PETALING JAYA: Healthcare facilities under the Health Ministry have been instructed to prepare a concrete plan to manage overcrowding at emergency departments within three months.
“Each facility shall prepare a written implementation action plan within three months from the date of this letter.
“State Health Departments shall be responsible for monitoring the implementation within their respective facilities and conducting periodic audits to ensure operational effectiveness and sustainability,” Health director-general Datuk Dr Mahathar Abd Wahab said in a circular dated June 4 sighted by The Star.
He said the Emergency and Trauma Department (ETD), as the primary gateway to hospital wards, faces recurring and systemic overcrowding issues each year.
He said a stronger holistic approach is needed as managing overcrowding is not solely the ETD’s responsibility, adding that it is a shared responsibility involving various services and departments within healthcare facilities.
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“The Health Ministry views this matter with utmost seriousness and has designated it as one of the key initiatives under the Minister of Health’s transformation agenda during the MOH Leadership Retreat on Jan 12-13,” he said.
The matter was subsequently refined through the MOH Strategic Planning Workshop and the Patient Flow and Movement Management Workshop, involving various stakeholders at the headquarters, state Health Departments, hospitals and health clinics, with the objective of formulating comprehensive and holistic policy actions, he added.
He said improvements to patient flow and movement management, revolving around patient-centred care, must be implemented comprehensively across the patient journey from patient arrival (input) and treatment processes (throughput) to and post-treatment care (output).
This includes strengthening input by enhancing access, triage, referral systems and healthcare system capacity to ensure services are delivered efficiently and in an integrated manner.
Optimising throughput involves improving internal hospital processes and treatment pathways, including interdepartmental coordination, bed management, patient flow from the ETD to ward admission, discharge management, as well as enhancing output by strengthening continuity of care through effective appointment management, virtual follow-ups, stepping up engagements with transport providers, and providing training to manage patients and outpatient parenteral antibiotic therapy.
The guidelines attached to the circular highlighted the need to expand the use of digital triage systems, standardising referral criteria and enhancing triage functions across both ETD and primary healthcare facilities.
Low-risk patients are to be managed at health clinics, while high-risk cases requiring admission should be directly referred to hospital wards.
Access to primary healthcare should be improved through the expansion of extended hours (EH) services at health clinics, particularly in high-demand areas.
This should be supported by strengthening existing EH services, improving laboratory capabilities, deploying health clinic personnel to hospitals where appropriate, and increasing public awareness of available after-hours healthcare services.
Selected health clinics should be upgraded to Integrated Health Clinics with enhanced diagnostic capabilities, including X-ray and laboratory services, to reduce pressure on nearby hospitals.
Direct admission processes from health clinics to hospital wards should also be streamlined through clear policies, standardised clinical guidelines and collaboration between family medicine specialists and hospital-based specialists.
