Weightage of Patients' Feedback on Performance Grading of Nurses

23 Mr Louis Ng Kok Kwang asked the Minister for Health (a) whether feedback from patients and their families is taken into consideration in a nurse’s performance grading; (b) if so, what is the weightage given to such feedback in a nurse’s performance grading; and (c) how are nurses protected against unfair feedback or abuse by patients or visitors.

The Senior Parliamentary Secretary to the Minister for Health (Ms Rahayu Mahzam) (for the Minister for Health): Nurses’ performance appraisal is holistic and includes various key areas, such as the provision of timely and quality patient care, display of leadership capabilities and professional and personal development. While institutions take feedback from patients and their family members seriously, this is not used to directly determine the performance grade that a nurse receives.

In general, feedback from patients and their family members is considered an integral part of quality and care improvement for our public healthcare institutions. Positive feedback is conveyed to the nurses and care team to recognise their efforts as well as to encourage and motivate them to keep up the good work. On the other hand, negative feedback is looked into in case there is a need to address any gaps in quality of care in the spirit of continuous improvement.

As for abuse and harassment, our public healthcare institutions take a serious stance against these and staff are encouraged to report such instances to their supervisor or appropriate whistle-blowing channels if necessary. These will be looked into fairly, as it is crucial to protect and support staff against abusive patients or family members accompanying patients. When necessary, Police reports have been lodged before, for the Police to conduct further investigations and actions to be taken.

Mr Speaker: Mr Louis Ng.

Mr Louis Ng Kok Kwang (Nee Soon): Thank you, Sir. I thank the Senior Parliamentary Secretary for the reply. I think she mentioned that it is not considered directly in the appraisal. So, could I just ask and confirm again that the negative feedback about nurses that they receive from the patient or the family will not directly affect their bonus, appraisal or their promotion as well?

Second, I think MOH has shared that the Care Ambassador position will be made permanent and there might be some job redesign as well. Could I just ask for a timeframe for that? This is because I think that will help in terms of having some staff members on the ground who are customer service trained in the wards and can handle some of these complaints and feedback that the nurses receive.

Ms Rahayu Mahzam: I thank the Member for the question. I just want to, firstly, mention that the nurses are in the business of patient care. So, it is about making sure that they are taking care of the patients well. And if there is feedback from the patients and family members, we do have to consider this. It is an integral part of the quality and care improvement for public health institutions (PHIs). But this is something we look at in general.

Holistically, when we talk about bonuses, when we talk about their promotion, a lot of other aspects come into play and this something that all nurses would know and that has been practised by the PHIs. We do take the concerns of patients and family members and, if it impacts their work and their performance, we then need to take action. In some ways, it does have some relevance, if it is investigated and if there are some areas where the nurses can improve, this needs to be taken into account. Training may be provided, some support may be provided. So, in some ways, it does impact on their performance and appraisal, but this is not the only factor. Promotion and bonus are things which will come after looking at the whole performance holistically.

On the second issue about Care Ambassadors, I note that the Member has been concerned about the workload and having to balance some of the issues that the nurses have raised. We have been working on this, as the Member is aware. There have been various efforts. The public healthcare institutions, especially different clusters, all have different efforts that they are putting in place. Some of these things we are harmonising to see how we can make sure that all the clusters can also step up and have similar practices amongst them. This is something that is a work-in-progress. And in different institutions, there may be some things that they can do first, there may be somethings that they can do faster and we are letting that happen. But, in general, this is a work-in-progress and we will make the appropriate announcements when it is ready.