad­di­tion, all hos­pi­tal work­ers, in­clud­ing se­cu­rity of­fi­cers, are re­quired to com­plete ba­sic car­diac life sup­port (BCSL) train­ing and aware­ness. In that way, they can give first aid in case, for ex­am­ple, some­one has a heart prob­lem or is in need of life sup­port.

The man­age­ment also runs sev­eral con­scious­ness rais­ing pro­grams about pa­tients’ rights, so its cus­tomers can re­ceive the best pos­si­ble ser­vice.

“Through our brochure ‘Speak Up’, pa­tients are en­cour­aged to com­mu­ni­cate with or gain de­tailed in­for­ma­tion from their doc­tors,” he says. “They are also en­cour­aged to ask health­care work­ers who help them whether they have washed their hands be­fore ex­am­in­ing them.”


Andry, who has a back­ground in med­i­cal law, joined the Siloam Hos­pi­tals Group in 1995, fol­low­ing a tour as a doc­tor in Pa­pua, where he de­vel­oped a pas­sion for hos­pi­tal busi­ness man­age­ment.

“I found that build­ing an ef­fi­cient hos­pi­tal sys­tem was very crit­i­cal, as this would en­able all rel­e­vant par­ties in­volved in health­care, such as doc­tors, nurses, etc… to work ef­fec­tively ac­cord­ing to their re­spec­tive roles.”

The Siloam Hos­pi­tals Group started to adopt such a sys­tems ap­proach at Siloam Hos­pi­tals Lippo Karawaci in 1996.

While not per­fect, the sys­tem is un­der con­stant im­prove­ment. It is like tend­ing a gar­den, which re­quires groom­ing, wa­ter and care. Oth­er­wise, it will be wither. The im­por­tant thing is we strive to make to­day better than yes­ter­day,” he says.

As more peo­ple suf­fer from ill­nesses such as coro­nary heart dis­ease, strokes or di­a­betes, the man­age­ment of Siloam Hos­pi­tals Group is mulling over es­tab­lish­ing an in­te­grated clinic in­volv­ing doc­tors from var­i­ous spe­cial­ties to ap­proach these life­style-re­lated dis­eases.

“As for busi­ness, I want to con­tinue to con­trib­ute my part, in a team, in de­vel­op­ing Siloam’s hos­pi­tals into role mod­els for other hos­pi­tals in In­done­sia, ”Andry says.

The father of two has a hobby of drink­ing cof­fee, which he mostly does in the com­pany of his lov­ing wife, who also en­joys drink­ing cof­fee. To keep in shape and re­main healthy, Dr. Andry main­tains a habit of walk­ing his dog in the morn­ings be­fore go­ing to the of­fice.

This ar­ti­cle is part of a se­ries spon­sored by the Siloam Hos­pi­tals Group.

DR. ANDRY Chief Op­er­at­ing Of­fi­cer of the Siloam Hos­pi­tals Group

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