Studies have shown that organisational excellence is influenced amongst others by top management leadership and management quality, human resource management and customer focus. This is clearly illustrated by international organisational excellence models, e.g the Malaysian Prime Minister Quality Award, the American Quality Award, EFQM Excellence and Deming Prize Criteria Models.
With the objective of finding out how well the Pathology Department, Hospital Tuanku Ja'afar Seremban fares, a study was conducted in early 2006 and a repeated study performed in 2007 after remedial actions and continuous improvement activities have been undertaken by the department leadership and top management. The study was performed on the staff (internal customer) to gauge the degree of satisfaction in the areas of leadership, resource management and customer focus.
The study showed an increased in the overall satisfaction i.e. 65.43% in 2007 compared to 18.29% in 2006. The staff of the department have appreciated that the current leadership has been strengthened and the management has shown improved caring, professionalism and team work as stipulated by the Ministry of Health's Corporate Culture. There has also been increased sense of belonging, feeling being cared for, appreciated and loved by the management. This has led staff being more proud of the organisation and 88.1% have maintained that they have worked very hard in 2007 study compared to 57.69% in 2006 study. This study has shown that top management and leadership commitment and being staff or internal customer focus, while instituting changes in the organisation would inevitably lead to increased staff satisfaction and this in turn leads to improved staff participation and contribution to the organisation.
A previously healthy eleven month old male Malay infant presented with fever, upper respiratory tract infection and right knee swelling. Pallor, bilateral proptosis, hepatosplenomegaly, multiple scalp swellings and a right cheek swelling were observed. Investigations revealed that he had acute monoblastic leukemia or FAB M5a. Immunophenotyping by flow cytometry showed that the blast cells were positive for CD45, CD13, CD33, HLA-DR, CDllc, CD71, EMA, and Cytokeratin. They were negative for CD34, CD19, CD10, CD22, CD2, CD3, CD4, CD7, CD8, CD61, NK, Glycophorin A, and CD14. The monoblasts were used to evaluate anti-EMA and anti-cytokeratin. They were unexpectedly found to be positive. Acute monoblastic leukaemias are well known to show extramedullary infiltration and this may be their primary mode of presentation. Thus, in immunochemostry, when using EMA and cytokeratin expression in the differential diagnosis of neoplastic diseases, it is important to consider that monoblasts may express these markers as illustrated by this case.