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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gsm_1999_24_a soft systems

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