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Fulltext Quality in family practice

Rajakumar MK

Asia Pac Fam Med, 2002;1(2&3):74-8.

Quality programs are difficult to implement where social support for healthcare costs are inadequate and there is no institutional support for quality programs to guide and assist the doctor in pratice. ‘Quality’ is not the good intention to do better, but the process of measurement of behavioral change against set targets. For the majority of the doctors of this region who practice under great constraints, this article outlines some quality activities that are entirely within their personal initiative and responsibility, but should make a real difference to the quality of care provided.nd responsibility, but should make a real difference to the quality of care you provide.
Republished in: Republished in: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare and Society: Essays by Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019: 68-74

Matched MeSH terms: Quality Assurance, Health Care
Cytopathology in malaysia

Jayaram G, Yahya H

Diagn Cytopathol, 2002 Nov;27(5):322-4.
PMID: 12412003
Matched MeSH terms: Quality Assurance, Health Care*
Teaching quality assurance in Malaysia: a report on six workshops on quality assurance in patient care services for health care providers in government service

Reerink E, Nafisah bte Alihussein

Med Educ, 1990 Jul;24(4):359-65.
PMID: 2395428 DOI: 10.1111/j.1365-2923.1990.tb02452.x

In the government hospitals of Malaysia quality assurance activities have been introduced since 1985. Local clinicians and other health care workers had been stimulated by the Ministry of Health to pursue these activities, but they found themselves untrained and ill-prepared for the job. With the help of the World Health Organization a programme of training courses has been set up and conducted, most recently, in February 1989. A model for teaching quality assurance was developed, geared towards the needs of the Malaysian clinicians and taking into account the recent progress made in the development of quality assurance approaches worldwide. Moreover, quality assurance results from one Malaysian hospital were used, thus increasing the relevance of the teaching. Results show that Malaysian clinicians have appreciated the training and have relaxed in their attitude towards quality assurance and the government's involvement in it. During the various courses pitfalls have been identified in the teaching of modern quality assurance in health care for audiences from developing and newly industrialized countries.

Matched MeSH terms: Quality Assurance, Health Care*
An integrated MUSA to measure health care service quality from a patient's perspective in a resource-constrained setting

Al-Awlaqi MA, Aamer AM

Int J Health Plann Manage, 2020 Jan;35(1):e119-e132.
PMID: 31670407 DOI: 10.1002/hpm.2943

PURPOSE: Although assessing the quality of health services offered in a least developed country such as Yemen is very important, it is not yet given attention. As a result, Yemeni patients started to look for higher quality of health services abroad. Thus, Yemeni health private providers need to know how to link their patients' satisfaction to the quality of the services offered to end up with more satisfied patients and higher health service quality offered.
METHODOLOGY: Data were collected form 5310 patients in 249 private clinics. The patients evaluated their satisfaction on the quality of service on the basis of nine criteria that comprised 31 subcriteria. We used multicriteria satisfaction analysis (MUSA) to analyze the data.
FINDINGS AND CONCLUSION: The data analysis results showed low level of satisfaction on the health care quality services offered by the private clinics in Yemen. The majority of the criteria and subcriteria showed low level of satisfaction, high demand, and high mandate for improvement.

Matched MeSH terms: Quality Assurance, Health Care/methods*
Experience of the first survey of the pilot project of Asian Quality Assurance Survey program

Lee KN, Yoon SY, Cho HI

Southeast Asian J Trop Med Public Health, 2002;33 Suppl 2:30-43.
PMID: 12755265

The Asian Network for Clinical Laboratory Standardization (ANCLS) decided to start her First Inter-laboratory Quality Assurance survey at the business meeting during the Second Asian Colloquium on October 21-22, 2000 in Kobe, Japan. The first survey materials of Asian Quality Assurance Survey (AQuAS) were distributed in July 2001 to 21 hospitals in the field of chemistry and 22 hospitals in the field of hematology among total 24 participating laboratories from seven Asian countries: Indonesia, Japan, Korea, Malaysia, Philippines, Singapore and Thailand. The survey methods in chemistry and in hematology were somewhat different. In chemistry the survey material was considered as unknown but handled similarly to the sample from the patient. Nineteen routine tests were performed only once. The hematology samples were considered as unknown but handled similarly to control or calibration material. Five parameters were tested five times repetitively and their average for each parameter was calculated. All the results were supposed to be sent back to the office within two weeks. Although it took more than two weeks, the return rate was 100%. The analysis was performed in several ways such as all the results together, by instruments and by methods. Mean, standard deviation (SD), standard deviation index (SDI), coefficient of variation (CV) and variance index score (VIS) were to be calculated in chemistry, and in hematology the same parameter were to be calculated except CV and VIS. In the first survey, the CV in chemistry was not calculated and the analysis by instrument or by methodology was also not attempted since there were not enough participating hospitals to do such analysis. In hematology the analysis was done by instrument only. The survey process was carried out successfully though there were some difficulties in communication tools, transportation methods and handling of specimens due to different weather conditions, and returning the report in the correct unit and to the correct place. The submitted data were acceptable for analysis. There were some differences in the units of measurement in different countries or laboratories. It was necessary to convert some of the units. Some laboratories apparently do not perform certain tests such as calcium, potasium and gamma-glutamyltransferase (gamma-GT). The gamma-GT is the most frequently not performed test. With the experience of this first survey, all the members involved in the survey have been trained well to do future surveys.

Matched MeSH terms: Quality Assurance, Health Care*
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
Fulltext An audit of the quality of lateral cephalometric radiographs for orthodontic treatment

Mohd Zambri Mohamed Makhbul, Rashidah Burhanudin, Wan Nurazreena Wan Hassan

Malaysian Dental Journal, 2016;39(1):35-51.
MyJurnal

It is not uncommon for lateral cephalometric radiographs to be outsourced for orthodontic treatment, as not all orthodontic clinics in Malaysia have their own cephalometric radiograph machine. Since the quality of outsourced radiographs is not within the governance of the clinician, there is a need to monitor the quality of cephalometric radiographs received. Aim: To audit the quality of lateral cephalometric radiographs received at the Orthodontic Specialist Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur, Malaysia. Methodology: Lateral cephalometric records of patients with registration numbers up to 200 in 2015 were selected and assessed using a light box. The quality of good radiographs were based on 15 parameters: correct head position; presence of the scale; important structures centered on the film; patient’s name; date taken; patient’s identifier; label not obscuring radiograph; soft tissue visible; teeth in occlusion; good contrast; ‘A’ point identifiable; ‘B’ point identifiable; nasion identifiable; sella identifiable; incisors visible and their angulation measureable. Standard was set at 100%, as radiographs received should contain all parameters. Results: Five records were excluded (2 had no radiographs, 2 had digital radiographs, and 1 record could not be traced). 64.5% radiographs had all 15 parameters, 30.3%, 3.9% and 1.3% with 14, 13 and 12 parameters, respectively. Patient’s name, identifier, date taken, soft tissue visible, ‘B’ point identifiable, nasion identifiable were present in all radiographs (100%). Incisor visible and their angulation measurable were present in 99%; good contrast and ‘A’ point identifiable in 98%; presence of scale, important structures centred on films and sella identifiable in 97%, label not obscuring radiographs in 96%; correct head position in 86%; and teeth in occlusion in 88% of radiographs. Conclusion: There is a need to liaise with the radiology unit to improve the quality of radiographs taken.

Matched MeSH terms: Quality Assurance, Health Care
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*
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
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*
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*
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
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
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
Navigating the mammography quality standard act in USA: Role of US FDA and future scopes of regulation-A narrative review

Bhumika NM, Mishra S, Arjun M, Venkatesh MP

J Med Imaging Radiat Sci, 2024 Dec;55(4):101420.
PMID: 38789291 DOI: 10.1016/j.jmir.2024.04.013

BACKGROUND: The Mammography Quality Standards Act (MQSA) has significant impact on providing high-quality mammography services for the early detection of breast cancer. MQSA emphasizes quality assurance, regulatory compliance, and patient safety. It guides technological integration, ensuring uniform quality across the United States of America (USA). This review synthesizes key MQSA information, analysing compliance, and facilitating policy discussions for improvements, aiming to inspire further policy research in cancer screening by adopting MQSA's success factors.
METHODS: The review spanned 1997 to 2023, adhering to Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Databases like PubMed, ScienceDirect, and Google Scholar were searched for relevant literature. Selection criteria covered English-language journals, US Food and Drug Administration (FDA) guidelines, and professional organizational standards, revealing key aspects of MQSA and breast cancer diagnostics in the USA.
RESULTS AND DISCUSSION: MQSA's legislative aspects guarantee the effectiveness of regulations for high-quality mammography. It addresses technology, emphasizes inspections, and balances compliance with healthcare burdens. Procedural guidelines prioritize patient outcomes, minimize errors, and address access disparities. Regular updates are crucial to align screening services with technological changes, maintaining safety and accuracy nationwide.
CONCLUSION: The FDA's collaboration with stakeholders, including medical specialists and patient advocacy groups, has contributed to crucial legislative aspects of MQSA. The accuracy of mammography screenings has significantly improved by MQSA's installation of stringent quality and regulatory standards. Compliance with MQSA guidelines led to higher accuracy, safety, and better detection rates. Ongoing efforts must aim to refine guidelines, address emerging challenges, and optimize breast cancer detection.

Matched MeSH terms: Quality Assurance, Health Care
Enlightened oncologists can provide quality cancer care at reduced costs

Devi CR

J Surg Oncol, 2014 Nov;110(6):643-4.
PMID: 25125148 DOI: 10.1002/jso.23746
Matched MeSH terms: Quality Assurance, Health Care*
Hospital waiting time: the forgotten premise of healthcare service delivery?

Pillay DI, Ghazali RJ, Manaf NH, Abdullah AH, Bakar AA, Salikin F, et al.

Int J Health Care Qual Assur, 2011;24(7):506-22.
PMID: 22204085

This is a national study which aims to determine the average waiting time in Malaysian public hospitals and to gauge the level of patient satisfaction with the waiting time. It also aims to identify factors perceived by healthcare providers which contribute to the waiting time problem.

Matched MeSH terms: Quality Assurance, Health Care/organization & administration*
Critical incident monitoring in anaesthesia (2)

Choy CY

Curr Opin Anaesthesiol, 2008 Apr;21(2):183-6.
PMID: 18443485 DOI: 10.1097/ACO.0b013e3282f33592

PURPOSE OF REVIEW: Updates on developments in critical incident monitoring in anaesthesia, and assesses its role in improving patient safety.
RECENT FINDINGS: Critical incident reporting has become more widely accepted as an effective way to improve anaesthetic safety, and has continued to highlight the importance of human errors and system failures. The establishment of an international database also improves critical incident reporting. Experiences from the national reporting and learning system in the UK have provided some solutions to the many problems and criticisms faced by the critical incident reporting technique. Direct observations to detect errors are more accurate than voluntary reporting of critical incidents, and may be a promising new approach.
SUMMARY: Critical incident monitoring is a valuable tool in ensuring patient safety due to its low cost and the ability to provide a comprehensive body of detailed qualitative information. The qualitative information gathered can be used to develop strategies to prevent and manage existing problems, as well as to plan further initiatives for patient safety. Novel approaches should complement existing methods to achieve better results. The development of a culture which emphasises safety should go hand in hand with current audit activities.

Matched MeSH terms: Quality Assurance, Health Care/methods*
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*
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*

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