Displaying publications 41 - 60 of 66 in total

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  1. User satisfaction with services provided by a drug information center in Sudan
    Fathelrahman AI, Awang R, Bashir AA, Taha IA, Ibrahim HM
    Pharm World Sci, 2008 Dec;30(6):759-63.
    PMID: 18704750 DOI: 10.1007/s11096-008-9245-0
    OBJECTIVE: The services of the Ministry of Health Drug Information Center--Khartoum State were evaluated by assessing users' satisfaction.

    METHOD: Four hundred and twenty-three subjects were recruited from center records using a systematic random sampling technique. Subjects who consented were interviewed by telephone using a specially designed semi-structured questionnaire. Descriptive as well as comparative analyses were carried out. Differences between groups were tested using the Chi-square test when applicable.

    RESULTS: The majority of users surveyed (89.6%) had called the center from within Khartoum State and 10.4% of users had called from other states. Of the enquiries, 36.1% were from pharmacists, 29.5% from physicians, and 22.3% from laypersons. The vast majority (93.1%) of respondents were educated to degree level or higher. Approximately one fifth, one half, and one third of the users surveyed had consulted the center >5 times, 2-5 times, and once, respectively. More than 90% of users rated the services provided as good to excellent and 94.7% declared their probable intention to continue utilizing the center in the future.

    CONCLUSION: The center succeeded in satisfying and retaining its users by providing an acceptable quality of service.

    Matched MeSH terms: Quality Assurance, Health Care*
  2. Domestic and imported products--the Malaysian experience in assuring safe and sufficient plasma products
    Ayob Y
    Dev Biol (Basel), 2007;127:169-73.
    PMID: 17486890
    Matched MeSH terms: Quality Assurance, Health Care/standards*
  3. Fulltext Quality assurance in mammography: College of Radiology Survey in Malaysia
    Ho EL, Ng KH, Wong JH, Wang HB
    Med J Malaysia, 2006 Jun;61(2):204-8.
    PMID: 16898312
    Malaysia's mammography QA practice was surveyed based on the Malaysian Ministry of Health and the American College of Radiology (ACR) requirements. Data on mammography unit, processor, image receptor, exposure factors, mean glandular dose (MGD), sensitometry, image quality and viewbox luminance were obtained. Mean developer temperature and cycle time were 34.1 +/- 1.8degreesC and 107.7 +/- 33.2 seconds. Mean base+fog level, speed index and contrast index were 0.20+/-0.01, 1.20+/-0.01 and 1.33+/-0.26 respectively. Eighty-six percent of the fifty centres passed the image quality test while 12.5% complied with ACR recommended viewbox luminance. Average MGD was 1.0+/-0.4 mGy. Malaysia is on the right track for QA but with room for total quality improvement.
    Matched MeSH terms: Quality Assurance, Health Care*
  4. Global quality control perspective for the physical and technical aspects of screen-film mammography--image quality and radiation dose
    Ng KH, Jamal N, DeWerd L
    Radiat Prot Dosimetry, 2006;121(4):445-51.
    PMID: 16709704
    The systematic monitoring of image quality and radiation dose is an ultimate solution to ensuring the continuously high quality of mammography examination. At present several protocols exist around the world, and different test objects are used for quality control (QC) of the physical and technical aspects of screen-film mammography. This situation may lead to differences in radiation image quality and dose reported. This article reviews the global QC perspective for the physical and technical aspects of screen-film mammography with regard to image quality and radiation dose. It points out issues that must be resolved in terms of radiation dose and that also affect the comparison.
    Matched MeSH terms: Quality Assurance, Health Care/standards*
  5. Comparison of radiology residency programs in ten countries
    Willatt JM, Mason AC
    Eur Radiol, 2006 Feb;16(2):437-44.
    PMID: 15702337
    The purpose of our study was to compare various aspects of radiology training schemes in ten countries. A questionnaire was sent to senior residents in the UK, USA, Canada, Australia, New Zealand, Italy, Egypt, India, Malaysia and Greece. The questions concerned length of training, required pre-training experience, the organization of the training scheme, teaching, resources, stages at which residents can independently perform and report examinations, fellowships, and progression to jobs. A wide variety of training, ranging from highly scheduled programs with detailed aims and objectives, to self-learning occurs across the world. Examinations and assessments are also variable. There are lessons to be learned from varying practices; more exchanges of ideas should be encouraged. In view of the "internationalization" of radiology services and the variation in training styles an international qualification for quality assurance purposes may be desirable.
    Matched MeSH terms: Quality Assurance, Health Care/standards
  6. Fulltext An audit of intraoperative frozen section in Johor
    Khoo JJ
    Med J Malaysia, 2004 Mar;59(1):50-5.
    PMID: 15535336 MyJurnal
    A 4-year-review was carried out on intraoperative frozen section consultations in Sultanah Aminah Hospital, Johor Bahru. Two hundred and fifteen specimens were received from 79 patients in the period between January 1999 and December 2002. An average of 2.72 specimens per patient was received. The overall diagnostic accuracy was high, 97.56%. The diagnoses were deferred in 4.65% of the specimens. False positive diagnoses were made in 3 specimens (1.46%) and false negative diagnoses in 2 specimens (0.98%). This gave an error rate of 2.44%. The main cause of error was incorrect interpretation of the pathologic findings. In the present study, frozen sections showed good sensitivity (97.98%) and specificity (97.16%). Despite its limitations, frozen section is still generally considered to be an accurate mode of intraoperative consultation to assist the surgeon in deciding the best therapeutic approach for his patient at the operating table. The use of frozen section with proper indications was cost-effective as it helped lower the number of reoperations. An audit of intraoperative frozen section from time to time serves as part of an ongoing quality assurance program and should be recommended where the service is available.
    Matched MeSH terms: Quality Assurance, Health Care*
  7. Fulltext Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions
    Jarrar M, Abdul Rahman H, Don MS
    Glob J Health Sci, 2016;8(6):44132.
    PMID: 26755459 DOI: 10.5539/gjhs.v8n6p75
    Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia.
    Matched MeSH terms: Quality Assurance, Health Care/standards*
  8. Fulltext POSSUM--a model for surgical outcome audit in quality care
    Ng KJ, Yii MK
    Med J Malaysia, 2003 Oct;58(4):516-21.
    PMID: 15190626
    Comparative surgical audit to monitor quality of care should be performed with a risk-adjusted scoring system rather than using crude morbidity and mortality rates. A validated and widely applied risk adjusted scoring system, P-POSSUM (Portsmouth-Physiological and Operative Severity Score for the enUmeration of Mortality) methodology, was applied to a prospective series of predominantly general surgical patients at the Sarawak General Hospital, Kuching over a six months period. The patients were grouped into four risk groups. The observed mortality rates were not significantly different from predicted rates, showing that the quality of surgical care was at par with typical western series. The simplicity and advantages of this scoring system over other auditing tools are discussed. The P-POSSUM methodology could form the basis of local comparative surgical audit for assessment and maintenance of quality care.
    Matched MeSH terms: Quality Assurance, Health Care*
  9. Cross-calibration, Least Significant Change and Quality Assurance in Multiple Dual-Energy X-ray Absorptiometry Scanner Environments: 2019 ISCD Official Position
    Jankowski LG, Warner S, Gaither K, Lenchik L, Fan B, Lu Y, et al.
    J Clin Densitom, 2019 09 07;22(4):472-483.
    PMID: 31558404 DOI: 10.1016/j.jocd.2019.09.001
    In preparation for the International Society for Clinical Densitometry Position Development Conference (PDC) 2019 in Kuala Lumpur, Malaysia, a cross-calibration and precision task force was assembled and tasked to review the literature, summarize the findings, and generate positions to answer 4 related questions provided by the PDC Steering Committee, which expand upon the current ISCD official positions on these subjects. (1) How should a provider with multiple dual-energy X-ray absorptiometry (DXA) scanners of the same make and model calculate least significant change (LSC)? (2) How should a provider with multiple DXA systems with the same manufacturer but different models calculate LSC? (3) How should a provider with multiple DXA systems from different manufacturers and models calculate LSC? (4) Are there specific phantom procedures that one can use to provide trustworthy in vitro cross calibration for same models, different models, and different makes? Based on task force deliberations and the resulting systematic literature reviews, 3 new positions were developed to address these more complex scenarios not addressed by current official positions on single scanner cross calibration and LSC. These new positions provide appropriate guidance to large multiple DXA scanner providers wishing to offer patients flexibility and convenience, and clearly define good clinical practice requirements to that end.
    Matched MeSH terms: Quality Assurance, Health Care*
  10. Reduction of central-line-associated bloodstream infection (CLABSI) in resource limited, nonintensive care unit (ICU) settings
    Poh KW, Ngan CH, Wong JY, Ng TK, Mohd Noor N
    Int J Health Care Qual Assur, 2020 Feb 25;ahead-of-print(ahead-of-print).
    PMID: 32108452 DOI: 10.1108/IJHCQA-11-2019-0195
    PURPOSE: There was limited study available on successful intervention for central-line-associated bloodstream infection (CLABSI) done at nonintensive care unit (ICU) and resources-limited setting. The objective of this study was to design, implement and evaluate a strategy to reduce CLABSI rate in non-ICU settings at general medical wards of Hospital Tuanku Ja'afar Seremban.

    DESIGN/METHODOLOGY/APPROACH: Preinterventional study was conducted in one-month period of January 2019, followed by intervention period from February to March 2019. Postintervention study was conducted from April to July 2019. The CLABSI rates were compared between pre and postintervention periods. A multifaceted intervention bundle was implemented, which comprised (1) educational program for healthcare workers, (2) weekly audit and feedback and (3) implementation of central line bundle of care.

    FINDINGS: There was a significant overall reduction of CLABSI rate between preintervention and postintervention period [incidence rate ratio (IRR) of 0.06 (95 percent CI, 0.01-0.33; P = 0.001)].

    PRACTICAL IMPLICATIONS: CLABSI rates were reduced by a multifaceted intervention bundle, even in non-ICU and resource-limited setting. This includes a preinterventional study to identify the risk factors followed by a local adaption of the recommended care bundles. This study recommends resources-limited hospitals to design a strategy that is suitable for their own local setting to reduce CLABSI.

    ORIGINALITY/VALUE: This study demonstrated the feasibility of a multifaceted intervention bundle that was locally adapted with an evidence-based approach to reduce CLABSI rate in non-ICU and resource-limited setting.

    Matched MeSH terms: Quality Assurance, Health Care*
  11. Fulltext Critical incident monitoring in anaesthesia (1)
    Choy YC
    Med J Malaysia, 2006 Dec;61(5):577-85.
    PMID: 17623959
    Critical incident monitoring in anaesthesia is an important tool for quality improvement and maintenance of high safety standards in anaesthetic services. It is now widely accepted as a useful quality improvement technique for reducing morbidity and mortality in anaesthesia and has become part of the many quality assurance programmes of many general hospitals under the Ministry of Health. Despite wide-spread reservations about its value, critical incident monitoring is a classical qualitative research technique which is particularly useful where problems are complex, contextual and influenced by the interaction of physical, psychological and social factors. Thus, it is well suited to be used in probing the complex factors behind human error and system failure. Human error has significant contributions to morbidities and mortalities in anaesthesia. Understanding the relationships between, errors, incidents and accidents is important for prevention and risk management to reduce harm to patients. Cardiac arrests in the operating theatre (OT) and prolonged stay in recovery, constituted the bulk of reported incidents. Cardiac arrests in OT resulted in significant mortality and involved mostly de-compensated patients and those with unstable cardiovascular functions, presenting for emergency operations. Prolonged-stay in the recovery extended period of observation for ill patients. Prolonged stay in recovery was justifiable in some cases, as these patients needed a longer period of post-operative observation until they were stable enough to return to the ward. The advantages of the relatively low cost, and the ability to provide a comprehensive body of detailed qualitative information, which can be used to develop strategies to prevent and manage existing problems and to plan further initiatives for patient safety makes critical incident monitoring a valuable tool in ensuring patient safety. The contribution of critical incident reporting to the issue of patient safety is far from clear and very difficult to study. Efforts to do so have tended to rely on incident reporting, the only practical approach when funding is limited. The heterogeneity of critically ill patients as a group means that huge study populations would be required if other research techniques were to be used. In the era of evidence-based medicine, anaesthetists are looking for alternative evidence-based solutions to problems that we have accepted traditionally when we cannot quantify for good practical reasons. In the quest for patient safety, investment should be made in reliable audit, detection and reporting systems. The growing recognition that human error usually result from a failure of a system rather than an individual should be fostered to allow more lessons to be learnt, an approach that has been successful in other, safety-critical industries. New technology has a great deal to offer and investment is warranted in novel fail-safe drug administration systems. Last but not the least the importance of simple and sensible changes and better education should be remembered.
    Matched MeSH terms: Quality Assurance, Health Care/methods*
  12. Fulltext A quality assurance study on the administration of medication by nurses in a neonatal intensive care unit
    Raja Lope RJ, Boo NY, Rohana J, Cheah FC
    Singapore Med J, 2009 Jan;50(1):68-72.
    PMID: 19224087
    This study aimed to determine the rates of non-adherence to standard steps of medication administration and medication administration errors committed by registered nurses in a neonatal intensive care unit before and after intervention.
    Matched MeSH terms: Quality Assurance, Health Care*
  13. Fulltext Active resuscitation in Malaysian district hospitals--is it adequate?
    Chan SC
    Med J Malaysia, 1997 Sep;52(3):244-50.
    PMID: 10968093
    Adequacy of active resuscitation in collapsed inpatients aged 12 and above (excluding those with terminal illness) were studied in 6 Malaysian district hospitals for 3 months starting 1/1/93. Results showed 59.5% (25 out of 42 inpatients) were inadequately resuscitated measured by: failure of nurses to initiate resuscitation (24%), duration of resuscitation less than 30 minutes (42%) and incompletely equipped emergency trolleys (44%). Questionnaires revealed lack of knowledge and training in cardiopulmonary resuscitation in medical staff. Regular cardiopulmonary resuscitation courses, regular spot checks on emergency trolleys and management protocols on active resuscitation are recommended. Each hospital should design its own criteria for adequacy.
    Matched MeSH terms: Quality Assurance, Health Care
  14. Fulltext A study on the adequacy of outpatient management of essential hypertension in MOH hospitals and health centres
    Mohd Ghazali RJ
    ISBN: 983-3038-10-7
    Citation: Mohd Ghazali RJ. A study on the adequacy of outpatient management of essential hypertension in MOH hospitals and health centres. Kuala Lumpur: Institute of Health Management, Ministry of Health, Malaysia; 2006
    Matched MeSH terms: Quality Assurance, Health Care
  15. New horizon in quality care--Asian perspective
    Han MC
    World Hosp Health Serv, 1997;33(2):8-13.
    PMID: 10174544
    The current status and directions for changes of issues related to quality care in health services in Asian countries--Malaysia, China, Singapore, Japan and Korea are overviewed. In countries with public sector dominated health care systems such as Malaysia. China and Singapore, governmental leadership in quality care is prominent along with legislative backup. Japan and Korea have private sector dominated health care systems and quality care activities are mainly carried out by non-governmental organisations. Hospital accreditation programs are in the developing stages in most countries, although China and Korea started in 1980. Most Asian countries are at the initial stages in quality care activities and focus has been placed on education and training. Asian countries are not exempted from efforts to enhance quality care activities and a new horizon in quality health care is emerging.
    Matched MeSH terms: Quality Assurance, Health Care/legislation & jurisprudence; Quality Assurance, Health Care/trends*
  16. The growth of corporate private hospitals in Malaysia: policy contradictions in health system pluralism
    Barraclough S
    Int J Health Serv, 1997;27(4):643-59.
    PMID: 9399111
    The rapid growth of corporate investment in the Malaysian private hospital sector has had a considerable impact on the health care system. Sustained economic growth, the development of new urban areas, an enlarged middle class, and the inclusion of hospital insurance in salary packages have all contributed to a financially lucrative investment environment for hospital entrepreneurs. Many of Malaysia's most technologically advanced hospitals employing leading specialists are owned and operated as corporate business ventures. Corporate hospital investment has been actively encouraged by the government, which regards an expanded private sector as a vital complement to the public hospital system. Yet this rapid growth of corporately owned private hospitals has posed serious contradictions for health care policy in terms of issues such as equity, cost and quality, the effect on the wider health system, and the very role of the state in health care provision. This article describes the growth of corporate investment in Malaysia's private hospital sector and explores some of the attendant policy contradictions.
    Matched MeSH terms: Quality Assurance, Health Care/economics; Quality Assurance, Health Care/trends
  17. An evaluation framework for Health Information Systems: human, organization and technology-fit factors (HOT-fit)
    Yusof MM, Kuljis J, Papazafeiropoulou A, Stergioulas LK
    Int J Med Inform, 2008 Jun;77(6):386-98.
    PMID: 17964851
    The realization of Health Information Systems (HIS) requires rigorous evaluation that addresses technology, human and organization issues. Our review indicates that current evaluation methods evaluate different aspects of HIS and they can be improved upon. A new evaluation framework, human, organization and technology-fit (HOT-fit) was developed after having conducted a critical appraisal of the findings of existing HIS evaluation studies. HOT-fit builds on previous models of IS evaluation--in particular, the IS Success Model and the IT-Organization Fit Model. This paper introduces the new framework for HIS evaluation that incorporates comprehensive dimensions and measures of HIS and provides a technological, human and organizational fit.
    Matched MeSH terms: Quality Assurance, Health Care/methods*; Quality Assurance, Health Care/organization & administration*
  18. External quality assurance in Malaysia
    Nawawi H, Lim HH, Zakiah I
    Southeast Asian J. Trop. Med. Public Health, 1999;30 Suppl 3:39-45.
    PMID: 10926257
    An activity supportive of the MOH QA Programme, the National EQAS for clinical chemistry monitors for analytical performance in core routine biochemical testing by the pathology laboratories, with unsatisfactory performance scores serving to alert against deficiencies or problems and the scores in subsequent challenges providing the feedback of effectiveness of remedial actions taken. While unacceptable individual analyte performance score (variance index score, VIS) indicated problems in instruments, reagent and calibrators, or the use of inherently poorer methods, repeated occurrence of unsatisfactory OMRVIS was traceable to generally poor laboratory management of usually inadequately-equipment small laboratories. The outcome has been one of slow but gradual improvement in the overall performance of participating laboratories, with a move towards methods upgrading and standardization to achieve greater concordance of results. Presently, the programme is limited to 61 government and 4 private hospital laboratories in the country for 12 commonly assayed clinical biochemistry analytes. It is hoped that the NEQAS could be extended to the other private laboratories and that of academic institutions. However, this is dependent to a large extent on the manpower and financial support obtainable by the organizing body of the programme in the future. Belk and Sunderman, 1947 demonstrated that laboratories participating in an quality assessment scheme could rapidly and dramatically improve their analytical performance. In some countries, participation has become mandatory, and acceptable performance is a requirement in laboratory accreditation. The need and value of the NEQAP is, therefore, evident. While there may be limitations in the national programme. efforts are being made at improving the programme within the means and resources of the organising body. The goals of the NEQAP are not just to monitor performance but also to educate. On this, matters related to and supportive of these goals have also been pursued. The annual workshop/forum on quality controls had allowed exchange of information between representatives of participating laboratories and the organising body. Recently in the 1997 MOH Quality Improvement evaluation, Quality Control has been evaluated together with the other 17 such activities. The study on knowledge, attitude and practice has provided the necessary feedback and will be used for future planning in making efforts at increasing the effectiveness and benefits of the all QC activities including this NEQAP for clinical chemistry. In addition, there is a need to look into areas such as selection of methods and test systems, and improvement of continuing education, training as well as research in quality improvement as suggested by the Quality Improvement evaluation.
    Matched MeSH terms: Quality Assurance, Health Care/methods; Quality Assurance, Health Care/organization & administration*
  19. Fulltext Development and validation of a new Prescription Quality Index
    Hassan NB, Ismail HC, Naing L, Conroy RM, Abdul Rahman AR
    Br J Clin Pharmacol, 2010 Oct;70(4):500-13.
    PMID: 20840442 DOI: 10.1111/j.1365-2125.2009.03597.x
    The aims were to develop and validate a new Prescription Quality Index (PQI) for the measurement of prescription quality in chronic diseases.
    Matched MeSH terms: Quality Assurance, Health Care/methods*; Quality Assurance, Health Care/standards
  20. Fulltext Quality in health care
    Sahan AK
    Med J Malaysia, 1986 Dec;41(4):284-6.
    PMID: 3670148
    Matched MeSH terms: Quality Assurance, Health Care
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