Displaying publications 1 - 20 of 167 in total

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  1. Ismail FF, Mohamed Noor Z, Muda SM, Ab Rahman NS
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S681-S690.
    PMID: 33828361 DOI: 10.4103/jpbs.JPBS_383_19
    Context: The attitude of healthcare professionals and social supports give big influence toward self-esteem of physically disabled people.

    Aims: To explore how impairments could affect the self-esteem of physically disabled people and how healthcare professionals and social support boost their self-esteem.

    Materials and Methods: This study was conducted qualitatively whereby face-to-face interviews were conducted among 10 participants with physical disabilities. Participants were recruited from two rehabilitation centres in Kuantan, namely Community-based rehabilitation and rehabilitation, occupational therapy, and physiotherapy of public hospital in Kuantan. Interviews were conducted using the developed interview guide that explored on the disabled peoples' self-esteem and motivation, feelings toward attitude of the healthcare professionals, and satisfaction toward the physical, services, and social support from the healthcare professionals. Thematic analysis was done to identify the themes emerged from the interview transcripts.

    Results: Five males and five females with age ranging from 31 to 58 years were interviewed. Five are still working or studying post impairments. Participants claimed being low self-esteem resulted from negative perception from the society, issue of rejection, being discriminated, and difficulty in getting support from the society. Most of the participants asserted that they gained their motivation and self-esteem due to the continuous support from various groups, such as their spouses, family members, colleagues, employers, and healthcare professionals.

    Conclusions: Despite heavy workload and stressful working environment, positive attitude showed by the healthcare professionals is highly praised. Hence, this will indirectly improve the self-esteem, motivation, and rehabilitation progress of physically disabled people.

    Matched MeSH terms: Hospitals, Public
  2. Thevi T, Abas AL
    Kathmandu Univ Med J (KUMJ), 2019 4 1;17(66):101-106.
    PMID: 32632055
    Background Since cataract is the leading cause of blindness and no study has been done on the surgical incidence trends, we conducted this research in Melaka. Objective To describe incidences of cataract surgery according to basic demographic variables and types of surgery performed. Method Using the National Eye Database (NED), we performed descriptive statistics calculating incidence rates per 1,000 population by demographic features and types of cataract operations to look at the trends of surgeries in the population. Statistics for population were obtained from the department of statistics. Result From 2007-2010, 6270 patients mostly 60-69 years underwent cataract surgery. Phacoemulsification (78.2%) was the commonest surgery performed. The annual incidence rate of cataract surgery reduced from 2.05 per 1000 population in 2007 to 2.02 per 1000 population in 2010 (p<0.05). Incidence rates for those aged 60 and above rose while for those aged below nine years it declined. Indians had the highest incidence rates followed by Chinese and Malays per 1000 population. Females had a higher incidence rate although there was a declining trend over the years. Conclusion Cataract surgery rates showed a decline. Public health education and awareness on detection and operating upon cataracts should be increased and especially targeted towards vulnerable groups such as women, individuals of Indian ethnicity and those aged 50 years and above.
    Matched MeSH terms: Hospitals, Public/statistics & numerical data*
  3. Nor Hasliza Mat Desa, Maznah Mat Kasim, Abdul Aziz Jemain
    Sains Malaysiana, 2015;44:239-247.
    The issue of age difference in hospital admission should be given special attention since it affects the structure of hospital care and treatments. Patients of different age groups should be given different priority in service provision. Due to crucial time and limited resources, healthcare managers need to make wise decisions in identifying priorities in age of admission. This paper aimed to propose a construction of a daily composite hospital admission index (CHAI) as an indicator that captures relevant information about the overall performance of hospital admission over time. It involves five different age groups of total patients admitted to seven major public hospitals in the Klang Valley, Malaysia for respiratory and cardiovascular diseases for a period of three years, 2008 - 2010. The criteria weights were predetermined by aggregating the subjective weight based on rank ordered centroid (ROC) method and objective weight based on entropy - kernel method. The highest and lowest scores of CHAI were marked, while the groups of patients were prioritized according to the criteria weight ranking orders.
    Matched MeSH terms: Hospitals, Public
  4. Ahmad Arif Che Ismail, Yasmin Ayob, Abdul Rahim Hussein
    MyJurnal
    CAD accounts for 25% of mortality in Malaysia public hospitals. CABG is one of treatment for patients with CAD, but requires RBC transfusion, which is associated with morbidity and mortality. This study was to evaluate the association between RBC transfusion and morbidity and mortality in CABG patients at the National Heart Centre, Malaysia (IJN). Methods: Retrospective cross-sectional study performed using data from 434 patients who underwent CABG in 2013 and 2014. Subjects had systematic random sampling every fifth subject of the patients in the sequence of dates of the year. Data related to the relationship between RBC transfusion with mortality and morbidity, and the predicting factors captured. Results: 64.3% of CABG patients (n = 279) received RBC transfusion perioperatively. Age, gender, BMI, and EF, were factors that contributed for RBC transfusion. RBC transfusion was a contributor to longer intensive care unit length of stay (ICULOS) and hospital length of stay (HLOS). Multiple logistic regression revealed, for every 1 year increase of age, there is 3.5% higher chance of transfusion. Whereas an increase of 1 kg/m2 of BMI and 1% of EF reduced the odds of RBC transfusion by 13.0% and 3.0% respectively. Conclusions: Age, gender, BMI, and EF determine the probability of needing RBC transfusion during CABG, and RBC transfusion will result in longer ICULOS, and HLOS. Probability of RBC transfusion will be higher in older patients and reduced in those with higher BMI and EF.
    Matched MeSH terms: Hospitals, Public
  5. Mokhtar AS, Sridhar GS, Mahmud R, Jeffery J, Lau YL, Wilson JJ, et al.
    J Med Entomol, 2016 Sep 01;53(5):1234-1237.
    PMID: 27208008 DOI: 10.1093/jme/tjw071
    We report an unusual cause of gastrointestinal infection occurring in a 1-year-old infant patient who was brought to a public hospital in Kuala Lumpur, Malaysia. Larvae passed out in the patient's feces were confirmed by DNA barcoding as belonging to the species, Lasioderma serricorne (F.), known as the cigarette beetle. We postulate that the larvae were acquired from contaminated food and were responsible for gastrointestinal symptoms in the patient. To our knowledge, this the first report of human canthariasis caused by larvae of L. serricorne.
    Matched MeSH terms: Hospitals, Public
  6. Mohd Salleh MI, Zakaria N, Abdullah R
    J Infect Public Health, 2016 Nov-Dec;9(6):698-707.
    PMID: 27659115 DOI: 10.1016/j.jiph.2016.09.002
    BACKGROUND: The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia.

    METHODS: Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling.

    RESULTS AND CONCLUSIONS: Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity.
    Matched MeSH terms: Hospitals, Public
  7. Ahmad K
    Int J Speech Lang Pathol, 2010 Aug;12(4):317-9; discussion 329-32.
    PMID: 20590514 DOI: 10.3109/17549507.2010.483017
    Speech-language pathologists (SLPs) practising in Malaysia face similar dilemmas as their counterparts in more developed countries when it comes to deciding on discharge/termination of services for their patients. Furthermore, discharge dilemmas appear to be a frequent and inevitable part of their everyday practice. In an interview conducted for the purpose of this paper, it was clear that many SLPs found it difficult to articulate or justify the process they took to reach a decision on whether or not to terminate their services or discharge their patients. Much of the difficulty is anchored on the need to be realistic and function within the confines of limited resources. Malaysian SLPs were aware of the ideals that had to be abandoned along the way but had not allowed guilt to dissuade or discourage them from providing what they perceived as the next best available service. The not-so ideal decisions made by these SLPs may be frowned upon by international standards but must be examined within the local historical perspective of the development of the SLP profession in Malaysia. The dilemma will continue until the country produces SLPs in sufficient numbers but the profession is reminded that less-than-ideal practices may perpetuate over time into unhealthy traditions that will require major efforts to be undone.
    Matched MeSH terms: Hospitals, Public
  8. Ahmad A, Khan MU, Jamshed SQ, Kumar BD, Kumar GS, Reddy PG, et al.
    J Infect Dev Ctries, 2016 Aug 02;10(7):747-54.
    PMID: 27482807 DOI: 10.3855/jidc.7578
    INTRODUCTION: The World Health Organization (WHO) declared the Ebola virus disease (EVD) epidemic to be a public health emergency of international concern. Healthcare workers (HCWs) are at the highest risk of infection, as they may come into contact with patients' blood or fluids. This study was conducted to assess knowledge and attitudes of HCWs towards EVD in India.
    METHODOLOGY: A descriptive, cross-sectional study was conducted in a multispecialty public sector referral hospital of Telangana, India. Knowledge and attitude of HCWs were evaluated using a pre-validated questionnaire. A sample of 278 participants was selected to participate in this study. The Chi-squared test was used to assess the relationship between attitudes and demographic characteristics. Logistic regression was used examine the association between knowledge and study variables.
    RESULTS: Of 257 participants who responded (92.4% response rate), 157 (61.1%) were females. The majority of the respondents were physicians (n = 117, 45.5%). Radio and television were the major sources of information about EVD reported by participants (89%). Overall knowledge of HCWs was poor (mean knowledge score: 6.57 ± 2.57). Knowledge of physicians and experienced workers (≥ 10 years) was significantly higher than their respective groups. The overall attitude of the participants was positive (mean attitude score: 1.62 ± 0.57). Significant positive correlations between knowledge and attitude were observed.
    CONCLUSIONS: The findings indicate that participants lack basic understanding of EVD. We recommend future studies be conducted across India to identify and subsequently bridge the knowledge gaps among HCWs.
    Matched MeSH terms: Hospitals, Public
  9. Hussain R, Hassali MA, Hashmi F, Akram T
    J Pharm Policy Pract, 2021 Jan 04;14(1):5.
    PMID: 33397478 DOI: 10.1186/s40545-020-00287-3
    BACKGROUND: Spontaneous reporting of adverse drug reactions (ADRs) is a method of monitoring the safety of drugs and is the basic strategy for the post-marketing surveillance of the suspected drugs. Despite its importance, there is very little reporting of ADRs by healthcare professionals. The present study has evaluated the knowledge, attitude and practices of health care professionals (HCPs) regarding pharmacovigilance activities in Lahore, Pakistan.

    METHODS: A cross-sectional questionnaire-based survey was employed, and a convenience sampling was opted to collect the data among physicians, pharmacists and nurses working in tertiary care public hospitals of Lahore, Pakistan from September 2018 to January 2019.

    RESULTS: Of the 384 questionnaires distributed, 346 health care professionals responded to the questionnaire (90.10% response rate). Most participants had good knowledge about ADR reporting, but pharmacist had comparatively better knowledge than other HCPs regarding ADR (89.18%) pharmacovigilance system (81.08%), its centres (72.97%) and function (91.89%). Most of the participants exhibited positive attitude regarding ADR reporting, such as 49.1% of physicians (P 

    Matched MeSH terms: Hospitals, Public
  10. Aoun M, Hasnan N, Al-Aaraj H
    East Mediterr Health J, 2018 Jun 10;24(3):269-276.
    PMID: 29908022 DOI: 10.26719/2018.24.3.269
    Background: Lean practices are critical to eliminate waste and enhance the quality of healthcare services through different improvement approaches of total quality management (TQM). In particular, the soft side of TQM is used to develop the innovation skills of employees that are essential for the continuous improvement strategies of hospitals.

    Aim: The main objective was to study the relationship between lean practices, soft TQM and innovation skills in Lebanese hospitals.

    Methods: A quantitative methodology was applied by surveying 352 employees from private and public hospitals in Lebanon. The primary collected data were valid and reliable when analysed by SPSS and AMOS software as a part of structural equation modelling.

    Results: Lean practices significantly influenced the innovation skills; however, soft TQM did not mediate this relationship because it was not well implemented, especially at the level of people-based management and continuous improvement.

    Conclusion: This study has implications for healthcare practitioners to make greater efforts to implement lean practices and soft TQM. Future studies are suggested to highlight different challenges facing quality improvement in the Region.

    Matched MeSH terms: Hospitals, Public
  11. ul Haq N, Hassali MA, Shafie AA, Saleem F, Aljadhey H
    Health Qual Life Outcomes, 2012 Aug 06;10:91.
    PMID: 22866752 DOI: 10.1186/1477-7525-10-91
    OBJECTIVE: The study aims to assess Health Related Quality of Life (HRQoL) among Hepatitis B (HB) patients and to identify significant predictors of the HRQoL in HB patients of Quetta, Pakistan.

    METHODS: A cross sectional study by adopting European Quality of Life scale (EQ-5D) for the assessment of HRQoL was conducted. All registered HB patients attending two public hospitals in Quetta, Pakistan were approached for study. Descriptive statistics were used to describe demographic and disease related characteristics of the patients. HRQoL was scored using values adapted from the United Kingdom general population survey. EQ-5D scale scores were compared with Mann-Whitney and Kruskal-Wallis test. Standard multiple regression analysis was performed to identify predictors of HRQoL. All analyses were performed using SPSS v 16.0.

    RESULTS: Three hundred and ninety HB patients were enrolled in the study. Majority of the participants (n = 126, 32.3%) were categorized in the age group of 18-27 years (36.07 ± 9.23). HRQoL was measured as poor in the current study patients (0.3498 ± 0.31785). The multivariate analysis revealed a significant model (F(10, 380) = 40.04, P 

    Matched MeSH terms: Hospitals, Public
  12. Arokiasamy JT
    Med J Malaysia, 1979 Sep;34(1):13-7.
    PMID: 542143
    Study site: Outpatient clinic at District hospital in Terengganu
    Matched MeSH terms: Hospitals, Public/utilization*
  13. Nwagbara VC, Rasiah R, Aslam MM
    Medicine (Baltimore), 2016 Sep;95(36):e4688.
    PMID: 27603363 DOI: 10.1097/MD.0000000000004688
    Public hospitals have come under heavy scrutiny across the world owing to rising expenditures. However, much of the focus has been on cutting down costs to raise efficiency levels. Although not denying the importance of efficiency measures, this article targets a performance issue that is relevant to address the quality of services rendered in public hospitals. Thus, it is important to focus on the effectiveness of resource utilization in these hospitals. Consequently, this article seeks to examine the impact of average length of stay (ALOS) and bed turnover rates (BTR) on bed occupancy rates (BOR).
    Matched MeSH terms: Hospitals, Public/utilization*
  14. Saleem F, Hassali M, Shafie A, Atif M
    J Young Pharm, 2012 Apr;4(2):101-7.
    PMID: 22754262 DOI: 10.4103/0975-1483.96624
    The study is aimed to explore the perceptions and experiences of hypertensive patients toward medication use and adherence. The study was qualitative in nature conducted at Sandamen Provisional Hospital of Quetta city, Pakistan; a public hospital catering to the health needs of about 40% of the population. A qualitative approach was used to gain an in-depth knowledge of the issues. Sixteen patients were interviewed, and the saturation point was achieved after the 14(th) interview. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Thematic content analysis yielded five major themes. (1) Perceived benefits and risks of medications, (2) physician's interaction with patients, (3) perception toward traditional remedies, (4) layman concept toward medications, and (5) beliefs toward hypertension and its control. The majority of the patients carried specific unrealistic beliefs regarding the long-term use of medication; yet these beliefs were heavily accepted and practiced by the society. The study indicated a number of key themes that can be used in changing the beliefs and experiences of hypertensive patients. Physician's attitude, patient's past experiences, and knowledge related to hypertension were noted as major contributing factors thus resulting in nonadherence to therapy prescribed.
    Matched MeSH terms: Hospitals, Public
  15. Akbar FH, Rivai F, Awang AH
    Enferm Clin, 2020 10;30 Suppl 6:165-169.
    PMID: 33040892 DOI: 10.1016/j.enfcli.2020.06.038
    OBJECTIVE: To know the difference in patient satisfaction level in the dental department of public hospitals and private hospital in Makassar.

    METHODS: This study was conducted in December 2017-February 2018 in the dental department of Labuang Baji, which is a government hospital and Ibnu Sina Hospital, which is a private hospital. The samples were all patients who received dental treatment. Patient satisfaction was measured using a questionnaire (PSQ-18). Data were tested using Independent T-Test and ANOVA using SPSS version 24.

    RESULTS: There were significant differences in accessibility, comfort, and communication between the public and private hospitals (p<0.05); the average value of patient satisfaction was higher in private hospitals.

    CONCLUSION: Patients in private hospitals are more satisfied with the health services provided by health care providers, compared to patients in public hospitals.

    Matched MeSH terms: Hospitals, Public
  16. Sharifa Ezat WP, Yang Rashidi A, Azimatun Noor A
    Med J Malaysia, 2023 May;78(3):318-328.
    PMID: 37271841
    INTRODUCTION: Private health insurance (PHI) plays an important supplementary role on top of the existing subsidised health financing system to prevent heavy reliance on out-of-pocket (OOP) expenses, especially in diseases with high costly treatment. This study was done to examine the factors associated with PHI usage among cancer patients and its associated influencing factors in Malaysia.

    MATERIALS AND METHODS: This cross-sectional study was conducted in three Malaysian public hospitals using a multilevel sampling technique to recruit 630 respondents. A validated self-developed four-domain questionnaire which includes one domain for health insurance was used to collect the relevant data.

    RESULTS: Approximately 31.7% of the respondents owned PHI. The PHI usage was significantly higher among male respondents (p=0.035), those aged 18-40 years old (p<0.001), Indian and Chinese ethnicities (p=0.002), with tertiary education level (p<0.001), employed (p<0.001), working in the private sector (p<0.001), high household income (T20) (p<0.001), home near to the hospital (p=0.001) and medium household size (p<0.001). The significant predictive factors were age 18-40 years aOR 3.01 (95% CI: 1.67-5.41), age 41-60 years aOR 2.22 (95% CI 1.41-3.49), medium (M40) income aOR 2.90 (95% CI: 1.92-4.39) and high (T20) income aOR 3.86 (95% CI: 1.68-18.91), home near to the hospital aOR 1.68 (95% CI: 1.10-2.55), medium household size aOR 2.20 (95% CI: 1.30-3.72) and female head of household aOR 1.79 (95% CI: 1.01-3.16). The type of cancer treatment, the location of treatment, prior treatment in private healthcare facilities and existence of financial coping mechanisms also were significant factors in determining PHI usage among cancer patients in this study.

    CONCLUSION: Several factors are significantly associated with PHI usage in cancer patients. The outcome of this study can guide policymakers to identify high-risk groups which need supplementary health insurance to bear the cost for their cancer treatment so that a better pre-payment health financing system such as a national health insurance can be formulated to cater for these groups.

    Matched MeSH terms: Hospitals, Public
  17. Zubaidah AW, Ariza A, Azmi S
    Med J Malaysia, 2006 Oct;61(4):487-9.
    PMID: 17243529 MyJurnal
    Hospital-acquired vancomycin-resistant enterococci (VRE) were first reported in the late 1980s and have since been an increasing problem worldwide. Kuala Lumpur Hospital thus far, to the best of our knowledge has been spared from this pathogen. We describe the first confirmed case of Enterococcus faecium exhibiting the van A phenotype in our hospital, in a patient with chronic renal failure who was successfully treated with linezolid. The microbiology laboratory plays an important role in the identification and detection of VRE.
    Matched MeSH terms: Hospitals, Public
  18. Humaidi N, Balakrishnan V
    Health Inf Manag, 2018 Jan;47(1):17-27.
    PMID: 28537207 DOI: 10.1177/1833358317700255
    BACKGROUND: Health information systems are innovative products designed to improve the delivery of effective healthcare, but they are also vulnerable to breaches of information security, including unauthorised access, use, disclosure, disruption, modification or destruction, and duplication of passwords. Greater openness and multi-connectedness between heterogeneous stakeholders within health networks increase the security risk.

    OBJECTIVE: The focus of this research was on the indirect effects of management support (MS) on user compliance behaviour (UCB) towards information security policies (ISPs) among health professionals in selected Malaysian public hospitals. The aim was to identify significant factors and provide a clearer understanding of the nature of compliance behaviour in the health sector environment.

    METHOD: Using a survey design and stratified random sampling method, self-administered questionnaires were distributed to 454 healthcare professionals in three hospitals. Drawing on theories of planned behaviour, perceived behavioural control (self-efficacy (SE) and MS components) and the trust factor, an information system security policies compliance model was developed to test three related constructs (MS, SE and perceived trust (PT)) and their relationship to UCB towards ISPs.

    RESULTS: Results showed a 52.8% variation in UCB through significant factors. Partial least squares structural equation modelling demonstrated that all factors were significant and that MS had an indirect effect on UCB through both PT and SE among respondents to this study.

    CONCLUSION: The research model based on the theory of planned behaviour in combination with other human and organisational factors has made a useful contribution towards explaining compliance behaviour in relation to organisational ISPs, with trust being the most significant factor. In adopting a multidimensional approach to management-user interactions via multidisciplinary concepts and theories to evaluate the association between the integrated management-user values and the nature of compliance towards ISPs among selected health professionals, this study has made a unique contribution to the literature.

    Matched MeSH terms: Hospitals, Public
  19. Basit AA
    J Psychol, 2017 Nov 17;151(8):701-721.
    PMID: 29043913 DOI: 10.1080/00223980.2017.1372350
    In the social context of job engagement, the role of trust in supervisor in predicting engagement of employees has received attention in research. Very limited research, however, has investigated the mechanisms mediating this dynamic relationship. To address this important gap in knowledge, the aim of this study was to examine psychological safety and felt obligation as two psychological mechanisms mediating the effect of trust in supervisor on job engagement. Drawing from job engagement and social exchange theories, the mediating roles of psychological safety and felt obligation in the trust-engagement relationship were empirically investigated in the Malaysian context. Using self-report questionnaires, data were collected from 337 nurses employed in a public hospital located near Kuala Lumpur, Malaysia. Results fully supported the proposed serial multiple mediator model. Trust in supervisor was indirectly related to job engagement via psychological safety followed by felt obligation. This study provides empirical evidence that trust in supervisor makes employees feel psychologically safe to employ and express their selves in their job roles. This satisfaction of the psychological safety need is interpreted by employees as an important socioemotional benefit that, in turn, makes them feel obligated to pay back to their organization through their enhanced level of job engagement. Implications for theory and practice were discussed.
    Matched MeSH terms: Hospitals, Public
  20. Lum KY, Binti Indera Putera KAS, Krishnan M, Binti Libasin Z, Binti Abdullah NNR, Binti Saman Saimy IS
    PLoS One, 2023;18(11):e0294055.
    PMID: 37956122 DOI: 10.1371/journal.pone.0294055
    INTRODUCTION: In Malaysia, lean was initiated in 2012 as part of an effort to reduce waiting time at the Ministry of Health (MOH) hospitals. As of now, there are 52 public hospitals that have officially implemented lean. However, little is known whether lean is sustained within the hospitals and the critical success factors (CSFs) affecting sustainability. Therefore, this study protocol aims to fill the gap by (i) identifying the critical success factors [CSFs] for lean sustainability in the MOH, (ii) developing a validated framework to support hospitals in sustaining lean, (iii) the framework will be adapted into a checklist to measure the level of lean sustainability (iv) interviewing hospitals with the lowest and highest level of lean sustainability to further explore the barriers and boosters in sustaining lean.

    METHODS AND ANALYSIS: This study will employ a mixed-method approach and will be conducted in three phases. The first phase involves a combination of scoping review and interviews with key informants to identify the CSFs known to affect lean sustainability at the MOH hospitals and present them in a validated framework. In the second phase, the framework will be adapted into a checklist to measure the level of lean sustainability in the MOH hospitals. The findings will be used to select the hospital with the lowest and highest level of lean sustainability for an interview in the third phase.

    DISCUSSION: The lean sustainability framework will be able to provide more relevant guidance on how to increase the likelihood of lean sustainability and serve as a validated measurement tool for MOH hospitals. In addition, this study will be able to outline the differences in the contributing factors between health organizations that showed a high level of lean sustainability compared to those struggling to sustain.

    Matched MeSH terms: Hospitals, Public*
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