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.
This cross-sectional study looked at the prevalence of microalbuminuria and retinopathy in a cohort of 926 young, Type 1 and Type 2 diabetes mellitus (DM) patients, and determined the factors which were associated with these microvascular complications. The prevalence of microalbuminuria, defined as the albumin:creatinine ratio > or = 2.5 (for males) or > or = 3.5 mg/mmol (for females), was 13.4% in Type 1 DM, 69.5% in insulin-requiring Type 2 DM and 16% in Type 2 DM treated only with oral hypoglycemic agents. Compared to those with normal renal functions, these patients were older (P < or = 0.01), had significantly elevated blood pressures (P < 0.01 or P = 0.0001), and in the case of Type 1 DM, with a higher body mass index (P = 0.0001) and waist-hip ratio (P < 0.01). The prevalence of diabetic retinopathy in Type 1 DM was found to increase with the duration of diabetes, from 1.4% in the newly-onset (< 5 years), to 9.9% in those with 5-10 years disease, to 35% among patients with more than 10 years of diabetes (P < 0.0001). In this study, it was also observed that 10% of the Type 2 DM patients already had retinopathy within 5 years of diagnosis, and the prevalence increased significantly to 42.9% (P < 0.0001) among patients who had been diabetics for more than 10 years. Stepwise multiple regression analysis showed that besides the disease duration, systolic blood pressure was the most common and significant determinant for both microalbuminuria and retinopathy in both types of DM, thus implying that in order to reduce the risk of microvascular complications in diabetes mellitus, systolic and not just the diastolic blood pressure, should be effectively controlled.