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  1. Use of ammonium-enriched skim latex serum to compost rubber biomass wastes and its effect on planting brassica alboglabra
    Jutarut Iewkittayakorn, Juntima Chungsiriporn, Prukraya Pongyeela
    Sains Malaysiana, 2017;46:1763-1769.
    Ammonium-enriched skim latex serum - used for absorption of contaminating ammonia gas - when composted with other rubber tree wastes, is promising as a good compost. The objective of this research was to utilize ammonium-enriched skim latex serum (S) as a raw composting ingredient after being combined with para sawdust (W1) and para rubber leaves (W2). Several ratios of S, W1 and W2 were experimented in a 15L composting vessel to determine the most effective compost. The best ratio was found to be 3:1:3 by weight at 12-day retention. The modified 30 L composting reactor employed with the derived optimum mixing conditions yielded N, P and K of 2.40, 1.51 and 14.84 %w/w. The growth of Brassica alboglabra after application of this compost combined with a chemical fertilizer generated the highest fresh weight (4.48 g/plant). Thus, compost from these wastes could be used as a fertilizer and logically should contribute to cost saving of waste disposal.
    Matched MeSH terms: Cost Savings
  2. Unlocking the application potential of forward osmosis through integrated/hybrid process
    Ang WL, Mohammad AW, Johnson D, Hilal N
    Sci Total Environ, 2020 Mar 01;706:136047.
    PMID: 31864996 DOI: 10.1016/j.scitotenv.2019.136047
    Study of forward osmosis (FO) has been increasing steadily over recent years with applications mainly focusing on desalination and wastewater treatment processes. The working mechanism of FO lies in the natural movement of water between two streams with different osmotic pressure, which makes it useful in concentrating or diluting solutions. FO has rarely been operated as a stand-alone process. Instead, FO processes often appear in a hybrid or integrated form where FO is combined with other treatment technologies to achieve better overall process performance and cost savings. This article aims to provide a comprehensive review on the need for hybridization/integration for FO membrane processes, with emphasis given to process enhancement, draw solution regeneration, and pretreatment for FO fouling mitigation. In general, integrated/hybrid FO processes can reduce the membrane fouling propensity; prepare the solution suitable for subsequent value-added uses and production of renewable energy; lower the costs associated with energy consumption; enhance the quality of treated water; and enable the continuous operation of FO through the regeneration of draw solution. The future potential of FO lies in the success of how it can be hybridized or integrated with other technologies to minimize its own shortcomings, while enhancing the overall performance.
    Matched MeSH terms: Cost Savings
  3. Understanding waste for lean health information systems: a preliminary review
    Kalong NA, Yusof MM
    Stud Health Technol Inform, 2013;192:749-53.
    PMID: 23920657
    Despite the rapid application of the Lean method in healthcare, its study in IT environments, particularly in Health Information Systems (HIS), is still limited primarily by a lack of waste identification. This paper aims to review the literature to provide an insight into the nature of waste in HIS from the perspective of Lean management. Eight waste frameworks within the context of healthcare and information technology were reviewed. Based on the review, it was found that all the seven waste categories from the manufacturing sector also exist in both the healthcare and IT domains. However, the nature of the waste varied depending on the processes of the domains. A number of additional waste categories were also identified. The findings reveal that the traditional waste model can be adapted to identify waste in both the healthcare and IT sectors.
    Matched MeSH terms: Cost Savings/economics*; Cost Savings/methods*
  4. The impact of pharmacist intervention on the use of activated vitamin D in a tertiary referral hospital in Malaysia
    Siow JY, Lai PS, Chua SS, Chan SP
    Int J Pharm Pract, 2009 Oct;17(5):305-11.
    PMID: 20214273
    In recent years, the usage of activated vitamin D (alpha-calcidol and calcitriol) in the University Malaya Medical Centre (UMMC) has escalated and this has put unnecessary burden on the hospital's limited health care budget. The main aim of this study was to determine the effects of a clinical pharmacist's intervention in reducing the inappropriate use of activated vitamin D.
    Matched MeSH terms: Cost Savings
  5. The Impact of Antimicrobial Stewardship Program on Injudicious Use of Cefuroxime
    Arulappen AL, Danial M, Haron N, Hau LC, Khan AH
    Front Pharmacol, 2020;11:565818.
    PMID: 33664664 DOI: 10.3389/fphar.2020.565818
    Antimicrobial stewardship (AMS) program promotes the judicious use of antimicrobials. Hence, this study was conducted to analyze the impact of stewardship on the prescribing pattern of cefuroxime injection among the surgeons as perioperative antimicrobial prophylaxis (PAP). This study was conducted retrospectively in Malaysia. Various outcomes were measured including cefuroxime usage, compliance with the guidelines, surgical site infections, and cost savings. A total of 1,601 patients were recruited in the study. In terms of usage, the total defined daily dose (DDD) prior to the intervention was 202 DDD/100 procedures compared to that after intervention which was 144 DDD/100 procedures (p < 0.05). On the other hand, the excessively long administration of PAP dropped from 94.4 to 30.3% (p < 0.001). Focusing on the compliance with the newly developed local guidelines, it has increased from 53 to 94.3% after the interventions were made (p < 0.001), whereas the rate of surgical site infections was reduced from 17.0 to 9.0%. The cost of antibiotic being used has significantly reduced after the study intervention (p = 0.007). The quality of PAP directly impacts the antimicrobial usage, the surgical site infections, and the total cost involved. Thus, it is crucial to maintain the standard of PAP at all times in healthcare settings.
    Matched MeSH terms: Cost Savings
  6. Fulltext SYNTHESIS AND CHARACTERIZATION OF TiO2/ZnO-EPOXY BEADS AND THEIR PERFORMANCE FOR THE DEGRADATION OF DYE
    MOHAMAD HANIF AKMAL HUSSIN, WAN RAFIZAH WAN ABDULLAH, MOHAMAD AWANG
    UMT Journal of Undergraduate Research, 2020;2(2):9-14.
    MyJurnal
    Semiconductor oxides such as titanium dioxide (TiO2) and zinc oxide (ZnO) are used as the photocatalyst for removing contaminants. In addition, TiO2 and ZnO nanoparticles in the suspension form makes it difficult to be recovered and recycled. This study was conducted to investigate the efficiency of immobilizing TiO2 and ZnO nanoparticles in epoxy beads. The immobilization process using different ratios of photocatalysts TiO2/ZnO (1:0, 3:1, 1:1, 1:3 and 0:1) fixed on epoxy material. These epoxy beads were used for dye removal in photocatalysis using methylene blue (MB) solution at a concentration of 10mg/L. Besides, epoxy beads also characterized using scanning electron microscope (SEM), attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy and thermogravimetric analysis (TGA). The results showed that the highly recommended epoxy bead is 3:1 ratio of TiO2/ZnO because it has good performance in dye degradation that proved from reducing concentration of MB to 2.4mg/L (76%). However, TiO2/ZnO characterization of 3:1 by SEM show on the surface the particle are found to be spherical in shape which is relatively high efficiency for the degradation, ATR-FTIR pattern in broad band 4000 cm-1 - 400cm-1 which correspond to hydroxyl stretching to be adsorbed at peak (474.49 cm-1 - 3722.61cm-1) respectively to the optimum for the degradation and TGA rate of change are 5mg to 2.5mg that residue (49.78%) due to decomposition or oxidation from mass loss. These findings are very effective and economical technique to be cost saving and highly efficient photocatalyst.
    Matched MeSH terms: Cost Savings
  7. Fulltext Ranking the Meso Level Critical Factors of Electronic Medical Records Adoption Using Fuzzy Topsis Method
    Ahmadi H, Nilashi M, Ibrahim O, Raisian K
    Curr Health Sci J, 2016 03 29;42(1):82-93.
    PMID: 30568817 DOI: 10.12865/CHSJ.42.01.12
    As Electronic Medical Records (EMRs) have a great possibility for rising physician's performance in their daily work which improves quality, safety and efficiency in healthcare, they are implemented throughout the world (Boonstra and Broekhuis, 2010). In physician practices the rate of EMRs adoption has been slow and restricted (around 25%) according to Endsley, Baker, Kershner, and Curtin (2005) in spite of the cost savings through lower administrative costs and medical errors related with EMRs systems. The core objective of this research is to identify, categorize, and analyse meso-level factors introduced by Lau et al, 2012, perceived by physicians to the adoption of EMRs in order to give more knowledge in primary care setting. Finding was extracted through questionnaire which distributed to 350 physicians in primary cares in Malaysia to assess their perception towards EMRs adoption. The findings showed that Physicians had positive perception towards some features related to technology adoption success and emphasized EMRs had helpful impact in their office. The fuzzy TOPSIS physician EMRs adoption model in meso-level developed and its factors and sub-factors discussed in this study which provide making sense of EMRs adoption. The related factors based on meso-level perspective prioritized and ranked by using the fuzzy TOPSIS. The purpose of ranking using these approaches is to inspect which factors are more imperative in EMRs adoption among primary care physicians. The result of performing fuzzy TOPSIS is as a novelty method to identify the critical factors which assist healthcare organizations to inspire their users in accepting of new technology.
    Matched MeSH terms: Cost Savings
  8. Fulltext Investigation of comparative effectiveness research in Asia, Europe, and North America
    Patel I, Rarus R, Tan X, Lee EK, Guy J, Ahmad A, et al.
    Indian J Pharmacol, 2015;47(6):585-93.
    PMID: 26729947 DOI: 10.4103/0253-7613.169592
    Comparative effectiveness research (CER) is an important branch of pharmacoeconomics that systematically studies and evaluates the cost-effectiveness of medical interventions. CER plays instrumental roles in guiding government public health policy programs and insurance. Countries throughout the world use different methods of CER to help make medical decisions based on providing optimal therapy at a reduced cost. Expenses to the healthcare system continue to rise, and CER is one-way in which expenses could be curbed in the future by applying cost-effectiveness evidence to clinical decisions. China, India, South Korea, and the United Kingdom are of essential focus because these country's economies and health care expenses continue to expand. The structures and use of CER are diverse throughout these countries, and each is of prime importance. By conducting this thorough comparison of CER in different nations, strategies and organizational setups from different countries can be applied to help guide public health and medical decision-making in order to continue to expand the establishment and role of CER programs. The patient-centered medical home has been created to help reduce costs in the primary care sector and to help improve the effectiveness of therapy. Barriers to CER are also important as many stakeholders need to be able to work together to provide the best CER evidence. The advancement of CER in multiple countries throughout the world provides a possible way of reducing costs to the healthcare system in an age of expanding expenses.
    Matched MeSH terms: Cost Savings
  9. Fulltext International patients with congenital heart disease: what brings them to India?
    Maheshwari S, Animasahun BA, Njokanma OF
    Indian Heart J, 2012 Jan-Feb;64(1):50-3.
    PMID: 22572426 DOI: 10.1016/S0019-4832(12)60011-X
    Factors that have led to the increasing popularity of medical travel include the high cost of healthcare, long wait times for certain procedures, the ease and affordability of international travel, and improvements in both technology and standards of care in many countries.
    Matched MeSH terms: Cost Savings
  10. Fulltext Increasing the percentage of appropriate tests conducted in the serology laboratory, Hospital Sultanah Nur Zahirah
    Azlina Yahya, Osama Abdul Nasir
    Q Bulletin, 2019;1(28):36-44.
    MyJurnal
    Wastage due to unnecessary laboratory test requests is a major problem in government hospitals because they have cost implications. Although screening of infectious marker tests such as Human Immunodeficiency Virus (HIV), Hepatitis B surface Antigen (HBsAg), Hepatitis B antibody (AHBS) and Hepatitis C Virus (HCV)) before testing have been put in place, inappropriate tests were still being carried out in the Serology laboratory, which resulted in wasted human resources and reagents, increased workload and increased maintenance costs. Based on the verification studies using the Laboratory Information System (LIS), we observed only 70% of the tests followed the ordering guidelines or test specifications. Thus, we aim to increase the standard to more than 95% of the infectious marker test requests which were appropriate according to a few guidelines.
    A cross-sectional study was conducted for all infectious marker tests received at Serology Laboratory from January 2015 to June 2016 to verify the problem. A workplace audit and questionnaire survey on the staff were carried out to gain more information. Low level of knowledge, unavailability of standardised guidelines for quick and easy reference, lack of staff and inefficient work processes were among the main contributing factors. Empowering new staff to screen specimens, developing simple and informative screening guidelines, providing adequate trays and refrigerators for screening purposes and strengthening and developing a more effective process of care were the strategies taken during this study.
    The appropriate tests carried out from July to September 2015, October to December 2015, January to March 2016 and April to June 2016 were 99%, 98.80%, 99.50%, 98.90% respectively. During the same period, 711, 411, 710 and 768 tests were rejected. We monitored the performance and managed to achieve 100% appropriate testing for the period of July 2016 to June 2018 and an estimation of MYR 73,437.50 cost saving was achieve
    Matched MeSH terms: Cost Savings
  11. Increased work pace is unprofitable: a beef-cutting case study
    Vogel K, Karltun J, Yeow PH, Eklund J
    Meat Sci, 2015 Jul;105:81-8.
    PMID: 25828161 DOI: 10.1016/j.meatsci.2015.03.009
    The beef industry worldwide is showing a trend towards increased cutting pace aimed at higher profits. However, prior research in the duck meat industry suggested that a higher cutting pace reduced quality and yield, leading to losses. This study aimed to test this hypothesis by investigating the effects of varying beef-cutting paces on yield, quality and economy. A field experiment was conducted on six workers cutting beef fillet, sirloin and entrecôte. Three types of paces were sequentially tested: Baseline (i.e., status quo), 'Quantity focus' (i.e., pace required to maximise quantity) and 'Quality focus' (i.e., pace required to minimise errors). The results showed a significant drop in yield, increased rate of quality deficiency and economic losses with the change to 'Quantity focus' (from Baseline and 'Quality focus') for all meat types. Workers supported these results and also added health problems to the list. The results confirmed that an increased cutting pace is unprofitable.
    Matched MeSH terms: Cost Savings
  12. Fulltext Improvement of Blue Ribbon certification by including humanistic value (TFI Buddies)
    Siti Munira Yasin, Harizah Mad Hisma, Mazlifah Omar, Nurhuda Ismail, Zahir Izuan Azhar, Zalina Omar, et al.
    Jurnal Inovasi Malaysia, 2020;4(1):61-78.
    MyJurnal
    Cigarette smoke produces more than 4,000 toxic chemicals and 53 of these chemicals can cause cancer. Smoking increases your health risks such as lung cancer, heart attack and stroke. In Malaysia, between 10% and 12% of causes of death are caused by smoking and this results in over 10,000 deaths a year. According to the National Health Morbidity Survey (NHMS) in 2015, the number of smokers aged 15 and above in Malaysia is estimated to be more than 5 million (22.8%). This alarming amount will lead to increased health costs. Smoking can also lead to a reduction in worker productivity and air pollution and the pollution due to cigarette smoke. Therefore, smokers need to be aware of the effects of smoking habits and the importance of maintaining a tobacco-free environment for the health and well-being of their families, friends and the community around them. To address this, Smoke Busters have created an innovation called Blue Ribbon Star Certification with an additional component of humanization into the TFI Buddies existing Blue Ribbon Certification. The main goal of this innovation is to make University of Technology MARA (UiTM) campuses 100% tobacco free. The first project at the Sungai Buloh Campus resulted in a decrease in the percentage of ‘hotspots’, whereby the number of cigarette butts was found to be greatly reduced. In addition, the percentage of staff with good knowledge and attitude on the effects of cigarettes increased. Feedback from users comprising staff and students also showed a very positive response. The direct impact on faculty and campuses include cost savings in terms of medical expenses and increase in staff productivity. The long-term effects include enhancing UiTM’s image nationally and internationally. From a social point of view, this in addition creates a more caring and responsible generation of colleagues and the environment.
    Matched MeSH terms: Cost Savings
  13. Fulltext Impact of printed antimicrobial stewardship recommendations on early intravenous to oral antibiotics switch practice in district hospitals
    Sze WT, Kong MC
    Pharm Pract (Granada), 2018 06 17;16(2):855.
    PMID: 30023021 DOI: 10.18549/PharmPract.2018.02.855
    Background: Early intravenous to oral (IV-PO) antibiotics switch, which is one of the important elements in antimicrobial stewardship (AMS) is not well implemented in Malaysian district hospitals. A systematic interventional strategy is required to facilitate IV-PO antibiotic switch.

    Objective: This study aimed to evaluate the impact of printed AMS recommendations on early IV-PO antibiotics switch practice in district hospitals.

    Methods: This study was an interventional study conducted in medical wards of eight Sarawak district hospitals from May to August 2015. In pre-intervention phase, pharmacists performed the conventional practice of reviewing medication charts and verbally informed the prescribers on eligible IV-PO switches. In post-intervention phase, pharmacists attached printed checklist which contained IV-PO switch criteria to patients' medical notes on the day patients were eligible for the switch. Stickers of IV-PO switch were applied to the antibiotic prescription to serve as reminders.

    Results: 79 and 77 courses of antibiotics were studied in the pre-intervention phase and post-intervention phase respectively. Timeliness of switch was improved by 1.63 days in the post-intervention phase (95%CI 1.26:2.00 days, p<0.001). Mean duration of IV antibiotics in the post-intervention phase was shorter than pre-intervention phase (2.81 days (SD=1.77) vs 4.05 days (SD=2.81), p<0.001). The proportion of IV-PO switches that were only performed upon discharge reduced significantly in the post-intervention phase (31.2% vs 82.3%, p<0.001). Length of hospital stay in the post-intervention phase was shortened by 1.44 days (p<0.001). Median antibiotic cost savings increased significantly in the post-intervention phase compared to the pre-intervention phase [MYR21.96 (IQR=23.23) vs MYR13.10 (IQR=53.76); p=0.025)].

    Conclusions: Pharmacist initiated printed AMS recommendations are successful in improving the timeliness of IV-PO switch, reducing the duration of IV, reducing the length of hospitalisation, and increasing antibiotic cost savings.

    Matched MeSH terms: Cost Savings
  14. Impact of pharmacist recommendations on the cost of drug therapy in ICU patients at a Malaysian hospital
    Zaidi ST, Hassan Y, Postma MJ, Ng SH
    Pharm World Sci, 2003 Dec;25(6):299-302.
    PMID: 14689820
    To analyse clinical pharmacists interventions in the ICU of the Penang General Hospital (Penang, Malaysia) and to assess the pharmaco-economic impact of these interventions.
    Matched MeSH terms: Cost Savings/economics
  15. Impact of a renal drug dosing service on dose adjustment in hospitalized patients with chronic kidney disease
    Hassan Y, Al-Ramahi RJ, Aziz NA, Ghazali R
    Ann Pharmacother, 2009 Oct;43(10):1598-605.
    PMID: 19776297 DOI: 10.1345/aph.1M187
    Appropriate drug selection and dosing for patients with chronic kidney disease (CKD) is important to avoid unwanted drug effects and ensure optimal patient outcomes.
    Matched MeSH terms: Cost Savings
  16. Generic medicines in the Malaysian health care system: Opportunities and challenges
    Wong ZY, Alrasheedy AA, Hassali MA, Saleem F
    Res Social Adm Pharm, 2016 04 20;12(5):807-10.
    PMID: 27157864 DOI: 10.1016/j.sapharm.2016.04.002
    Matched MeSH terms: Cost Savings
  17. Fulltext Furnace Modelling Using State Space Representation
    Razidah Ismail
    Scientific Research Journal, 2006;3(1):37-52.
    MyJurnal
    The state space modeling approach was developed to cope with the demand
    and performance due to the increase in system complexity, which may have
    multiple inputs and multiple outputs (MIMO). This approach is based on timedomain
    analysis and synthesis using state variables. This paper describes the
    development of a state space representation of a furnace system of a combined
    cycle power plant. Power plants will need to operate optimally so as to stay
    competitive, as even a small improvement in energy efficiency would involve
    substantial cost savings. Both the quantitative and qualitative analyses of the
    state space representation of the furnace system are discussed. These include
    the responses of systems excited by certain inputs and the structural properties
    of the system. The analysis on the furnace system showed that the system is
    bounded input and bounded output stable, controllable and observable. In
    practice, the state space formulation is very important for numerical computation
    and controller design, and can be extended for time-varying systems.
    Matched MeSH terms: Cost Savings
  18. Fulltext Ergonomics in industrially developing countries: a literature review
    Huck-Soo L, Richardson S
    J Hum Ergol (Tokyo), 2012 Dec;41(1-2):1-16.
    PMID: 25665194 DOI: 10.11183/jhe.41.1
    The two final decades of the 20th century saw a significant increase in ergonomics activity (and resulting publications) in industrially developing countries (IDCs). However, a few ergonomics papers from Singapore, for example, were published in 1969 and 1970. This paper reviews developments in ergonomics in industrially developing countries from 1969 relying heavily on published papers although their quality varies considerably. Some criticism of these papers is offered. Most were concerned with the use of work tools, workstation operations, material handling and working environments especially in tropical climates. The similar problems encountered in a variety of countries are discussed, and the importance of low-cost solutions stressed. This study presents an overview of er gonomics research in IDCs. It concentrates on ASEAN countries whilst recognising the valuable work done in other areas.
    Matched MeSH terms: Cost Savings
  19. Ergonomics improvements of the visual inspection process in a printed circuit assembly factory
    Yeow PH, Sen RN
    Int J Occup Saf Ergon, 2004;10(4):369-85.
    PMID: 15598361
    An ergonomics improvement study was conducted on the visual inspection process of a printed circuit assembly (PCA) factory. The process was studied through subjective assessment and direct observation. Three problems were identified: operators' eye problems, insufficient time for inspection and ineffective visual inspection. These problems caused a huge yearly rejection cost of US 298,240 dollars, poor quality, customer dissatisfaction and poor occupational health and safety. Ergonomics interventions were made to rectify the problems: reduced usage of a magnifying glass, the use of less glaring inspection templates, inspection of only electrically non-tested components and introduction of a visual inspection sequence. The interventions produced savings in rejection cost, reduced operators' eye strain, headaches and watery eyes, lowered the defect percentage at customers' sites and increased the factory's productivity and customer satisfaction.
    Matched MeSH terms: Cost Savings
  20. Economic evaluation of pharmacist-led medication reviews in residential aged care facilities
    Hasan SS, Thiruchelvam K, Kow CS, Ghori MU, Babar ZU
    Expert Rev Pharmacoecon Outcomes Res, 2017 Oct;17(5):431-439.
    PMID: 28825502 DOI: 10.1080/14737167.2017.1370376
    INTRODUCTION: Medication reviews is a widely accepted approach known to have a substantial impact on patients' pharmacotherapy and safety. Numerous options to optimise pharmacotherapy in older people have been reported in literature and they include medication reviews, computerised decision support systems, management teams, and educational approaches. Pharmacist-led medication reviews are increasingly being conducted, aimed at attaining patient safety and medication optimisation. Cost effectiveness is an essential aspect of a medication review evaluation. Areas covered: A systematic searching of articles that examined the cost-effectiveness of medication reviews conducted in aged care facilities was performed using the relevant databases. Pharmacist-led medication reviews confer many benefits such as attainment of biomarker targets for improved clinical outcomes, and other clinical parameters, as well as depict concrete financial advantages in terms of decrement in total medication costs and associated cost savings. Expert commentary: The cost-effectiveness of medication reviews are more consequential than ever before. A critical evaluation of pharmacist-led medication reviews in residential aged care facilities from an economical aspect is crucial in determining if the time, effort, and direct and indirect costs involved in the review rationalise the significance of conducting medication reviews for older people in aged care facilities.
    Matched MeSH terms: Cost Savings
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