Singapore launches framework to protect healthcare workers from abuse and harassment

SINGAPORE: A framework aimed at protecting healthcare workers from abuse and harassment was launched on Wednesday (Dec 13).

The framework provides all healthcare institutions with a common definition of abuse and harassment, as well as a consistent set of standards to safeguard their workers, said the Ministry of Health (MOH) in a press release.

Once adopted, healthcare workers can take "immediate action" to protect themselves from harm, such as activating security officers.

The framework consolidates the findings and recommendations released in March by a tripartite workgroup, comprising representatives from MOH, the Healthcare Services Employees' Union, public healthcare clusters, community care partners and private healthcare providers.

The recommendations of the workgroup are to protect healthcare workers who face abuse and harassment, prevent situations that lead to such abuse, and "promoting positive relationships" between healthcare workers and patients or their caregivers.

"While the vast majority of patients and their next-of-kin are respectful and appreciative towards healthcare workers, there is a small minority of individuals who resort to words and actions which are abusive to healthcare workers," said MOH.

"To provide quality patient care, healthcare workers need to work in an environment where they feel safe and are not threatened or traumatised by incidents of abuse and harassment."

In March, the workgroup said almost one in three healthcare workers in Singapore witnessed or experienced abuse at least once a week.

MOH said the workgroup has scanned best practices and engaged stakeholders to develop the framework for implementing a zero-tolerance policy against abuse and harassment.

Public healthcare clusters have committed to adopting the framework, and aim to revise and update their internal protocols across their hospitals and institutions by June 2024.

“With the adoption of the framework, healthcare workers can look forward to a safer working environment,” the ministry added. 

WHAT THE FRAMEWORK ENTAILS

With the adoption of the framework, healthcare workers can take immediate action to protect themselves and others from harm, such as by "firmly telling the perpetrator to stop their abusive behaviour or activating security personnel". 

Every public healthcare institution will have a staff protection function, such as a team, to oversee proper and fair reviews of reported abuse and harassment incidents.

"Necessary physical and wellness support will also be provided for staff who are victims of abuse and harassment," said MOH.

In addition, healthcare institutions will have the autonomy to take action against perpetrators. This includes discharging abusive patients who are assessed to not require urgent medical care, issuing warnings, removing abusers from the premises, and refusing unreasonable requests outside of the healthcare workers’ job scope.

Repeat offenders will have their behaviour documented in their medical records, MOH said. 

The ministry added that other healthcare institutions, such as community care organisations, private hospitals and clinics, are also encouraged to support the zero-tolerance policy and adapt the guidelines for their work environment. 

Professor Philip Choo, group chief executive officer of the National Healthcare Group, said: “We recognise that the vast majority of people we serve are respectful to our healthcare workers and the work that we do. 

“However, we cannot allow the behaviour of a minority of individuals to wear down the morale of our staff and make it difficult for them to provide high standards of care.”

He added that staff protection teams will be set up at all of the healthcare group’s institutions and that training efforts will be stepped up to help employees learn how to manage incidents of workplace abuse and harassment.

For the National University Health System, there are existing protocols and a staff protection programme, including education, training, and a case escalation process, said chief executive Professor Yeoh Khay Guan. 

"Staff are encouraged to report incidents and support one another, with consequences for abusive patients and visitors," he added.

Group CEO of SingHealth, Professor Ivy Ng, said it “fully supports” the framework and implementation guide by the tripartite workgroup.

“We take a zero-tolerance stance towards the abuse and harassment of our staff, and will not hesitate to take necessary actions in reporting and standing up against such behaviour,” she added.

MOH said: "The impact of each act of abuse and harassment is profound, extending beyond the trauma to the immediate victim.

"It destroys the trust between patients/ next-of-kin and healthcare workers, and adversely affects the quality of patient care."

SUPPORT FOR HEALTHCARE WORKERS

MOH Holdings – the holding company of Singapore’s three public healthcare clusters – will progressively roll out a national public education campaign.

It aims to promote positive relationships between healthcare workers and patients, their caregivers and families, as well as encourage a zero-tolerance policy against abuse. 

“The goal is to foster positive empathy by driving much-needed conversations and inspire actions that will safeguard the well-being of our dedicated healthcare workers,” said MOH.

Speaking to reporters during the launch of the framework, Health Minister Ong Ye Kung said: “Although Singapore is now in DORSCON Green, our hospitals were never in DORSCON Green.

"Throughout the whole pandemic, after the pandemic, they have been very busy."

He was referring to the Disease Outbreak Response System Condition (DORSCON), which was lowered from yellow to green - the lowest level - in February as the COVID-19 situation stabilised. 

Mr Ong said: "You know that hospitals are quite full. We always have a big crunch. We're not the only country - every country is experiencing the same thing after COVID-19."

He added: "So you just imagine …. for many years now, day in, day out, with that kind of workload. They really need all the support we can give them.”

Mr Ong said that while the majority of patients are appreciative of healthcare workers, there is a “small minority” that gets angry and abusive. 

“We really need to protect our healthcare workers against abuse, lift up their morale ... because that's the best way to help them serve the great majority of … patients.”

Asked about the timeline for implementing the framework, Mr Ong said institutions that are ready may go ahead to do so.

In response to a question about healthcare workers dismissing abuse, Mr Ong noted that many healthcare workers have been “trained to really stomach everything” and be professional no matter what happens.

Abuse may cause significant emotional or mental harm to healthcare workers, added the minister.

“(It’s) better (to) correct the situation, tackle it at its roots and not let abuse become something that we expect healthcare workers to tolerate,” he said.

This article was originally published on ChannelNewsAsia. Its inclusion on this website is solely for education purposes.