ISQua's 39th International Conference

Enhancing healthcare workers' understanding of the medico-legal landscape in an acute hospital in Singapore
Patient Safety & Quality Improvement

C.S.KOH, G.H.LIM, J.CHIA, A.S.KOH and J.L.A.TAN
1 Medical Affairs, Ng Teng Fong General Hospital, Singapore, Singapore

P111

Introduction
With the rise of social media and patients having increased access to medico-legal (ML) information, managing clinical complaints and ML cases has become more complex. Being up-to-date with the ever-changing ML landscape would allow healthcare workers (HCWs) to be better positioned in avoiding potential pitfalls, increasing the ML risk management capabilities to deal with adverse events and complaints when they arise. Understanding how complaints are being managed would also help allay anxieties when HCWs are involved, improving cooperation in the management of complaints.

Objective
Using root cause analysis, the project team identified a knowledge gap among HCWs in their understanding of the ML landscape. Due to the lack of a structured education programme, HCWs may inadvertently overlook essential legal considerations in their course of work, potentially leading to legal consequences, professional disputes, or compromised patient care. This study investigated the impact of the project team’s education and outreach efforts in enhancing HCWs’ understanding of the ML landscape.

Methods
The project team implemented a series of education and outreach efforts in four areas:
Engaging Leadership
Briefings for new clinical heads to introduce essential information on managing adverse events and ML cases
This promotes understanding of key processes, allows clarification of misconceptions, and fuels a collective sense of team engagement
Building Local Expertise
Increase pool of local experts through appointment of department ML reps, who play a supportive role in the management of complaints
Department specific talks are held based on departments’ needs and topics of interest
Fostering Awareness
Semiannual talks covering latest ML regulations and thematic issues
Introduction of a five modular education series covering ML fundamental topics such as clinical negligence, consent and patient confidentiality, conflict de-escalation, alternative dispute resolution and open communication
Learning From Experience
A learning repository was set up to share past clinical incidents and complaints
Easily digestible decks summarising sequence of events, case analysis, corrective and preventive measures, legal orientation, and key learning lessons are made accessible
Surveys were conducted among HCWs who participated in the programmes in 2022. 127 forms were received. Participation was voluntary and responses were anonymized and kept condidential.

Results
126 out of 127 (99.2%) respondents felt that the sharing of real-life cases and role plays helped them learn to better manage adverse events and complaints. 124 out of 127 (97.6%) of respondents indicated they gained new and useful knowledge from the medico-legal topics shared. The effectiveness of the programmes were reflected in the comments received from the respondents, who shared that the “trainers were excellent with great skills” and there was a “good balance between theory and practical skills”. Suggestions such as to invite more speakers to provide other perspectives, e.g. HCWs personally involved in litigation to share their experiences, were also received from the respondents. Feedback will be considered to refine future programmes, enabling continuous improvement to meet the evolving needs of HCWs.

Conclusion
The study shows that HCWs had found the medico-legal education and outreach efforts to be effective in enhancing their knowledge in this field. It empowers them to identify potential areas of liability, mitigate risks associated with legal pitfalls, enhance patient safety, minimise malpractice claims and the anxieties it brings.
As some of the programmes were newly introduced in 2022, there is a need to further measure how the enhanced medico-legal knowledge of the HCWs' impacts the institution's management of adverse events and clinical complaints.