Assoc. Prof. Dr. M.A.

Kadar Marikar
CEO Malaysian Society of Quality in Health
Introduction to Malaysia
Key Patient Safety Strategies
Patient Safety Initiatives In Malaysia
Recent Achievement
The Success Factors
Challenges
 Statistics
POPULATION (2013) 28.3 million
Life expectancy male (2010) 71.9
Life expectancy female (2010) 77
Annual population growth rate 1.3
( 2011)
Total expenditure on health 4.96%
per GDP (2009)
MOH Hospitals & Institutions 138
(2011)
Private hospital s (2011) 220
132 HOSPITAL 879 HEALTH CLINIC 106 MOTHER & CHILD CLINIC

1,864 RURAL CLINIC 87 1MALAYSIA CLINIC 1,774 DENTAL CLINIC

SPECIAL MEDICAL 6
6 INSTITUTIONS NATIONAL INSTITUTE 16 SPECIAL INSTITUTIONS
185 AMBULANCE 7 FLYING DOCTOR SERVICE
1MALAYSIA MOBILE CLINIC 12

MOBILE DENTAL
25 MOBILE DENTAL CLINIC MOBILE DENTAL TEAM
410 136 SCHOOL TEAM

1 1MALAYSIA BOAT CLINIC 1 1MALAYSIA DENTAL CLINIC

KEY PATIENT SAFETY STRATEGIES
Promotion &
Education

Research
Policies &
Guidelines
PATIENT
SAFETY

Specific Organisational
Programmes Structure

Monitoring
System
 KEY PATIENT SAFETY STRATEGIES
Organisational Structure Policies & Guidelines
Malaysian Society for Healthcare standards (Hospitals,
Clinics,Chronic dialysis, Dental
Quality in Health (MSQH) Services)
Patient Safety Council Malaysian Patient Safety Goals
Malaysia (at MoH) Clinical Governance
Incident Reporting & RCA
Patient Safety Committee
Safe Surgery Saves Lives
(at health facility )
Peri-operative Mortality
PATIENTS for Patient Notification & Review
Safety Malaysia Independent Inquiry
Transfusion Safety
Clinical Practice Guidelines
Promotion & Education
1st National Patient Safety
Campaign 2013
Specific patient safety areas
Safety Culture
Malaysian Patient Safety
Goals
Clinical Governance
Incident Reporting, Root
cause analysis
Patient for Patient Safety
Malaysia in 2014
 KEY PATIENT SAFETY STRATEGIES
Monitoring System
Accreditation of
Healthcare Facilities and
Services.
Malaysian Patient Safety
Goal
Hospital Indicator
Performance for
Accountability (HPIA)
Clinical Indicators
Specific Research/Systematic
Programmes Review
Clean Care is Safer Care PRIMARY STUDIES
Safe Surgery Saves Lives Medical Safety - Inpatient Care
Tackling Antimicrobial Resistance Medical safety Primary care
Medication Safety
Improve accuracy of patient Blood Transfusion Safety
identification Vaccine Safety
Transfusion Safety Laboratory Safety
Medication Safety Culture the patient perception
Critical value program Handoff Communication
Fall prevention Dental Safety
Patient Falls
Healthcare- associated pressure ulcer
prevention Patient Safety Culture
Catheter-Related Bloodstream
Infection Prevention SYSTEMATIC REVIEW
Ventilator Associated Pneumonia
Culture
Handoff Communication
Prevention
Medication
Incident Reporting and Learning Patients unvoiced needs
System
PATIENT SAFETY COUNCIL MALAYSIA

Formed following directive from Malaysian Cabinet on 29th January

2003.
Functions:
Advise the Honorable Health Minister on national patient safety
policies, strategies and action plans
Enhance implementation of patient safety strategies
Monitor and evaluate achievement of the Malaysian Patient Safety
Goals and take action at national level
Promote and facilitate national, regional and international
collaboration in patient safety.
 Chairman
(Director General of
Health Malaysia)

Appointed Private Ministry of Ministry of Higher Education Patients for Secretariat

Members Sectors/NGOs Health Ministry of Patient
(3) UMMC, UKMMC, Safety (Quality in Medical
Defense
(3) (8) (19) HUSM Malaysia Care Section, MOH)

Association Malaysian Academy Malaysian Academy of Malaysian Academy Malaysian

of Private Occupational & Dental
Medical of Society for Pharmaceutica of Family
Hospital Environmental
Malaysia Association Medicine Quality in Health Medicine Malaysia l Society Physician Association

Currently 36 members

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PATIENT SAFETY COMMITTEE
(at facility level)
To lead patient safety initiatives
in the facility
To plan and establish ways,
work system and programme to
ensure patient safety
To ensure implementation
Malaysian Patient Safety Goals
To monitor and assess status
of patient safety using e-goals
patient safety
To discuss incidents, complaints
and patient safety issues; take
appropriate actions and assess
its effectiveness
To plan and implement
promotional and educational
activities related to patient
safety
Others deem necessary
Consortium of Association Ministry of Health
of Medical Clinics Malaysia
MSQH Committee Members
 PATIENTS FOR PATIENT SAFETY MALAYSIA
PATIENTS For Patient Safety Country
Workshop conducted by MSQH & Ministry
of Health in collaboration with WHO on
5th-6th Sept 2013.
Following this, PATIENTS For Patient
Safety Malaysia (PFPSM), voluntary
organization was established.
PFPSM was launched by Honorary Minister
of Health on 29th April 2014
PFPSM promotes partnership between
patients- healthcare providers -consumers in
enhancing patient safety.
Patients engagement & empowerment to
improve patient safety
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MSQH Accreditation Standards
Malaysian Hospital
Accreditation Standards (1999)

Medical Clinic Accreditation

Programme (2012)

Chronic Dialysis Treatment

Standards (2013)

Dental Clinic Accreditation

Programme (2016)
 First edition (1999 )

Second edition (2004)

Third edition (2008)

Fourth edition (2013)

Fifth edition (2017)

 Current WHO Patient Safety Goals

1. Identify patient correctly

2. Improve effective communication
3. Improve the safety of high-alert medications
4. Ensure correct-site, correct-procedure, correct-patient surgery
5. Reduce the risk of healthcare associated infections.
6. Reduce the risk of patient harm resulting from fall

PATIENT SAFETY SOLUTIONS

1. Look-Alike, Sound-Alike Medication Names
2. Patient Identification.
3. Communication During Patient Hand-Overs.
4. Performance of Correct Procedure at Correct Body Site.
5. Control of Concentrated Electrolyte Solutions
6. Assuring Medication Accuracy at Transitions in Care.
7. Avoiding Catheter and Tubing Misconnections.
8. Single Use of Injection Devices.
 POLICY -D.G HEALTH CIRCULAR NO 2/2013
-Establishment of Patient Safety Committee & Implementation
of Malaysian Patient Safety Goals

The Star Newspaper

Monday 20th May 2013

D.G Health Circular 2/2013

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1) *To implement Clinical Governance
2) To implement WHOs 1st Global Patient
Safety Challenge: Clean Care is Safer
Care
3) To implement WHOs 2nd Global Patient
Safety Challenge: Safe Surgery Saves
Lives
4) To implement WHOs 3rd Global Patient
Safety Challenge: Tackling Antimicrobial
Resistance
5) To improve the accuracy of patient
identification
6) To ensure the safety of transfusions of
blood and blood products
7) *To improve medication safety
8) To improve clinical communication by
implementing a critical value program
9)* To reduce patient fall
10)To reduce the incidence of healthcare- associated
pressure ulcer
11) To reduce Catheter-Related Bloodstream
Infection (CRBSI)
12) To reduce Ventilator Associated Pneumonia
(VAP)
13) *To implement the Patient Safety Incident
Reporting and Learning System
*Applicable for clinics
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 e-goals patient safety
(online notification of MPSG performance)
(http://patientsafety.moh.gov.my/)

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 MALAYSIAN PATIENT SAFETY GOALS
NOTIFICATION 2013 VIA e-goals patient safety
(1st 6 months of implementation)

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 38 indicators
e.g.: Percentage of issues raised in the meeting with the Board of
Visitors whereby response and action had been taken (Standard 70%)
 270 indicators
42 specialties and subspecialties
e.g.: Percentage of Post Partum Haemorrhage (Standard 1%)
Lists of Accredited Programme
Malaysian Hospital Accreditation Program is a voluntary,
independent programme conduct by Malaysian Society for
Quality in Health (MSQH); a member of the International Society
for Quality in Health (ISQua)
5th Edition Malaysian Hospital Accreditation Standards
Surveyor Training Programme
Guidelines produced by Ministry of Health Malaysia :
82 Clinical Practice Guidelines
1ST NATIONAL PATIENT SAFETY CAMPAIGN

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 1ST NATIONAL PATIENT SAFETY CAMPAIGN, SEMINAR
&
LAUNCHING OF MALAYSIAN PATIENT SAFETY GOALS 24TH JUNE 2013

D.G of Health with stakeholders

Signing of Malaysian Patient Safety

Press Conference 1st National
Goals Replica By D.G of Health 34
Patient Safety Campaign
CONFERENCES, CAMPAIGN AT FACILITY LEVEL &
EXHIBITION ON PATIENT SAFETY
MSQH-MOH Patient Safety
International Conference

Malaysian International
Healthcare Tourism Expo

Campaign & Seminar at Patient Safety Campaign in

UMMC Private Hospital
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MSQH Healthcare Summit 2016
5th Edition Hospital Accreditation Standards Training
ECRI Risk Management Training
International Forum on Quality & Safety in Healthcare organized
by BMJ
ISQua 2017 in London
ISQua 2018 in Kuala Lumpur Convention Centre, KLCC, Malaysia
 MSQH Healthcare Summit 2016

Risk Management Training

Programme by ECRI
International Forum on Quality & Safety
in Healthcare organized by BMJ
ISQua 2017 in London
ISQua 2018 in Kuala Lumpur Convention Centre,
KLCC, Malaysia
FIRST GLOBAL PATIENT SAFETY CHALLENGE
CLEAN CARE IS SAFER CARE

The Hon.Minister of Health, affirmed

Malaysia's commitment, 15th May 2006
witnessed by Professor Didier Pittet, leader of the
Global Patient Safety Challenge
INFECTION PREVENTION & CONTROL THROUGH INNOVATION
15th January 2014

Prof. Diedier Pittiet

Director, Infection Control Program, WHO Datuk Dr. Noor Hisham
Collaborating Centre on Patient Safety Abdullah
-Delivering lecture Infection Control: From Director General of Health
Rubbing to Dancing Around The World 43
-Delivering keynote address
 HAND HYGIENE COMPLIANCE VS
HEALTH CARE ASSOCIATED INFECTION
National Average of HHCR,
2008 - 2012
100
80
Percentage
82.8
60
40 56.6
20
0
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2008 2009 2010 2011 2012
National Average of HCAI, 2008 - 2012
3.5
3
3.15
Percentage

2.5
1.54
2
1.5
1
0.5
0
March Sept March Sept March Sept March Sept March Sept
2008 2009 2010 2011 2012 44
SECOND GLOBAL PATIENT SAFETY CHALLENGE
SAFE SURGERY SAVES LIVES
THEME MINISTRY OF HEALTH MALAYSIA
S A F E R S U R G E RY PERIOPERATIVE CHECKLIST
THROUGH BETTER
COMMUNICATION

Launching of Safety
Surgery Saves Lives
2009 45
IMPROVE PATIENT IDENTIFICATION

46
MEDICATION SAFETY

tall man lettering concept

for sound alike medication.

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RCA workshop for state health
department, hospitals & health
clinics:
State Directors & officers
Hospital Directors
Doctors
Paramedics
have been conducted since 2005.
According to zone, states and
facilities.
3-2 days workshop
30-50 people, 6-10 per group
Content of Workshop:
Concept of Incident Reporting &
Learning System
Flow of reporting
Concept of RCA
How to do RCA
Examples of case presentation
Group discussion on how to conduct
RCA based on scenarios
Group presentation
Latest Training on Incident Reporting & Learning System and RCA was
conducted in MSQH, The National Cancer Institute Malaysia and Kuala
Lumpur State Health Dept.
LESSONS LEARNT FROM INCIDENT
Why Patient Safety Incident Happen?

Lack of /unclear Refuse to use Assume culture

communication check list

Multi Lack of
OK Culture supervision
tasking

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 RECENT ACHIEVEMENTS OF 2017
Quality & patient safety now included in 11th Malaysia Plan (2016-2020)

Patient Safety Council of Malaysia (13th January 2014) agreed to implement WHO Multi-
professional Patient Safety Curriculum Guide in:
Medical, Pharmacy, Dental, Allied Health and Nursing undergraduate programs
Housemanship training

Chairperson of PATIENTS For Patient Safety Malaysia is now a member of Patient

Safety Council of Malaysia (patient representative) and MSQH Committee member.

Malaysian Patient Safety Goals notification (June- Dec 2013) received for the first time

Developments of Healthcare standards and Refinements and Upgrading of existing

standards.

PFPS Malaysia activities (Pilot project with 13 public & private hospitals in 2016)
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 SUCCESS FACTORS
Commitment of top leaders

Smart partnership and Good collaboration between Public, Private and

Profesional bodies.

Proactive and dedicated champions at national and facility level.

Internalization and institutionalization of patient safety mindset and

safety culture.

Top-down and bottom-up feedback system between policy makers,

implementers, providers and patients and families.

Integration of patient safety in Malaysian Healthcare Accreditation

Standards for facilities and services.
 CHALLENGES

Increase
workload

Staff
factors

Limited
resources

Patient &
family factors
 ACKNOWLEDGEMENT

WORLD HEALTH ORGANISATION Geneva and WPRO

MINISTRY OF HEALTH MALAYSIA
MALAYSIAN SOCIETY FOR QUALITY IN HEALTH
PATIENTS FOR PATIENT SAFETY MALAYSIA

Thank you

www.msqh.com.my
kadar@msqh.com.my
Always remember to be safety conscious and
above all do no harm

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