Head Office (HAHO)

The HA Head Office (HAHO) aligns corporate values and directions. It plays a strategic role in leading corporate development and supporting hospital clusters through interactive collaboration of six divisions, namely Cluster Services, Corporate Services, Finance & Information Technology Services, Human Resources, Quality & Safety, and Strategy & Planning.

In 2011-12, the HAHO initiated some 100 corporate targets corresponding to the five key strategic objectives outlined in the HA Annual Plan. It also made various endeavours in contributing to sustainable development.

Key Achievements

Strategic Objective: Implement a Planned Response to Manage Growing Service Demand

To meet rising service demand, modest increase was made in service capacity in priority areas despite healthcare workforce shortage. A new community health centre was opened in Tin Shui Wai as a one-stop centre to provide comprehensive primary care services by multi-disciplinary healthcare professionals. Capacities in cardiac care and primary / emergency percutaneous coronary intervention (PCI) were expanded; number of places in dialysis for patients with end stage renal failure were increased; and overall throughput of cataract surgeries were enhanced. Coverage of palliative care service was extended to 2,000 additional patients.

Initiatives were implemented to enhance primary care and optimise chronic disease management. They included expansion of the health call centre service to support high risk diabetic patients with electronic referral mechanism and protocols developed, and the establishment of a 24-hour hotline in January 2012 to support mental health. Multi-disciplinary teams were set up in selected general out-patient clinics to deliver protocol-driven care to diabetic and hypertension patients. Treatment duration of home visits provided by community nurses for chronic disease patients was enhanced. The Integrated Mental Health Programme was rolled out to benefit over 6,000 patients with common mental disorders.

Ambulatory and community care is important in preventing avoidable hospitalisation. Integrated care platforms across acute and community care settings were set up in all clusters to enhance discharge planning and case management visits to patients. Two community nursing centres commenced service in October 2011 in Yuen Long and Chai Wan respectively to serve local elderly population, and two other centres were being prepared. Three virtual wards were set up in Kowloon regions to provide enhanced care to patients with complex conditions.

Community care for patients with severe mental illness was strengthened through case management programmes and crisis intervention teams. The Early Assessment Service for Young Persons with Psychotic Disorders (EASY) programme was extended to adult patients with first episode psychosis aged between 26 and 64. Psycho-geriatric outreach service was also extended to cover more private residential care homes.

As part of the Government’s healthcare reform, public-private partnership (PPP) projects were launched as alternative models of service to meet increasing demand and promote collaboration between the public and private sectors. In 2011-12, capacity of the haemodialysis PPP programme was expanded from 70 to 100 places, and 3,000 additional cataract surgeries were provided under PPP. In March 2012, a pilot radiology PPP project was initiated to augment the provision of radiology service.

The Chinese Medicine Centres for Training and Research, set up in collaboration with non-government organisations and local universities, delivered about one million attendances in 2011-12. A new centre was opened in Kowloon City in December 2011.

Strategic Objective: Improve Continuously Service Quality and Safety

Committed to continuous quality improvement, HA implemented projects to promote safety culture and strengthen risk management. A specialty-based crew resource management (CRM) training programme was developed in two acute hospitals to facilitate the use of available resources, including people, process and technology, to enhance safety and operational efficiency. Pharmacy service was improved by expanding pharmacist coverage in general out-patient clinics, extending service hours in acute hospitals, developing clinical oncology pharmacy service, and upgrading aseptic dispensing service.

The safety of using reusable surgical instruments was enhanced with the elimination of flash sterilisation, and phasing out of re-use of moderate to high risk single use devices. A long term plan to improve the standard of operating theatre sterile services was formulated, and a framework for common cataloguing of surgical instrument was developed. Preparation has commenced for the development of a tracking and tracing system of surgical equipment.

HA’s hospital accreditation programme, which aimed to improve quality systems and clinical governance, continued. Last year, five public hospitals successfully attained full accreditation status recognised by international accreditation agency. In 2011-12, preparatory work has commenced for another 15 public hospitals in phase 2 accreditation programme. Training and development in building up a workforce of local surveyors progressed well with 16 surveyors appointed during the year.

Enhancement of the Advance Incident Reporting System to enable simpler data input and upgraded data analysis capabilities was completed in 2011-12, facilitating effective monitoring and tracking of incidents thus improving patient safety.

Various data security measures were implemented on an ongoing basis to ensure protection of patient data, including staff education, computer controls, regular monitoring of access to patient data, and security compliance checks throughout hospitals and clinics.

To reconfigure services and promote timely intervention for service improvement, the cancer case management programme, which had been piloted in two clusters, was extended to two more clusters to improve the quality of cancer services. Case managers were recruited and trained to deliver integrated care to patients with complex breast and colorectal cancers. Efforts were made to augment diagnostic radiology services to meet rising demand, e.g. operating hours of CT / MRI scanners in three clusters were extended, benefiting 4,000 patients more.

On mental health front, child and adolescent psychiatric service was enhanced by providing timely assessment and intensive intervention for children with autism spectrum disorder or attention deficit hyperactivity disorder.

Strategic Objective: Keep Modernising HA

Good corporate governance is of fundamental importance. Last year, HA initiated an independent consultancy review on its corporate governance practices to drive for continuous improvement. The phase 1 review, which focused at the Board level, was completed in late 2011. Implementation actions were made on all fronts to consolidate corporate governance practices, including to enhance the role of the Executive Committee; further involve the Board in long-term strategic planning; develop an integrated enterprise risk management approach as a holistic framework for managing risks facing HA; strengthen executive support to the Board, and revisit the terms of reference of its committees.

At the management level, HA engaged a consultant in 2011-12 to review its management and control framework. The study reinforced the effectiveness of the framework with identified improvement opportunities for implementation. Separately, a follow-up review on HAHO’s organisational structure was conducted to appraise the effectiveness of major changes made in 2006 and to consolidate the functions of clusters coordination, corporate communication, staff engagement and grade management, etc.

To maintain a healthy corporate image, HA implements proactive strategies to enhance communication and rapport. During the year, a total of 380 media events and activities were organised, 300 press releases were issued and 2000 media enquiries were handled.

On the clinical front, new technologies and treatment options with proven cost-benefit were introduced. 2011-12 saw the expansion of clinical applications of nine new drug groups to the HA Drug Formulary, covering a wide range of diseases. Three new self-financed drug items were introduced under the scope of the Samaritan Fund, and the indication of one existing drug was also extended. Three new HSCT (autologous haemopoietic stem cell transplant) centres on top of the three existing centres were set up in the year to enhance bone marrow transplant service. Prenatal screening for Group B Streptococcus (GBS) was introduced for eligible pregnant mothers.

HA regularly updates its medical equipment and capital facilities through additional investment. During the year, a total of 756 pieces of obsolete medical equipment and 29 engineering plants were replaced. Renovation works were carried out in 13 general out-patient clinics to improve outdated amenities, barrier-free access and pharmacy facilities. A total of HK$44.7 million was invested to procure 2,554 electrically operated beds and 1,500 pressure relieving mattresses, improving not only patient comfort, but also relieving physical stress for staff.

New information technology (IT) infrastructures are essential for supporting clinicians in efficient and effective delivery of modern healthcare services. Continuous revamp of HA’s Clinical Management System and related Clinical Departmental Systems are ongoing to modernise technology platforms, as well as introduce new or revamped functions, e.g. clinical dashboard, electronic referral, integrated care module etc. The Filmless HA project was further extended to 12 hospitals in 2011-12, reducing the use of traditional films and contributing to the electronic medical record system. The pharmacy procurement system was also upgraded to better monitor product quality and performance of suppliers.

HA has completed high-level design of the eHR sharing platform and core infrastructure in the Government initiated eHealth Record (eHR) Programme, and has started to develop the Clinical Management System extension modules targeting for implementation by the end of 2013-14. HA also provided IT support to the Government’s Elderly Health-care Voucher Scheme, Government Vaccination Scheme, Primary Care Directory System, and Communicable Disease Information System.

Last year, through an in-depth strategic planning process involving thorough environmental scanning and extensive consultation of some 750 stakeholders, including the HA Board, patient groups, staff representatives, clinicians and executives, the HA Strategic Plan 2012–2017 was formulated. A comprehensive strategic service framework for elderly patients was drawn up to guide the development of elderly care services in HA. Clinical service plan and master development plan were developed to steer the redevelopment of the United Christian Hospital.

Modernised service demand projection models were developed to guide demand management in HA hospitals, including quantification of the impact of cross border Eligible Person population on service utilisation, and projection of birth deliveries for assessing the need for additional neonatal intensive care and related services. Statistical analysis on all clinical specialties was completed and nursing manpower indicators were developed to support the formulation of workforce strategies.

Strategic Objective: Build People First Culture

To enhance professional competencies and build up effective management and leadership, a full spectrum of training strategies and initiatives were implemented, ranging from training on mediation and conflict resolution to leadership skills enhancement, benefitting over 1,600 frontline staff and 600 frontline managers. A total of 28 competency enhancement classes were organised for 2,660 supporting staff in 2011-12 to strengthen their personal, functional, people and team skills. Another 32 classes of vocational training were conducted for 800 patient care supporting staff.

Training on leadership skills and capabilities were offered to managers of different levels. A four-day management programme titled Management 202 was introduced for experienced frontline managers to strengthen their capabilities on self management, engaging others, assimilating teams and delivering results. Over 600 employees participated in the programme, achieving 70% of the target group.

A basket of measures were implemented to build a favourable working environment that attracts, retains and motivates well qualified employees. In addition to recruitment of more staff for relieving workload in pressure areas, opportunities of promotion and career advancement and succession planning were enhanced through job rotation, creating senior posts and better remuneration. A new promotion mechanism was implemented in 2011-12 to provide more promotion opportunities to qualified and experienced specialist doctors with meritorious performance, resulting in the promotion of 167 medical officers or resident specialist doctors to associate consultants during the year. The annual Consultant Advancement Exercise reactivated last year was conducted with 53 consultants advanced to senior consultant posts. For nurses, 50 nurse consultant and 150 advanced practice nurse posts were added. A pilot rotation scheme for senior healthcare administrators was also initiated to increase their exposure in management and hospital operation. A sponsorship scheme on Enrolled Nurse training was piloted in 2011-12 to provide supporting staff with professional nurse training and development opportunities.

Succession planning was strengthened by setting up succession management committees at the central and cluster level to formulate succession plans for strategic and operational leadership positions. Structured development programmes were offered to those selected into the succession pools.

Employment terms and conditions for a number of clinical staff groups such as part-time doctors and non-local doctors practising under limited registration were reviewed and enhanced in 2011-12 to strengthen and support local and overseas recruitment drives. Enhanced overseas remuneration packages for diagnostic radiographers, radiation therapists and podiatrists were also improved to help recruit allied health groups with manpower shortage. As at end March 2012, 12 non-local doctors, 287 new residents, 121 part-time doctors, 1,741 nurses and 351 allied health professionals were recruited in the year.

To continuously modernise the human resources functions and improve their efficiency and effectiveness, HA has upgraded its Human Capital Management System with enhancements in automation and self-service functions. The HA online learning platform, e-Learning Centre, won Silver Award in Best Professional Development in the Hong Kong ICT Award in 2012.

Strategic Objective: Maintain Financial Sustainability

The Government allocated HK$38 billion to HA in 2011-12. Throughout the year, the Authority made vigilant efforts to ensure optimal and value-for-money utilisation of resources in delivering quality patient care to the people of Hong Kong. With prudent financial management and close monitoring of performance, a surplus position was achieved for 2011-12.

The Pay-for-Performance (P4P) internal resource allocation system continued to provide HA with a framework to ensure that deployment of resources was in line with HA’s strategic areas of need. In context of heavy workload and manpower shortage, 2011-12 was a year of consolidation for the P4P system. Apart from its use as a tool for resources allocation, casemix data was also deployed to improve operation management and clinical outcome review. Another focus in the year was the review of the Quality Incentive Pilot (QIP) Programme introduced last year. Findings of the review supported the use of financial incentives to foster quality improvement.

Another focus in the year was the review of the Quality Incentive Pilot (QIP) Programme introduced last year. Findings of the review supported the use of financial incentives to foster quality improvement.

Contributing to a Green Environment

As a responsible corporate citizen, HA strives to deliver environmental friendly hospital services with a view to contributing to a green environment for sustainable development. “Oil-free” air-cooled chillers were installed as a pilot in the new Ambulatory Block of Tseung Kwan O Hospital to further conserve electricity consumption. LED and compact fluorescent lamps were progressively retrofitted to replace less efficient incandescent light bulbs. These examples of energy conservation initiatives helped HA reduce carbon emission. In 2011-12, carbon audits in all hospitals were completed, with 30 hospitals achieving the “carbon-less certificate” for meeting the carbon emission reduction standard of the Hong Kong Awards for Environmental Excellence Scheme.

Actions were taken to comply with new regulatory requirements of the Clinical Waste Control Scheme. Instead of disposal by landfill, clinical waste from hospitals and clinics was collected by licensed collectors under HA central contracts to designated disposal facility of the Environmental Protection Department at the Chemical Waste Treatment Centre at Tsing Yi for disposal by incineration.

Various waste reduction and recycling programmes were implemented to promote environmental protection. Quoting a few examples, a total of 2,300 tonnes of recyclables including waste paper, plastic, metals, glass bottles and used clothes were collected in the hospitals in 2011; the use of computer papers, hard copy pay slips and medical treatment forms were significantly reduced after digitalising the services; and recycling programmes of used fluorescent tubes, used rechargeable batteries, and plastic bottles continued to be implemented.

Environmental friendly LPG vehicles were gradually introduced to HA with replacement of 18 Non-Emergency Ambulance Transfer Service (NEATS) vehicles in 2011-12. Similar replacement of another 35 vehicles is planned for 2012 to 2014. In addition, the pool car transport services of HAHO, Castle Peak Hospital, Kwai Chung Hospital and Siu Lam Hospital won encouraging accolades in the Corporate Green Driving Award Scheme 2011 in Take a “Brake” Low Carbon Action for commendable fuel efficiency performance.

As of 31 December 2011, 28 hospitals / institutions and HAHO were awarded the “Class of Excellence” Wastewi$e Label by the Hong Kong Awards for Environmental Excellence.