Noor Hazilah Abd. Manaf

Effects of Lean Six Sigma application in healthcare services: a literature review.

Abstract The healthcare organization is the place where defects and mistakes cannot be tolerated. A simple mistake can cost a human life so defects or mistakes must be eliminated in healthcare service processes. A Lean Six Sigma (LSS) approach is the best option in a healthcare environment for dealing with a critical patient. The LSS methodology optimizes the average reduction of a desired process. The expected results can be reductions in several aspects of healthcare such as patient waiting time in emergency departments, lost charges for billing in patient financial services, delinquent medical records, diagnostic result turnaround times, accounts receivable days, patients’ length of stay, or medication errors. This paper mainly discusses the effects of the LSS approach in different hospitals around the world according to the literature review. This review also discusses the relationship between LSS as well as their impacts on healthcare services based on literature review.

Patient Satisfaction as An Indicator of Service Quality In Malaysian Public Hospitals

The Ministry of Health (MOH) is the major healthcare provider in Malaysia, although the service is also being complemented by the private sector which constitutes about 35% of overall healthcare services. Public hospitals in the country are organised into national level, state level and district level. The national level hospital is Hospital Kuala Lumpur, which serves as the National Referral Centre. It is the largest hospital in the country with 2500 beds, providing a comprehensive range of tertiary care services. The state level hospitals provide a comprehensive range of secondary care services and are located in the state capital of each of the thirteen federal states in the country. These are also large hospitals with bed capacity ranging from 800‐1200. The district level hospitals on the other hand, provide basic impatient care services. For those with resident specialist, some secondary level speciality services are also provided. District hospitals without specialities are generally smaller with beds ranging from 30 to 150, while those with specialists may have beds ranging from 200 to 500.

Inpatient satisfaction: an analysis of Malaysian public hospitals

Purpose – The purpose of this paper is to provide an empirical analysis on inpatient satisfaction in Malaysian public hospitals.Design/methodology/approach – A self‐administered questionnaire was the main data collection method. Altogether, 23 hospitals throughout Peninsular Malaysia participated in the survey. Cluster sampling was used in the selection of the respondent hospitals, while convenience sampling was used in administering the survey.Findings – Three factors of inpatient satisfaction were extracted, which were clinical and physical dimensions of service, and additional facilities for patients and family members. Inpatient satisfaction was found to be higher for the clinical dimension than for the physical dimension. Overall, inpatient satisfaction was high, as reflected by the high mean score of the variables, although caution was expressed in interpreting the findings, particularly the low expectations of patients to begin with.Research limitations/implications – The research was limited to in...

Medical tourism service quality: finally some empirical findings

The purpose of this paper is to examine service quality, perceived value, overall satisfaction and future intention among medical tourists who seek treatment in Malaysian private hospitals. Self-administered questionnaire was the main method of data collection. Respondents comprised foreign patients who seek medical treatment, and/or related medical services such as tests and medical check-ups. Expatriates and foreign nationals residing in Malaysia were excluded. Altogether 173 responses were received and analysed by SPSS 17. Three dimensions of medical tourism service quality were identified, namely, medical staff quality, supporting services quality and administrative services quality. Medical staff quality was found to predict all three variables of patient satisfaction, perceived value and future intention for treatment. Very limited empirical research has been carried out with actual data from patients due to difficulty in getting access to international patients, and patients’ reluctance to participate. This study is among the first few which examines medical tourism service quality with actual patient data. The research identifies important constituents of medical tourism which may assist policy-makers and hospital managers in better understanding the industry.

Critical factors of service quality in a graduate school of Malaysia

Purpose – This paper aims to evaluate the service quality of a higher educational institute in Malaysia based on the seven dimensions, namely administrative service, tangibles, academic programmes, academic staff, delivery of teaching, assurance, and empathy of academic staff. Design/methodology/approach – This study surveyed 221 students of IIUM Graduate School of Management (GSM) based on the self-administrative research questionnaire. The research data were analyzed by using exploratory factor analysis, reliability analysis, independent samples t-test, and multiple regression analysis. Findings – Results indicate IIUM GSM students have positive and significant perception on administrative service, tangibles, delivery teaching and assurance, but they do not have significant perception on academic programmes, academic staff and empathy of academic staff. Research limitations/implications – This research only conducted in a graduate school of Malaysia and this result might not represent all Malaysian grad...

Development and validation of patient satisfaction instrument

Purpose – Patient satisfaction of healthcare organisation is often used as a measure of organisational efficiency. However, there is a need for valid and reliable instruments to be used in order to ensure that the findings are accurate. This paper aims to explore the development and validation of an outpatient satisfaction instrument, with emphasis on the service of the attending physician.Design/methodology/approach – Twenty‐six items on service of the attending physician and registration service were developed for the instrument based on earlier published research. The instrument was applied to a cross‐sectional study and data collected were factor analysed to ascertain construct validity, while reliability was established by assessing the internal consistency.Findings – The instrument was found to establish excellent reliability with Cronbachs alpha 0.975, and two factors, “service of doctors” and “registration service”, were extracted from the factor analysis.Research limitations/implications – A val...

Satisfaction among Gen Y patients: A case study of students at the International Islamic University Malaysia

Purpose - The purpose of this paper is to assess satisfaction of Generation Y (Gen Y) patients in Malaysia. Design/methodology/approach - A patient satisfaction study was conducted on an outpatient clinic at the Health Centre of the International Islamic University Malaysia (IIUM). The majority of students at the IIUM comprise undergraduates who are within the age group categorised as Gen Y. Patient satisfaction questionnaire was used as the main method of data collection. The survey was administered to patients over a two-week period during regular semester session. Findings - More than 85 per cent of the respondents are below 25 years of age, reflecting the Gen Y demography. Significant difference is found in the level of satisfaction on the service of doctors between the younger Gen Y undergraduate students and postgraduate students; as well as the Gen Y and the employees. Level of confidence in the clinic is also lower among those of the Gen Y age group, reflecting the higher expectation of service quality. Originality/value - Patient satisfaction is an important measure of the quality of care provided by healthcare organisations. Understanding the needs of a target group of patients can be used for continuous improvement where their specific needs and expectations can be addressed. A study on patient satisfaction among the Gen Y has been rarely explored. The study is an early attempt in filling the void.

Sociodemographic, lifestyle and health determinants of suicidal behaviour in Malaysia

Suicide has become a serious matter in both developed and developing countries. The objective of the present study is to examine the factors affecting suicidal behaviour among adults in Malaysia. A nationally representative data which consists of 10,141 respondents is used for analysis. A trivariate probit model is utilised to identify the probability of having suicide ideation, suicide plan and suicide attempt. Results of the regression analysis show that to ensure unbiased estimates, a trivariate probit model should be used instead of three separate probit models. The determining factors of suicidal behaviour are income, age, gender, ethnicity, education, marital status, self-rated health and being diagnosed with diabetes and hypercholesterolemia. The likelihood of adopting suicidal behaviour is lower among higher income earners and older individuals. Being male and married significantly reduce the propensity to engage in suicidal behaviour. Of all the ethnic groups, Indian/others displays the highest likelihood of adopting suicidal behaviour. There is a positive relationship between poor health condition and suicide. Policies targeted at individuals who are likely to adopt suicidal behaviour may be effective in lowering the prevalence of suicide.

Preparedness for hospital practice in assuring quality of care

Purpose The purpose of this paper is to identify the dimensions of preparedness for hospital practice among newly graduated medical officers in Malaysian hospitals who are undergoing their housemanship training; and to compare the level of preparedness among the different curricula and predict the dimensions of preparedness for hospital practice. Design/methodology/approach A national study was carried out and data collection was by means of self-administered questionnaire. Data obtained (n=1,213) were subjected to exploratory factor analysis using Statistical Package for Social Sciences version 18 in extracting the dimensions of preparedness for hospital practice. Findings Nine dimensions of hospital practice were identified which were access to information and IT skills, interpersonal skills, basic skills, and continuing professional development, holistic skills, coping skills, ethic and legal skills, patient management skills, scientific knowledge, and clinical skills. Overall, the respondents felt their medical schools prepared them for hospital practice. The strongest predictor for preparedness for hospital practice is coping skills. Holistic skill and preparedness for hospital practice was found to be negatively associated. Those who graduated from twining programmes between Malaysian and overseas universities were found to be better prepared for hospital practice. Social implications An understanding on preparedness for hospital practice among newly graduated medical officers is a step forward in assuring patient safety and quality of care. Originality/value Although of significant importance, however, a study of this nature is rarely researched and the first for Malaysian houseman.

Measuring quality performance between public and private hospitals in Malaysia

Purpose This study aims to measure quality performance of the Malaysian hospitals based on eight items, namely, progress of quality management, medical service cost, reduce errors in medical services, patient waiting time, reduce waste in processes, patient complaint, employee job satisfaction and patient satisfaction. Mainly, it identifies difference or conformance between public and private hospitals on quality performance. Design/methodology/approach This study distributed 1,007 self-administered survey questionnaires to the hospital staff (i.e. doctors, nurses, pharmacists and medical laboratory technologists), resulting in 438 useful responses (43.5 per cent response rate). Research data were analysed based on descriptive analysis and independent samples’ t-tests using SPSS version 23. Findings The findings of this study indicate that there are significant differences between public and private hospital staff on progress of quality improvement process, patient satisfaction and cost of the medical services. Private hospital staff believed that their hospital’s quality management process and patient satisfaction has been improved over the past years compared to public hospital. However, private hospital staff does not perceive their medical service cost has been reduced over the past years compared to public hospital. Research limitations/implications This research focused solely on quality performance of the Malaysian health sector and, thus, the results might not be applicable to other countries. Originality/value Present research findings provide guidelines for enhancing quality performance in Malaysian public and private healthcare sectors and other countries.