gsm_1999_24_a soft systems
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UNIVERSITI PUTRA MALAYSIA
SELAYANG HOSPITAL PROJECT
CHOR CHOY YOOK
GSM 1999 24
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SELAYANG HOSPITAL PROJECT
BY
eHR eHY YK
Project Paper Submitted Partial
Fulment of the Requirement for the
Degree of Master of Business Administraton
Malaysia Graduate Schoo of Management
Januar 1999
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Pengesahan Keasan Lapuran dengan ini
saya Chor Choy Yook
No : Matrik ; 535
mengatakan baawa kertas roject I
kajian kes untuk kursus,
Sarjana Pentadbran erdagangan SN 53
ada lah : has usaa saya senir.
Tnngn;
Trikh: 30hb J 1999
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T ABLE O CONTENTS
A CASE STUDY O THE SELA YANG HOS PTAL PROJECT (SH P) ............. ...........
NTRODUCTON................................................................ ...................................................
PHYSICA LA YOUT.
FACIITES 5
COE O CNCA SERCES N EAYANG OSTA 5
ViSiON6
MOO 7
RGANZATIONA TRUCTURE 7
APPLCATONS O NORMATON TECHNOLOGY (T) .................... ... ................. 9
OTA OSTA NORATION YSTE ()
AGES ( ESS ENIRONENT
ECTRONIC MEDCA ECORD (M IDINiSTRATION
DANTAGES O 2
6 MON YSTE OR OSTA 2
RANING 4
SELA YANG HOSPTA DRY RUN N JANUARy...................................................... 5
ORMATON O SELAYANG HOSPTA CORE TEAM AND T COMMTTEE.
HU MN RESOURCE PANNNG.................................... ................................................9
REATED SSUES............................................................................................................... TA TRANSER 2
OAINTS 2
SEAYANG HOSPTAL - M PEMENTATON PHSE .............................................
MEETN G WTH THE D RECTOR GENERAL O HEALTH....................................
CASE ANALYSS .................................................................... ............................................. 9
SYNOPSIS OF E SE..................................................................................................
ASE SS UES ........................................................................... .......................................... ..
LCK 0 NCENTVES ........................................................................ .............................
ECOGNTION . ERSEA TR MONETARY 6
PR HUMAN RESURCE PLANING.......................................... ................................
pICATION NAySTS
MPEMENTATON O STRATEGC PAN................................................................
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RESISTANCE TO CHANG - FEAR O IT
LINE O OMMND NO WELL DEINED 7
REOMMENDON
RECOGN ITON. .... 49
MONETAY 50
SITE ViiT51
PEN AKET ECUITENT . 5
ONTACT NUE 54
GANIZING ECITENT CAPAIGN 54
STAFF TANFE FOHKL 54TTACHENT IN HKL 55 - RECUiT 55
LEX OU 56
AT E UNG 5
ONDUC UVEY 5
OVEROMN ER O
I NFEEZNG TAGE INFOATIVE TATEGY ..58
. NFEEZNG TAGE IPLEENTING TATEGY . 59
3 REFEEZING TAGE ATINAL ATEGE 0
ESTABLISH LINE OF COMMAND
NCOPOATE ECTO OF HKL NTO THE COE TEA1
PREERRED REOMMENDTON
PEN AKET ECUITENT 2
EIATE TANFE OF TWENTY PECENT QUOTA OF TAFF FO HKL. 2REWA WHEN THE ECONOY IPOVE
REFERENCES63
APPENDX66
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A CASE STUDY OF
THE ELAYANGHOSPIAL PROJEC (HP)
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Inroducion
The planing of Selayang Hospital stared in 1996, a proposed 960-bedded hospita ocated
on a 15.8 hectare site along the Kepong Selayang road within the Majlis Perbandaran of
Seayang of Gombak District in the state of Selangor Selayang Hospital (SH) is a
govement owned utra mode hospita in the country It has sophistication of a luxury
private medical center with state of the art technology t is one of the hospitals built
under the Seventh Malaysia Plan (7th MP) to reduce congestion at the Kuala Lumpur
Hospita (H)
Health Minister Dato' Chua ui Meng (Viswanathan, 1998) said that the reasons for
building this 960bedded hospita is because the Ministry of Health (MOH) had for a
longtime reaized that the KLH was too much overcrowded with patients Physicaly the
KLH was aready bursting to its imits wit staff overworked, quality of patient care
compromised and as a resut patient's dissatisfaction and compaints
Proper documentation on archives was not avaiabe with many patients records mislaid or
missing This had resuted on many lost cases for the KLH in legal matters
t was with the above background that the MOH came up with SHP with its mode IT
setting.
Physical Layout
The Selayang Hospita is buit on a sma hi with andscape layout The two blocks each
thirteen story high cater to the inpatient ward and clinical wards There are thirtyone wards
which are made of twenty onesecond and third cass wards, ve rst cass ward and ve
intensive wards. The second and third class wards (the genera ward) each consists of twenty
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eight eds of which 2nd class (8 Beds) 3 Class (18 eds) and isolation (2 eds). There are
twenty-eight eds in all the rst class wards.
Facilties
The SHP provides the following facilities Apar om staff quarters which include doctors
and nurses quarers condo accommodation for consultans and specialists the SHP also has a
well equipped spots complex which comprses a gymnasium tennis courts and adminton
courts and tale tennis. A mode cafeteia caters o the needs of all hospital staf
All uildings are connected with covered corridors This also includes access to pulic
transport on the other side of the highway.
Scope of clinical serices in Selayang Hospital
It has een planned that tetiary services like Oncology Neurology and Pediatric that are
availale at the KLH will not e provided y Seayang Hospital. The tetiary services at
Selayang Hospital include Gastroenterology Hepatoiliary Cardiology Nephrology
Uroogy, Hand and Micro and Surgery Also included are liver and kidney ransplant (refer
appendix I for denition of terms). The others come under secondary services outpatient
services, supportve servces are provde through the cncal and non-cnca departments.
The main business of Selayang hospital is the provision of a specic range of tertiary referral
services to customers across the nation and elsewhere and a broader range of clinical
servces to customers who rely on Selayang Hospital as their regonal or local hospitals
Linked to these major activities is essential contriution to teaching and research.
In addition to this referral role Selayang hospital also provides high quality specialist services
in a large numer of other elds .
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Over time Selayang Hospital expect the prole of the main business activities to be modied
in line with changing customers need and service developments elsewhere Seayang
Hospital will do this to provide the best value they can om the resources at their disposal
and to provide their customers with a service that is matched to their needs
Vision
n the planning and implementation of Selayang Hospita the Ministry of Health (MOH) has
taken coizance of the objective of Vision 2020 where Malaysia shall reach the status of a
developed country and the MOH vision
n ine with the Country's Vision of 2020 the countrys Vision for Health was formulated
and proposed a national health poicy his will provide the direction and means to integrate
al-important players to work towards achieving optimum population health and improved
uality of life for Malaysians in the 21 century
Dr Shahidah (1996) said he Ministry of Health would begin the process reorienting its role
in preparation for the changes which is expected to take place in the years approaching 2020
rincipally it will relate to enhancing its role in all matters pertaining to health: to ensure its
social commitment and responsibility euitable access by the population to acceptable heath
seices of good uaity and to pomote and monitor eat povider accountaility.
he mission of Seayang Hospita is formuated in ine with the Ministry of Health Vision
(Refer appendix 2 for MOH Mission) he Mission of MOH is to build partnerships for
health to facilitate and support the people: -
Attain lly their potentia in health
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ovae em o apprecae eal as a valuale asse
Take posve acon o mprove rer and susan er eal saus o enjoy a eer
qualy of lfe
Te Selayang Hospal sson s o e a role model for alaysan ospals usng
approprae ecnology wc s nnovave efcen and cos effecve (delvered n a
cusomer drven envronmen endly carng compassonae and umansc Ts wl e
aceved roug eamwork n parnersp w e communy o provde qualy care o e
sasfacon of our cusomers (refer appendx 3 for Hospal Selayang sson Vson
Moo
Selayang ospal recognzes a cusomers wan qualy and erefore srve for e ges
sandards n servce value and nnovaon
Te pursu of excellence exends o everyng Selayang Hospal does for s cusomer and
e commmen o qualy wll no e compromsed Te saff of Selayang ospal wl e
nculcaed w e core values of qualy professonalsm carng eamwork and process
excellence (ref Appendx 4 for denon
Oranzatona tructure
Te Selayang Hospal organzaon srucure s as per Appendx 5 aaced Cusomers are
Selayang Hospal op prory so e srucure s desgned o maxmze cusomers'
sasfacon w empass on saff efcency Te Board of Drecors (BOD w e
asssance of Toal Hospal nformaon Sysem and a edcal Advsory Board commee
oversees e ospal overall operaon Tere are 5 dvsons n e ospal admnsraon
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total medical and nonmedical sta orce stands at 090 The BD is accountable to the
tate Health irectors.
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Applications of Information Technolo (T)
r hhdh ( 1 996 sd o morce oo s he roduco o ew echooy o he
heh ed. he roress mde medc echooy or sce s md bo o oy
scoe bu so esecy so he seed o s deeome. order o kee bres o
hs he Msry s esbsh beer cby or echooy ssessme o esure he
doo o rore echooy or s serces. he roero o ew medc
echooy so cs or he eed o or ese suor o crry ou resro o
medc deces some deeoed coures.
O tcur eres o he Msry o Heh he 7 MP s he Medc cos o
ormo echooy (). Ad o rme moce o he Heh Msry s eed or o
e d d ormo or decso m reo o how we he orzo s
erorm d o wh exe s seces re mee ouo eeds. he srehe
o s Heh Meme ormo ysem wh comuer suor d o e ccess by
decso - mers s ed or he 7MP.
he cc cos o roy w be e o he coce o he e
ccess he cre eeded oe o o coc or odys ro semess cre or
heh c es whou boudres. her h h he e reered o rous ees
o cre s ossbe or he e o recee he cre eeded whcheer hos he/she
ccesses. he roduco o eemedce d coerec or exme w mee hs
eed. Vrous eures o co cud eress dmsro re desed or
d w be memeed he ew secs hoss e.. ey Hos eo
d my ohers sd r hddh.
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otal Hospitalnjormaton ystem (THIS)
Hospita Seayang has been desgned constructed and equipped for a ota Hospita
Infoation System (HIS) environment with the utimate aim of a paperess and mess
hospita operation. Extensive utiization of infoation technoogy wi be a core eement in
the daiy running of Seayang Hospita which is being prepared as the rst medica center in
Maaysia to operate in a paperess environment.
he RM 590 miion Seayang ospita wi create inteationa history as the words rst
y integrated paperess and mess hospita (Dato' Chua 1998) t is the rst hospita n
Maaysia to operate with HS covering a aspects of its operation he RM 60 miion I
system peeates a the operations of the hospita which are categorized into three areas
images cinica administration and nancia.
Expaining a the type about the phrases "paperess and mess" eam Vantage was
awarded the contract by Radicare the genera contractor for the tukey project. manager
Aen said "Starting om the time when the patient registers into the hospita unti the time
he eaves and retus for the occasiona outpatient check-ups every thing is done
eectronicay." he RM 60 miion system peeates a the operations of the hospita
which are categorized into three areas images cinica and administration and nancia
(US department of commerce 1998).
Imges mess envonment
In the images department the pictue archiving and communications system has appications
for sending receiving querying and retrieving images for viewing diagnosing reporting
and storing purposes. X-ray radiography magnetic resonance imaging topography and
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utasound images can e tansmitted eectonicay om one depatment to anothe within
the hospita and this povides fo the mess environment.
Heath Ministe Dato' Chua said patient imaging was aso avaiae unde the system. "With
this, images of any pats of the human ody can e stoed eectonicay. Doctos can otate
the image o enage it to seach fo actues fo instance."
Electronc Medcal Record (EMR)
he Seayang Hospita s unique in the sense that the integrated soution woud e centeed
on an eectronic medica ecod which captues and stoes a eevant cinica data fo each
patient in eectonicom
n the cinica aea the hospita infomation system is used fo patient management ode
management-scheduing data stoage and system opeation A patient and medica ecod
infomation is stoed in the Eectonic Medica Recod Data (EMR) and this ceates a
papeess envionment.
Admnstraton
n the administation and nance department appication fo human esouce payro,
mteril requiremets, ivetory cotrol d ccoutg sysems ae ll ecoded on
computes ceating an amost papeess envionment in these depatments. Some
govement documentaton howeve wi sti have to e in pinted om
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Advantages of THIS
"The adantaes o ths tye o hosital has oer others are a sinicant reduction in storae
and lin costs the cost o hain eole moe documents and other inoation rom one
lace to another and the comlexities and consion related to this. The cost o relication o
document and a hiher quality o care roided resultin om the seedier and more
accurate serices which will be roided said Aen (hankar 1 998).
he dierence between the elayan Hosital and some dozen other similar hositals is that
al the three systems areas are lly interated. This allows or an uninterruted ow o
inoation and imaes across all three systems areas whereas in other hositals a articular
deartment may only be artly or not at al interated within the other areas. "hats why
you see that some doctors hae about three dierent screens behind their desks. It is
cumbersome and time wastin said Allen.
Rm 60 Mlion System for Hospital
Team Vantae was awarded the contract in Febrary this year by Redicare (M) dn. Bhd.
The eneral contractor or the tukey imlementation o the 960 - bed elayan Hosital
roject manaer Team Vantae is resonsible or the desin rocurement installation
testing, commissioning training of the medical equipment as we as soware an harware.
They also hae to license aerless nancials and Human Resource Manaement ystems
(HRM) as ar o this or elayan hosital. Other than a comlete set o human resource
nctionality the instaation will also include nancia modules o accounts receiables and
bilin.
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he peopleso impemenaion involves several sages and is being ndeaken in paralel by
wo eams; one wong on e nanas we e oe on e HM. A aves ae
eng onded a Vson ene. e sysem reremen sdes ad een onded w
Ceer Coporaons na sysem wh deas wh meda eords hey ae now
dng pooype sysem aer w ey sa move no e somzaon and esng
sage a w ae ao wo monhs o ompee. he peopeso sysem s sheded o go
ve y Marh o Ap nex yea e sysem and eam Vanage sgned he ageemen n
Kaa Lmpr on oe 1 6 1 997 .
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Taining
Dao Cua said aou 2,000 Hea inisry saff would e rained o use THS Currenly
120 are eing rained niially ere was resisance om e saff ecause ey ad o
compleely move away om e usua operaing sysem of e ospia and adap i o e
running of a paperless and lm less ospial environmen Te THS was a oa cange om
e convenional sysem However ey now realize is advanages and are commied
o i Te saff wil l evenuay e e key users of e sysem a e Selayang Hospial" said
Dao Cua. All new saff reporing for duies mus rs go roug T raining (Cok
1 998To prepare for is e SHP a presen was raining is key users wo would rain e
end users
An iniial group of wo docors and eig nurses were rained o e Applicaion Analyss
(AA Te main ncions of e AA were o uid all forms sceduling regisraion and
oer documenaion
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layang otal y - un n Januay
The Selayang Hospital the Goveents rst ultra mode, paperless hospital with a
sophistcated Total nformation System will begin trial runs om January. Health Minister
Dato Chua said the Rm 530 Million hospitals would receive its rst patient next June and
will begin operations in phases
The THS, Dato Chua said will be the rst of its ind in the world and it was an "entirely
Malaysian system, customized and adapted for our needs". The trial runs are to ensure that
the system runs smoothly when the hospital is lly operational. Hospital staff will be able to
familiaize themselves with the sysem via simulations "This is important as human lives are
involved The staff must now what to do when there is, for instance, a power failure. The
project is being carried out by Radcare (M) Sdn. Bhd. and the Health Minstry will manage
it. Dao Chua said among others, the information system would enable medical health
records of a patient "om womb to tomb" to be ept electronically. These medical records
can be accessed via computers easily anywhere in Malaysia just by eying in the relevant
codes Patients can also mae appointments with doctors easily Now several telephone cals
have to be made rst before an appointment can be xed. With THS, all the information
regarding each doctors wor schedule is in the computer All the receptionist needs to do is
loo at the computer screen for the relevant details to x an appointment for a patient. Dato
Chua said Selayang hospital woud be used as a model for other goveent hospitas.
Eventually, we hope to mae all govement hospitals paperless" (Cho, 199).
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Formation of Selayang Hospital Core Team and IT Committee
O 22d Juy 996 Hospita eayag Pojet Chaia a i Au Baka ueima
Dieto Geea of Heath (DGH) aed fo a meetig duig whih oe team ad I
ommittee wee appoited
he haia weomed a patiipats ad thaked them fo aeptig the appoitmet as
the Coe eam & I Committee memes to e ivoved diety i the eayag Pojet to
make it a suess He said I ode to meet the ojetive of the state of the at faiity a
highy quaied effetive ogaizatio opeatio ad maagemet has to e esued fo the
suess of this hospita A Coe eam ad I Committee was appoited i 22 Juy 996
ad they ae to e ivoved diety i the eayag Pojet to make it a suess. he Coe
team eed to wok o the foowig stategies; said a i Au Baka
o adapt to hages i thei wok i poess i ie with hages i tehoogia
advaemet he oe team memes wee to at as hage agets fo oth the staff ad
iets Fo a stat they shoud hage om the ovetioa wok poess to the ew I
eviomet Highe maagemet wi ot e povided with eks o seetaies istead
they wi e povided with a ompute eah ad they ae expeted to do thei ow typig
o data ety
o adopt a ew atttude that s ette eogto of ustomes' eeds oweve eve
though the itodutio of sophistiated I they must ot foget ot to ose the huma
touh despite the tehoogies that ome with the I itodued at the HP he
ogaizatio hat had ee fouated with emphasis o sevig the patiets With
ivestmet expesive I ad ette quaity staff thee shoud e o difuty to offe
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eer qualiy services e an Sri rer reminded all presen a SHP mus e made a
model ospial
To ideni every ncion and develop deailed work processes suiale for Selayang
Hospial Work processes om oversea ospials can e used as reference u need o e
cusomized o sui local needs
To develop wole ospial policies and policies for every deparmen
o form working groups / eams wic will work ogeer o come up wi e desirale
work process ey will e given e auoriy and auonomy o selec and ransfer saff
om HKL o e SHP ey are o come up wi individual planning and organizing eir
deparmen wic includes suggesion for e purcasing of equipmen uman resource
and e operaion of e uni
e working group need o develop policies eg admission and discarge policies
referral policies ec ese operaional policies need o e spel ou
Te Direcor General of Heal made clear o e Core Team a ey wil e given e
opporuniy o work in Selayang Hospial e core eam as o come up wi e ission
saemen for Selayang Hospial in line wi e O ission Saemen e workow and
process sould e consisen wi e ission
(Selayang ospial General Opeaional Policy)
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Some ore eam memers rogh o Tan Sr aenon ha hey were no workng ll me
a he SHP hey od no do a ood jo as he enon was dded eween SHP nd
KLH. To expe hem o ary o he ered saeges may e askng oo mh one o
hem een sggesed o a peanen rnser o he SHP To hs Tan Sr sad he wod
ranse hem on pemnen ass when he SP pogessed o a ean sage.
ne doo aso asked he DH a he meeng ao promoon spe o workng a SP.
To hs he DH sad he wod we n o he MH o he aros poss o e eed. He
pnned o p orward a workng paper o he MH o added poss ke head o he n,
onsan nrsng oes and manaes.
He aso menoned ha a he ore eam memes wod hae a hane o s ng oher T
hospas oerseas o ea ao ohe's expeene.
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Human Resoure Planning
In e seond meeng w e DGH e nfoed e ore eam a e pannng of e
man resore reremen was de o e ompeed. In vew of e os onsran a
meda personne were o e ransferred from e govemen ospas e Genera
ospa wod onre e mos nmer ease of s sze dsane and e expeed
derease n woroad wen eayang Hospa was y n operaon. e aane w e
ransferred om eer oer saes govemen ospas or dsr ospas ne
eayang wod e e mode ospa of e onry speror ay man resore was
rered e rera for seeon of saff ransfer are experene and osandng
perfoane.
Eary pro-ave aons ad een aen n e pannng of man resore n vew of e
g meda personne sppy n e mare. e Hman esore Manager w e
asssane of e Board of Dreors ad oaned onsen om MH for e ransfers.
Leers of ransfer ad een sen o e respeve meda personne more an sx mons
ago n order o gve e personne nvoved sfen me for e ransfer A meda
personne nvoved were rered o repy y e rs aer of 998 as e ranng orses
wod e sarng om e seond arer of e year onwards.
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Related Issues
Staff transfer
n Aprl 1 998 the HKL Drector receved a letter om the nstry of Health nstructng hm
to release selected doctors and staff to Selayang osptal Project
A meetng was mmedately convened whereby varous ssues were dscussed Present n the
meetng were the Nursng Dvson atron, Consultants and Specalsts, Nurse anagers,
apart om the varous Heads of Department
At the meetng the Drector was vsbly upset as he sad that he was not nvolved n the SHP
nether was he brefed on the progress of the SHP He just receved nstructons to release
staff to the SHP and HKL was already understaffed and the takng away of better-traned and
experenced personnel would affect the hosptal operaton negatvely n some cases the
prospect of a complete department beng transferred out would spell dsaster and he asked the
Head of Hand and crosurgery what would happen to hs department f the whole group
moved over to SHP
The head of Hand and cro deparment repled that ths was beyond hs control as Selayang
Hosptal Project was a Prorty Goveent Project and he was merely folowng nstructons
om the nstry The Core team was delegated by the DGH wth the authorty and
autonomy to select and transfer staff to the SP The Drector then sad that he was not
nformed about ths new role of he core eam and he woud seek clarcaton n the next
meetng wh the DH
To ths Dr Pathma repled that ths vacuum created by the staff transfer was ony temporary
Once Selayang Hosptal was lly operatona t would help to decongest HKLHence t
would be benecal f the staff conceed were reeased wthout rther delays
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Te direcor repied a e woud no reease any saff i e soug rer caricaions
om e DH Even oug i was ony a ransiional proem u e was no appy aou
e woe issue e en commened a wa woud appen o HKL during is ransiional
period He sressed a e Medica profession was deaing wi maers reaed o i fe and
deas and ere sould e no compromise
Complants
Te Maron suppored e Direcor in voicing er conce a e nursing saff was already
overworked and e nursing care was in a sae of compromise Se quoed on e saff o
paien raio of 1 o 4 in e inensive care uni were e recommended gure soud e one
o one Se rer commened a a er efcien saff was seeced for ransfer Se
expressed e prospec of running er wards wi junior and less experienced nurses
Te Direcor en menioned a jus yeserday wo eads of deparmens came o see im
regarding some complains om e pulic regarding some dissaisfacion of paien care
One of e paiens in e oupaien compains a e ad o wai four ours efore e go
o see a docor A oroug invesigaion sowed a is was mainy due o e acue
sorage of docors Since e docor ad o see aou wo undred ou paiens a day a
comes to three minute attending time to one particula patient. On top of tat e t o i
ward round and aso aend o emergencies efore e coud sar o run is cinic A e end
of e day e roo of e proem was due o acue sorage and overworked docors
Te oer complains was regarding a paien wo ad o wai for one our efore a nurse
coud aend o im for a simpe glass of waer
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Te maron answered a e nurse in a ward on duy ad o aend o weny paiens
since one of er coleague was on emergency leave se was le wi only wo aendans o
work wi
Te irecor said a e paiens conceed ave wrien in ocially o e inisry and
ey were looking ino e maer seriousy e en rer commened a e jus did no
know wa was going o appen in ospia Kuala umpur wen e ad o deploy more saff
o ospial Selayang e en read e lis of names of docors and nurses wo would e
ransferred o ospial Selayang as sceduled
Te Head of Surgical depamen r Rami asked Wa is e crieria for e selecion of
sa o work in ospial Selayang can a saff apply o work ere if ey are neresed
Te irecor en raised i s voice and answered a r Rami jus informed al l o f you
regarding e safng siuaion in ospial Kuala umpur will no recommend any more
saff o e posed o Selayang ospial so pease don ask any more quesions
Te Pediaric deparmen ead r Raja en commened Wa is so grea aou working in
ospial Selayang ospia ere is no added incenives e erm of condions are jus e
same as working in any pulic ospials a quie comforale ere no need o crack my
ead over e T aspec I am quie comforale ere Te saff of K gave a ig clap o
his sttement
Te Surgical ead of depamen said e was offered o work a SP u e ued e offer
down ecause ere was no compensaion for im o e ransferred o SP e menioned e
would incur addiional expenses Tere was of course no promoion involved To is r
Pama said moneary consideraion aone was no sufcien o jusi suc a decision as one
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