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5.0000 Reception counter, 4.1569 Vending Machine, Signages, 3.9020
4.0000 Waiting Area,
4.0588 4.0000 Changing room, Temperature,
4.0196 4.0196

Stairs, 4.1961 Lightings, 4.0196

3.0000 Pharmacy, 4.2549 Scent/smell, 3.9804
Registration
Lift, 4.1961
counter, 4.1176

Carpark, 4.0196 Recovery room,
3.9216

2.0000 Storage/locker ,
3.9804
Toilet, 4.2157 Surau, 4.0196 Medical

Canteen, 3.6667 Chairs and sofas, instruments/infrastruct
3.9804 ures, 4.0588

1.0000

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Total Mean Value: 4.039 (High Satisfaction)

Figure 6. 18: Infrastructures and Facilities Satisfaction Index

6.3.4 Factors Influencing Inpatient Satisfaction

Figure X illustrates the CTC inpatient satisfaction index in terms of healthcare service
delivery and performance. The following conclusions regarding CTC’s current
performance in healthcare service delivery may be drawn from statistics as below:

i. Inpatient data indicates a high degree of satisfaction with the quality and
performance of CTC’s services.

ii. All factors were noted to have a high satisfaction index; however, emphasis
should be given to several items from Treatment and Related Information
(nurse in charge did not introduce themselves at each shift), Physical
Environment (do not have a choice of menu for meals), and Infrastructures and
Facilities (canteen condition) which contribute to moderate satisfaction index.

iii. Overall, only two factors, Access & Admission and Hospital Experience, were
shown to significantly affect inpatient satisfaction with CTC’s service quality
and performance when all factors were regressed to find the link.

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CA CR AVE P Values Results
0.955 0.964 0.816
Satisfaction 0.984 0.985 0.781 0.030 +
Access & Admission à Satisfaction 0.98 0.983 0.88 0.911 -
Discharge & Follow-Up à Satisfaction 0.98 0.983 0.908 0.047 +
Hospital Experience à Satisfaction 0.973 0.976 0.672 0.413 -
Infrastructure & Facilities à Satisfaction 0.97 0.974 0.755 0.686 -
Psychical Environment à Satisfaction 0.98 0.982 0.793 0.663 -
Treatment & Related Information à
Satisfaction 0.769
R Square

5

4

Discharge & Treatment &

3 Follow-Up , 3.931 Infrastructure & Related

Facilities , 4.039 Information , 4.036

2 Access & Hospital Psychical
Admission, 4.005 Experience , 4.15 Environment ,

1 3.992 Satisfaction, 4.137
12 67
345

Figure 6. 19: CTC Inpatient Satisfaction Index in Healthcare Service Delivery &
Performance

6.3.5 Data Visualization for Inpatients Feedbacks

At the end of the questionnaire, inpatients were also invited to offer further input. The
responses to open-ended questions are summed together using text data
visualization. The word cloud below, shown in Figure X, demonstrates simple text
analysis based on the most prevalent terms. The larger and bolder a word appears,
the more frequently it appears in a document and the more essential it is. “Patients,”
“ward,” “noisy,” “service improvement,” “cancer treatment,” “satisfactory,” “public
doctor,” “good specialist,” and “best” are the most often used terms in the remarks.

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Figure 6. 20: Text Data Visualization for Inpatient Feedbacks

6.4 FINDINGS FOR POTENTIAL SEGMENT

6.4.1 Non-Patient Profiling

The demographics profile of the respondents is presented in Table 6.6. For non-patient
respondents, the profiling was based on age, gender, religion, education level,
monthly income, location, employment status and affiliation (additional data is
attached in Appendix J). With 44.3% males and 55.7% females, the gender distribution
is nearly identical. The majority of respondents (31.9%) are between the ages of 36
and 45, with a minority of those aged 65 and over (2.5%). Islam has the most significant
percentage of adherents (81.7%). Overall, 86.1% of people had a diploma or above,
with 31.6% of those are in the B40 group (RM2,000 to RM4,000). Pulau Pinang had the
largest percentage of respondents (46.1%), followed by Kedah (22.3%, and Perak
(9%). 61% of the population is unaffiliated with USM.

Table 6. 6: Demographics Profile of Non-Patient

Variables Frequency % Variables Frequency %
Age Gender
18-25 Years 65 20.1 Male 143 44.3
26-35 Years 79 24.5 Female 180 55.7
36-45 Years 103 31.9 Religion
46-55 Years 55 17.0 Islam 264 81.7

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56-65 years 13 4.0 Buddha 25 7.7
> 65 Years Old 8 2.5 5.0
Location Hindu 16 4.3
Perlis 8 2.5 1.2
Kedah 72 22.3 Christian 14
Pulau Pinang 149 46.1 0.9
Perak 29 9.0 Others 4 13.0
Selangor 21 6.5 23.2
Negeri Sembilan 2 0.6 Education 40.6
Melaka 1 0.3 15.2
Johor 7 2.2 Primary 3 7.1
Terengganu 4 1.2
Kelantan 21 6.5 Secondary 42 27.9
Pahang 2 0.6 31.6
Sabah 1 0.3 Diploma 75 17.3
Sarawak 4 1.2 11.1
WP Kuala Lumpur 2 0.6 Bachelor’s Degree 131 5.9
Employment Status 6.2
Unemployed 30 9.3 Master’s Degree 49
Self-employed 44 13.6 27.6
Government 143 44.3 Ph.D. 23 61.0
Private 55 17.0 10.5
Student 36 11.1 Monthly Income 0.9
Housewife 15 4.6
< RM 2,000 90

RM 2,001 – RM 4,000 102

RM 4,001 – RM 6,000 56

RM 6,001 – RM 8,000 36

RM 8,001 – RM 10,000 19

> RM 10,000 20

Affiliation

USM Staff 89

Not USM Staff 197

USM Student-Local 34

USM Student- 3

International

6.4.2 Awareness of CTC as an Executive Health Services (EHS)

We probed about the respondents’ awareness of CTC Executive Health Services and
their readiness to pay for private wings. The cross-tabulation result is shown in Figure
6.21. It is noted that the respondents are aware of the services and are prepared to
pay for the services. This is a promising sign that CTC should start marketing and
profiting from CTC EHS. If the additional services are of high quality, the respondents
are ready to pay for it. Having said that, the services provided by EHS should be of the
highest quality to maintain the standard of equivalency with private hospital services.

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140 Willing to Not Willing
120 Pay to Pay
100 134 51

80 78 60
60
40
20

0

Know About CTC EHS
Do Not Know About CTC

EHS

Figure 6. 21: CTC EHS Service Awareness

6.4.3 CTC Customer Brand-Based Equity

Customer brand-based equity (CBBE) is a metric that assesses how the CTC brand is
perceived by its customers. Consumer attitudes regarding CTC have shifted as a result
of this. CTC should be able to determine its brand value based on the CBBE results,
which will enable them to determine how stakeholders and the general public view
CTC as a healthcare brand. Table X shows that the stakeholders agree that CBBE
(which includes all six variables investigated) is an essential factor in building an
excellent brand-based relationship with CTC.

Brand Awareness Mean Std. Deviation Agreement Scale
Brand Association 2.2402 1.00024 Agree
Brand Trust 2.2867 1.01157 Agree
Brand Image 2.1771 0.97336 Agree
Brand Equity 2.1558 0.92132 Agree
Perceived Quality 2.3375 1.00691 Agree
2.2056 0.96193 Agree

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5

Brand Image, Perceived Quality,
2.2056
4 Brand Trust, 2.1771 2.1558
Brand Equity,
Brand Awareness, 2.3375
3 2.2402

2

Brand Association, 2.2867

1
1 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6

Figure 6. 22: Agreement Scale for CBBE

The results of the relationship analysis between all of the variables studied showed that
they had a positive and significant impact on CTC. The CBBE link is predicated on the
notion that CBBE influences CTC as a healthcare provider and service brand. As
demonstrated in Table 6.7, Brand Trust, Brand Image, and Brand Equity all have a role
in the Perceived Quality of CTC services.

Table 6. 7: CTC Brand Value as a Healthcare Service Delivery & Performance

CA CR AVE P Values Results
0.974 0.979 0.905
Perceived Quality 0.240 -
Brand Awareness à Perceived 0.954 0.965 0.845
Quality 0.042 +
Brand Associations à Perceived 0.945 0.958 0.821
Quality 0.045 +
Brand Trust à Perceived Quality 0.969 0.976 0.891 0.000 +
Brand Image à Perceived Quality 0.949 0.96 0.798 0.000 +
Brand Equity à Perceived Quality 0.965 0.975 0.906 0.000 +
Word-of-Mouth à Perceived Quality 0.960 0.964 0.968
0.831
R Square

6.5 OTHER FINDINGS

6.5.1 The Quality of Infrastructure & Facilities

In addition, we compared the mean value of Infrastructures and Facilities in CTC for
two patient segments: outpatients and inpatients. Overall, we discovered that the
mean values are similar and at a high level of satisfaction. Most notably, both groups

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agreed that the canteen is the weakest aspect that requires immediate
improvement, with an average score at Moderate Satisfaction Index.

Medical instruments/infrastructures 4.0549.253
Scent/smell 3.948.1004
4.0240.261
Temperature 4.0240.237
Lightings 3.940.0221
Signages 33.8.95252
3.7223.980
Recovery room 3.848.0420
Storage/locker 3.9840.203
Changing room
Chairs and sofas 44.2.35155
3.846.7020
Pharmacy 3.49.10720
Surau
44..000209
Carpark 44..129166
Vending Machine 44.1.29666

Stairs 4.045.1987
Lift 4.140.2816
3.3403.667
Waiting Area 4.1148.311
Toilet 4.41.52757

Canteen
Registration counter

Reception counter

1.000 2.000 3.000 4.000 5.000

Outpatient Inpatient

Figure 6. 23: Comparison Between Two Patient Segments on Infrastructures and
Facilities

6.5.2 The Effect of Word-of-Mouth Communication

Surprisingly, we looked at the factor of word-of-mouth communication when
determining the uncontrolled component of communication on the CTC brand. The
outcome is intriguing, as the influence of word-of-mouth communication is strong for
CTC patients but low for stakeholders and the general public. It demonstrates that
CTC’s recommendation, conversation, dialogue, and reputation as a healthcare
provider have a smaller influence on the general public than current CTC patients.

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5.0000

4.0000

3.0000

2.0000

1.0000 I heard that Within a
CTC is a healthcare
I heard and I heard about I heard about I heard about trusted, provider, I
known about CTC excellent CTC reliability CTC as a heard that
CTC before trustworthy reputable and CTC is among
services in medical health credible
from others treatment provider name the best
3.9627
Outpatient 4.0954 2.38 4.0913 4.0249 4.0373 3.9502
Non-Patient 2.30 2.32
2.32 2.33 2.50

Figure 6. 24: Word-of-Mouth Effect Between Current and Potential Patient

6.5.3 CTC Brand Based Equity for 3 Stakeholder Segments

The importance of developing a strong CTC brand is highlighted in this section. It also
gives CTC service marketers helpful advice on building brand equity, placing hospital
services in marketplaces, and patient and customer selection procedures. CTC’s
brand’s position in the minds of patients, stakeholders, and their companions may be
improved by applying any of the compelling aspects of CTC brand equity. The mean
brand equity value for the three segments is explained in Figure 6.24. The data show
that the mean values are concentrated around the Agree scale line, indicating that
CTC has a better possibility of becoming a powerful healthcare service provider if its
brand value is enhanced (additional data is attached in Appendix K).

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5 Brand Equity for Brand Equity for
Inpatient, 1.9853 Outpatient,
Brand Equity for 1.8237
Non-Patient,
Agree
4 2.3375

3

2

1
123

Figure 6. 25: Brand Equity Mean Value Comparison between 3 Stakeholder
Segments

6.5 RECOMMENDATION AND CONCLUSION

Understanding the attitudes and perceptions of current and potential patients is
critical for maintaining high-quality service and developing a strong brand image and
value. As a healthcare service provider, CTC must develop a mechanism to measure
the satisfaction of current and prospective patients. For this survey, we utilized the
SERVQUAL instruments, Public Hospitals in Australia, and Keller’s Customer Brand Based
Equity to assess overall present and potential patient satisfaction and brand
perception.

Despite this, we may conclude that current patient satisfaction is high based on all
mean values obtained. On the other hand, the analyses resulted in a better
knowledge of the elements that contribute to satisfaction and dissatisfaction. Four
evaluated variables positively impacted outpatient satisfaction: Service Tangibility,
Reliability, Empathy, Fee Fairness, and CTC Infrastructures and Facilities, but inpatient
satisfaction was positively impacted by just two variables: Access and Admission and
Hospital Experience. These validated variables can be used as an appropriate
management measuring result for overall CTC patient satisfaction

Although from all mean values calculated, we can conclude that the current patient
level of satisfaction is high. However, the analyses resulted in the understanding of
factors that lead to satisfaction and dissatisfaction. For outpatient, four tested
variables were confirmed to positively impact satisfaction: Service Tangibility,
Reliability, Empathy, Fee Fairness and CTC Infrastructures and facilities. In contrast, for
inpatients, only two variables were confirmed to contribute to the satisfaction of CTC
services and performances: the Access and Admission and Hospital Experience. These

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confirmed variables can be applied as the appropriate managerial measuring result
for overall CTC patient satisfaction.

According to the analysis also, CTC Customer Brand-Based Equity that explains the
Perceived Values of CTC as a healthcare brand indicates that five tested variables
were confirmed to have a positive contribution out of six tested that is Brand
Associations, Trust, Image, Equity and Word-of-Mouth. At the same time, Brand
Awareness was found to have no impact on the brand perceived value. This is a
glaring indicator that CTC should take into consideration. CTC potential customers
have low brand awareness, although their connection with the brand is promising.

The following are some of the areas that may be addressed at CTC when assessing
existing and potential patient satisfaction and perception.

Fee Fairness CTC should be cautious with pricing strategy because most
present patients are in the B40 sector. Patients do not favour
Infrastructure And the price hike, although CTC intends to improve service quality
Facilities and hospital facilities.
Inpatient Hospital
Experience CTC should consider the canteen’s state since it has been a
Marketing significant source of dissatisfaction. Patients believe that CTC
must address the issue of the canteen or dining area as fast as
Brand Awareness: possible.
CTC could consider increasing the etiquette of in-ward nurses
since many patients have expressed dissatisfaction with the
nurses in charge and the ward being noisy most of the time.
CTC should consider taking this aspect seriously. Potential
patients of CTC are not aware of CTC and hence, making the
value of the CTC is low to them. When the awareness is low,
CTC won’t be in the consideration set of the patient in using the
healthcare services if this matter is not treated. CTC may keep
not getting new patients as they are not aware of CTC’s quality
service. In doing so, marketing communication activities is the
utmost way to treat this issue.
CTC should actively address the aspect of brand awareness.
Potential CTC patients appear to be unaware of the
procedure, lowering the CTC’s value in their eyes. When patient
knowledge is limited, CTC will not be in the patient’s
consideration to use healthcare services if this problem is not
rectified. CTC may continue to struggle to attract new patients
since they are unaware of CTC’s high-quality service. Therefore,
marketing communication efforts are the most effective
method to address those issues.

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CHAPTER 7 | FINDINGS ON COST, REVENUE AND PROJECTION ANALYSIS OF CTC

7.1 PREAMBLE

Understanding the capabilities of hospitals is a multi-faceted task since it deals with
the ability of the entity to harness its skills, improve human resources, and enhance
capacity to provide quality and affordable services to the clients. Generally, a
healthcare institution wants to achieve two things:

i. Provide quality services to the patients; and
ii. Achieve financial sustainability

While achieving financial sustainability (cover up costs and generate profit) is a core
agenda for commercial healthcare providers, government institutions may have
different objectives (s). However, achieving financial sustainability in a government-
funded institution would reduce the tax burden of the commoner. Even if it is not
possible to achieve financial sustainability, minimizing the gap (between revenue and
cost) would reduce dependency on the public money.

Hence, in this part of the analysis, we use secondary data to understand the current
state of the Clinical Trial Centre (CTC) of Universiti Sains Malaysia (USM) in terms of its
staff productivity, cost efficiency and provide some plausible recommendations. In
particular, we examine how the resources (financial and non-financial) have been
utilised to generate output (e.g., revenue, number of patients served, etc.). Then, to
make CTC achieve its financial sustainability, the study provides some scenario
analysis with possible recommendations.

7.2 METHODS OF ANALYSIS

Considering the availability of secondary data, we consider market penetration, staff
productivity and efficiency of CTC by several formulas below. Nonetheless, a brief
discussion on the data used in the analysis is also discussed in this section.

7.2.1 Market Penetration

Market penetration in the healthcare industry can measure how much of a
healthcare product/service/provider is being used by customers compared to the
total estimated market. It is synonymous with ‘market share’. To calculate market
share, we have used the following formula:

Market Penetration/Share CTC= (Total Patients served by CTC/Total Estimated
Market) *100

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We used the yearly number of patients served as an indicator to estimate the market
penetration of CTC. Unavailability of the other healthcare service providers' data
(e.g., number of patients served, or total revenue generated by each of them in the
healthcare market) did not allow us to compute ‘market concentration’ or
‘competition’.

7.2.2 Staff Productivity

Productivity of staff can be measured in several ways. In this case, the productivity of
staff at CTC has been estimated by considering both the patient and revenue
perspectives. We generally look at productivity by considering some classical
approaches, such as how many each staff serves patients/brings financial benefits to
CTC.

7.2.2.1 Patient Perspective

Considering the limited data, we look at the ratio of patient and staff in various
dimensions as follows.

Patient per doctor = Total number of patient/total doctor
Patient per non-doctor = Total number of patient/total non-doctors (admins
and nurse)
Patient per staff = Total number of patient/total staff (doctors and non-doctors)

7.2.2.2 Revenue Perspective

To analyze how each of the staff is bringing monetary benefits to CTC as a measure
of staff productivity, we use the following formula.

Revenue per doctor = Total revenue/total doctor
Revenue per non-doctor = Total revenue/total non-doctor
Revenue per staff = Total revenue/ total staff

7.2.3 Cost Efficiency

For any firm or institution, cost remains a determinant to achieve greater financial
performance. Therefore, minimizing the costs can enable a firm to maximize its profit.
Having said that, aggregate cost analysis may not give us concrete understanding of
how CTC is using its financial resources, thus, we consider a different approach. For
example, we consider the classical ratio approach to examine the cost aspects of
CTC by considering the following formula.

Administrative expense per patient = Total administrative cost/total patients

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Operating expense per patient = Total operating expense/total patients
Machine and equipment expense per patient = Total machine and equipment
expense/total patients.

7.2.4 Data
As per the objective of the analysis, we requested CTC to provide us secondary data
on some pre-determined variables. Unfortunately, it took quite a while to get the data
from CTC on relevant parameters. Moreover, some other secondary data, such as
population, were obtained from the Department of Statistics, Malaysia. In the
following section, we discuss some of the features of the data in appoint by point
fashion.
Health Care Services provided to patients, workforce and expenses were obtained
from the internal reports of CTC. Population and demographic data were obtained
from the Department of Statistics, Malaysia (DoSM) to calculate the market
penetration. Population for 2012-2019 were calculated using average growth based
on the ‘Population Census’ of 2010 and 2020. The duration of the coverage ranges
from 2012-2020 (stated otherwise) as per the availability of data. All the revenue and
cost related to patients are in aggregate amount. No segregated information is
available for revenue as per the data source. None of the data used in the analysis is
audited or verified. Thus, we use the raw data provided by the CTC as it is.

7.3 RESULTS
7.3.1 Market Penetration
Before estimating market penetration, we first look at the number of patients served
by the CTC from 2012 to 2020 as illustrated in Figure 7.1. While there was a sudden
drop in patients from 2013 to 2014, CTC has observed a gradual increase in patients
until 2019. The maximum number of patients served within the study duration was in
2019, close to 27,000.

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Patient served at IPPT(number) 2012 2013 2014 2015 2016 2017 2018 2019 2020
13000 15000 17000 19000 21000 23000 25000 27000 Year

Note: Assuming that there is no repeating patient in a single year to avoid double
counting.

Figure 7. 1: Trend of Patients served at CTC

Now, there are several assumptions that we have to consider while estimating the
market penetration of CTC. These are:

Assumption Description
1 The number of patients served by CTC is not repeating patients in a
single year. This is to avoid double counting as we do not have data
2 on repeating patients.
All the population (100%) in Seberang Prai-Utara and Penang are
3 exposed to various diseases, requiring inpatient/outpatient
4 treatment from hospitals/clinics.
5 Seberang Prai-Utara district is considered the main reference point
since CTC is located within the same district.
Opportunity costs to get service within Penang are zero/negligible.
Similar services are available from other healthcare service providers
with almost identical prices and quality.

Under the assumption that everyone needs healthcare services, CTC's market
penetration/share is estimated to be around 1-1.5% and 4-7% for Penang and
Seberang Perai-Utara, respectively which can be found in Figure 7.2.

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Market Penetration(%)
012345678

2012 2013 2014 2015 2016 2017 2018 2019 2020

Market Penetration of CTC (Penang Market) Market Penetraion of CTC (Seberang Prai_Utara Market)

Note: Seberang Perai-Utara and Penang market only.

Figure 7. 2: Market penetration of CTC (100% population as potential market)

Now we change one of our assumptions (assumption 2 and others remain the same):
only 50% of the total population are susceptible to various diseases, requiring
inpatient/outpatient treatment from hospitals/clinics. Then the market penetration of
CTC would be as follows.

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Market Penetration(%)
0 2 4 6 8 10 12 14

2012 2013 2014 2015 2016 2017 2018 2019 2020

Market Penetration of CTC(Penang Market) Market Penetration of CTC(Seberang Prai-Utara market)

Note: Seberang Perai-Utara and Penang market only.

Figure 7. 3: Market penetration of CTC (50% population as potential market)

Under the assumption that only 50% of the population needs healthcare services, the
market penetration/share for CTC is estimated to be around 2-2.5% and 8-14% for
Penang and Seberang Prai-Utara, respectively as illustrated in Figure 7.3.

While it is difficult to pinpoint the exact market penetration of CTC, Figure 7.3 is more
appealing and convincing that CTC is controlling around 2-2.5% of the Penang market
and approximately 8-14% of the Seberang Prai-Utara market. For example, there are
approximately 50-52 clinics/hospitals (estimated) in Penang. Assuming each caters to
equal/closely equal market share (actual outcome may differ), it will reflect around
100% of the total market.

7.3.2 Staff Productivity

As per the Figure 7.4, staff productivity, particularly patient per doctor, has risen from
2014 to 2018. Considering 215 working days a year (excluding public holiday and
personal leave, altogether 45 days), each doctor has served only 2.06 patients per
day at CTC at its highest peak (2019). The World Health Organization (WHO) suggests
a doctor-population (not patients) ratio as 1: 1000 and nurses to population 3:1000.
Considering this, the WHO-recommended doctor-patient/population ratio would give

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this figure at 4.65 patients per day. Hence, it is highly likely that the doctors are
underutilized in CTC as they are serving only 2.06 patients per day. In other words,
more patients can be served with the same number of doctors to meet the WHO
threshold.
While there is an inconclusive ideal ratio of doctors and nurses/non-doctor, as per
2018, the total number of doctors was 52 and 279 non-doctors in 2019. Hence, the
best doctor and non-doctor ratio for the CTC was 5.36.

Best point!
Number of patient
50 125 200 275 350 425 500 Best point

2012 2013 2014 2015 2016 2017 2018 2019 2020
Year Patient per non-doctor

Patient per doctor
Patient per staff

Figure 7. 4: Staff Productivity- Patient’s perspective

There is no threshold for staff productivity in terms of revenue generation, but higher is
the better. Hence, the revenue trend should be further upward along the time horizon
as a sign of improving productivity as depicted in Figure 7.5. A steeper pattern is better
than a flattened one.

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Revenue (MYR)
2500 5000 7500 10000 12500 15000

0

2012 2013 2014 2015 2016 2017 2018 2019 2020
Year

Revenue per non-doctor Revenue per doctor
Revenue per staff

Figure 7. 5: Staff Productivity (Revenue Perspective)

7.3.3 Cost Efficiency

Overall, CTC has been improving in terms of its cost-efficiency in recent years. In
particular, the 2019 production mix (input-output) was the overall best cost-effective
year for CTC as illustrated in Figure 7.6. Moreover, the highest number of patients were
served in the same year, resulting in a lower average cost.

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Expense (MYR) Overal best point
50 300 550 800 1050 1300 1550 1800 2050

2012 2013 2014 2015 2016 2017 2018 2019 2020
Year

Administrative expense per patient Operating expense per patient
machine and equipment expense per patient

Figure 7. 6: Cost Efficiency (Overall perspective)

Table 7. 1: Correlation Analysis (Total Cost, Workforce, and Patient)

(1) (2) (3) (4) (5) (6) (7)

Patient 1.000

Operating Expense -0.425 1.000

(0.294)

Machine and 0.422 -0.597 1.000

Equipment

Expense

(0.298) (0.090)

Administrative -0.471 0.989 -0.688 1.000

Expense

(0.239) (0.000) (0.041)

Doctors 0.401 -0.900 0.507 -0.857 1.000

(0.325) (0.001) (0.164) (0.003)

Non-doctors -0.188 -0.309 -0.108 -0.264 0.083 1.000

(0.656) (0.419) (0.782) (0.493) (0.832)

Total Staff -0.035 -0.863 0.317 -0.803 0.803 0.660 1.000

(0.934) (0.003) (0.405) (0.009) (0.009) (0.053)

Note: p values are within the bracket. p value less than 0.10 indicates a significant

relationship between two variables. The number of observations is relatively small;

hence the findings should be treated with caution.

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We also extend our analysis to see if serving more patients is linked with higher costs
of CTC. Therefore, a pairwise correlation is estimated with p values in Table 7.1.
Unfortunately, the number of patients served is not significantly correlated to the
overall total costs of CTC as the p-value remains insignificant. It may mean that CTC
costs are markedly driven by other factors and not necessarily by the number of
patients it serves.

7.3.4 Projections for Breakeven

We would like to examine whether CTC can be transformed into a financially
sustainable entity considering its current performance. Before proceeding with the
projection(s), we look at the trend of average cost per patient and average revenue
per patient. Indeed, there is a considerable gap between cost and revenue, although
it has declined from 2014 till 2019 (Figure 7.7).

MYR Minimum gap
30 280 530 780 1030 1280 1530 1780 2030

2012 2013 2014 2015 2016 2017 2018 2019 2020
Year

Revenue per patient Average expense (total) per patient

Figure 7. 7: Revenue cost gap: Narrowing or widening?

7.3.4.1 Break-Even Scenario Analysis for CTC
Now, we analyze several scenarios for CTC to break-even or achieve financial
sustainability. Hence, we ask a question, with average revenue of MYR 39 per patient

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(Present Value) in 2020 and the average cost per patient of MYR 1071 (based on the
whole duration) (Future Value), how many years is needed for CTC to break even
(intersection between average cost and revenue) (See Appendix O for descriptive
statistics).
Scenario 1(S1): Revenue intervention (moderate)
We use the following ‘future value’ formula and assume a constant growth rate
(i=20%) in revenue per patient,
FV=PV(1+i)n
Replacing values from above in this equation, we will get the value of n (closely) = 18
years. Meaning it will take 18 years for CTC to break even with moderate revenue
intervention, ceteris paribus (Figure 7.8).
Scenario 2 (S2): Revenue intervention (drastic)
Now, if we increase average revenue per patient growth by 50%, it will reduce the
breakeven duration to only around 8 years under the drastic revenue intervention
approach, ceteris paribus (Figure 7.8).
Scenario 3(S3): Cost and revenue intervention (moderate)
We consider intervening in the average cost of serving per patient and assume that
CTC can minimise the average cost by 5% every year. The increase in average
revenue remains the same at 20%. Then it will take around 15 years for CTC to break
even, ceteris paribus (Figure 7.8).
Scenario 4(S4): Cost and revenue intervention (drastic)
Now we consider the cost intervention to remain at 5% and a drastic intervention in
average revenue generation at 50%, so the combination of both interventions will
take only 7 years for CTC to break even (Figure 7.8).

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MYR per patient S2 S1
0 200 400 600 800 1000 1200 1400 S4 S3

2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039
Year

Average revenue (moderate growth-20%) Average cost(constant)
Average revenue (drastic growth-50%) Average Cost (5% reduction per year)

Note: S represent scenario.

Figure 7. 8: Scenario analysis for breakeven of CTC

Overall, CTC should not only rely on increasing average revenue (e.g., increase in
prices). It should also undertake initiatives to minimize the average cost per patient. In
this way, breakeven years can be brought forward. To minimize cost, the year 2019
production mix can be a good starting point for CTC.

7.4 RECOMMENDATION AND CONCLUSION

As per the discussion presented above, we highlight some of the crucial findings and
provide some recommendations in the following aspects.

Market Share Overall, CTC control about 10% of the Seberang Prai-Utara and
around 2% of the overall Penang Market.
Staff The productivity of staff is not at par. Thus, scaling up (serving more
Productivity patients) without a significant increase in resources (e.g.,
workforce)/costs is possible, as the evidence suggested.
Cost Cost efficiency is volatile; however, administrative expense needs
Efficiency to be minimized through an optimal combination of doctors and
non-doctors.
Cost-patient Surprisingly, the correlation analysis also suggests that the cost of
ratio CTC is not significantly driven by the number of patients it serves.

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Economies of Economies of scale (serving more patients should reduce overhead
scale cost) is the key to CTC's cost minimization.
Service Quality and non-identical healthcare facilities are the keys to
quality increase average revenue per patient.
Pricing To increase average revenue growth per patient, the optimal
combination of increasing price and number of patients should be
Financial considered rather than solely relying on the price increase.
performance If CTC management decides to undertake interventions prescribed
above to enhance financial performance, the performance might
Way forward likely face the 'J' curve effect. Meaning, the situation becomes
worse in the first few years, then gradually starts to improve.
Therefore, achieving a better performance (e.g., breakeven)
would be highly unlikely in the short run. Thus, a long-term plan with
solid interventions and follow up should be put in place.

Our analysis was indeed limited by several aspects and one of the main hurdles we
face is related to data. Being a healthcare service provider, CTC did not have proper
data management as per our understanding. Following are some other limitations
that are worth to mention.

Values The output, number of patients and revenue generation served
estimation may not be an actual reflection of staff productivity.
Data Some doctors might have engaged with various academic
constraint activities, but they are not captured in the analysis due to
unavailability of such data.
Scope of The duration used in the analysis is relatively short; hence, the
analysis conclusion drawn might need to be revised when more extended
data periods are available.
Performance We have only suggested average revenue growth (not price) and
comparison cost reduction; however, how it should be done is out of the scope
of the analysis.
Results We have not compared the performance of CTC with any other
interpretation service providers (cost and revenue information is not publicly
available). However, if possible, comparing the performance of
CTC with other identical healthcare services providers would
provide a concrete understanding of CTC's performance.
The analysis above is done purely based on the quantitative and
secondary data; hence, several contextual aspects are not
considered in interpreting the results.

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CHAPTER 8 | RECOMMENDATIONS

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REFERENCES

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APPENDICES
APPENDIX A – PICTURES OF SITE VISITS
1. Reception Counter

2. Registration Counter

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3. Canteen

4. Toilet

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5. Waiting Area

6. Lift

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7. Stairs

8. Vending Machine
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9. Carpark

10. Praying Room (Surau)

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11. Pharmacy

12. Chairs and Sofas

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13. Changing Room

14. Storage/Lockers

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15. Recovery Room/ Observation Room
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16. Signages

17. Lightings
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18. Medical Instruments/ Infrastructures

19. Staff’s Uniforms

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APPENDIX B – PICTURES OF UMMC MEETING

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APPENDIX C – PICTURES OF ROUNDTABLE DISCUSSIONS

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APPENDIX D – FGD PENCIL WRITTEN ASSESSMENT

Responden yang dihormati,
Bagi pihak Universiti Sains Malaysia, kami ingin menjemput anda untuk mengambil
bahagian dalam tinjauan ini. Tujuan utama tinjauan ini adalah untuk menilai prestasi
penyampaian servis kepada pelanggan di Clinical Trial Center (CTC), Institut
Perubatan dan Pergigian Termaju (IPPT). Penyampaian servis yang cemerlang akan
menyumbang kepada kesetiaan pelanggan yang berterusan. Oleh yang demikian,
CTC perlu mencari pelbagai alternatif secara berterusan bagi meningkatkan dan
memastikan servis yang ditawarkan sentiasa berada pada tahap lebih baik
berbanding pesaing. Anda telah dikenal pasti sebagai salah seorang yang
berkepentingan dalam perkembangan CTC dan transformasi ke arah organisasi
yang menjana pendapatan Betam Medical Center (BMC) . Oleh itu, pandangan,
maklum balas dan cadangan anda amat penting untuk mencapai objektif
tranformasi CTC dan amatlah dihargai. Penyertaan anda adalah secara sukarela
dan maklumat yang diberikan adalah sulit. Maklumat yang diperolehi akan
digunakan untuk penambahbaikan kualiti servis yang ditawarkan oleh CTC. Sekiranya
anda mempunyai sebarang pertanyaan mengenai projek ini, sila hubungi Profesor Dr
Azizah Omar, Universiti Sains Malaysia. E-mel: [email protected] (HP: 0124041747).

Dear Esteemed Respondents,
On behalf of the Universiti Sains Malaysia, we would like to invite you to participate in
this survey. The main objective of this survey is to assess the services performance
delivery for Critical Trial Center (CTC), Advanced Medical and Dental Institute (AMDI)
customers. Excellent Customer Services delivery towards customer lifetime value
requires the CTC to continuously seek various alternatives to enhance and ensure our

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services are top-notch compared to our competitors. You have been identified as
one of the key person for CTC development and future transformation as profit-center
organization (Bertam Medical Centre – BMC)). Hence, your honest opinion,
feedbacks and suggestions are vital to achieve the objective of the transformation of
CTC and very much appreciated. Your participation is voluntary and the information
provided is strictly confidential. All information will be used to improve the quality of
services offered by CTC. If you have any queries concerning the project, please
contact Professor Dr Azizah Omar, Universiti Sains Malaysia. Email: [email protected]
(HP: 0124041747)

DEMOGRAPHIC BACKGROUND

1. Nama/ Name <Option>

2. Jantina/ Gender <Jawapan/ Answer>

3. Unit/ Seksyen/ Unit/Section <Jawapan/ Answer>

4. Tahun bertugas di CTC/ <Jawapan/ Answer>
Years of working at CTC <Jawapan/ Answer>

5. Jawatan/Gred/ Position/Gred

6. Fungsi perkerjaan di CTC/ <Jawapan/ Answer>

Job Functions at CTC:

(i) Utama/ Primary

(ii) Sokongan/ Secondary

7. Bilangan latihan yang berkaitan <Jawapan/ Answer>

dengan fungsi perkerjaan dihadiri

dalam setahun (kekerapan)/

Number of trainings attending that

related to job functions in a year

(Frequency)

8. Pengalaman pekerjaan sebelum <Jawapan/ Answer>

menyertai CTC, IPPT/

Past job xxperience before joining

CTC, IPPT

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SOALAN TINJAUAN/ SURVEY QUESTIONS

KATEGORI KEPIMPINAN (visi, aspirasi, kepimpinan, pengurusan atasan).
LEADERSHIP CATEGORY (vision, aspiration, leadership, top management).

Definisi: Merujuk kepada bagaimana pemimpin/ketua di CTC atau eksekutif (yang
membuat keputusan) mentadbir dan memantau hubungan kontrak.
Definition: Refers to how the CTC’s leaders or decision-makers (executives) administer
and monitor contractual relationships.

Soalan/ Questions
1. Sila terangkan tugas/tanggungjawab anda dan tempoh anda telah bekerja di

jabatan/jawatan ini?
Please describe your job/duties and how long you have been working in this
particular department/position?

<Jawapan/ Answer>

2. Apakah pendapat anda tentang struktur organisasi CTC yang terkini dan
kepimpinan? Anda juga boleh sertakan maklumat pada peringkat jabatan anda.
What is your opinion regarding the current organisational structure of CTC and the
leadership? You can also include some information at your department level.
<Jawapan/ Answer>

3. Adakah terdapat cabaran/masalah tertentu yang anda hadapi dengan
ketua/pihak pengurusan?
Any particular challenges/problems that you have faced with the
leaders/management?
<Jawapan/ Answer>

4. Apakah pandangan anda terhadap pendekatan/tindakan yang diambil untuk
menyelesaikan masalah (samada di peringkat organisasi atau jabatan). Boleh
sertakann contoh jika perlu.
What do you think about the approach/action taken towards problem solving
(can be at organisational or department level). Can give examples if necessary.
<Jawapan/ Answer>

5. Apakah pandangan anda mengenai sokongan oleh pihak pengurusan tertinggi
USM sedia ada?
What do you think of the support given by the current top management of USM?
<Jawapan/ Answer>

KATEGORI KEMAMPUAN TENAGA KERJA
WORKFORCE CAPABILITY CATEGORY

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Definisi: Mereka yang terlibat di dalam servis di CTC yang tujuan utamanya adalah
untuk meningkatkan penyampaian penjagaan kesihatan termasuk staf klinikal dan
staf sokongan iaitu: mereka yang tidak terlibat dengan menyampaikan servis secara
langsung tetapi penting terhadap prestasi sistem kesihatan CTC
Definition: Staff involved in CTC services where the primary objective is to enhance
healthcare delivery. This include clinical staff, and support staff, i.e. those who do not
deliver services directly but are essential to the performance of the CTC health systems

1. Apakah pendapat anda terhadap jumlah tenaga kerja semasa di CTC/jabatan
anda? (dari segi jumlah, kecekapan dan pengalaman)
What is your opinion regarding the current workforce at CTC/your department? (in
terms of number, competency and experience).
<Jawapan/ Answer>

2. Adakah anda atau rakan sekerja anda pernah mengalami kelesuan,
kemurungan, kerja berlebihan atau kurang bekerja?
Have you or your colleagues ever experience burnout, depression, overwork or
underwork?
<Jawapan/ Answer>

3. Adakah anda memerlukan latihan secara berterusan untuk memperbaiki tahap
kecekapan dan kemahiran? Adakah terdapat sebarang program latihan yang
disediakan pada masa sekarang?
Do you require continuous training to improve your competency/skills? Any
training program provided currently?
<Jawapan/ Answer>

4. Pada pandangan anda, jenis motivasi apa yang akan membantu untuk
meningkatkan prestasi kerja anda?
In your opinion, what kind of motivational exercise that will help to enhance your
job performance?
<Jawapan/ Answer>

5. Adakah anda bersedia untuk berkhidmat di CTC sekiranya ia ditranformasi
sepenuhnya kepada badan swasta? YA/TIDAK. Sila jelaskan sebab kepada
jawapan anda.
Are you ready serve CTC if it is being transformed into a fully private entity? YES/NO
Please briefly explain the reason for your answer.
<Jawapan/ Answer>

6. Pernahkah sebarang kursus motivasi dianjurkan kepada staf? Jika ya, siapakah
penganjur? Adakah ia relevan kepada anda?
Was there any motivational courses organised for the staff? If yes, who were the
organisers? Do you think it was relevant to your job?
<Jawapan/ Answer>

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KATEGORI PERALATAN (Penyenggaraan, Penggunaan, Kecekapan, Aset, Pembekal,
SOP)
EQUIPMENT CATEGORY (Maintenance, Utilisation, Efficiency, Assets, Suppliers, SOP)

Definisi: Peralatan di CTC merangkumi semua peralatan yang digunakan dalam
diagnosis, analisis makmal, rawatan dan pemantauan rawatan pesakit
Definition: Include all equipment in CTC used in diagnosis, laboratory analysis,
treatment and assessing progress of patients’ treatment

1. Adakah anda mempunyai peralatan/kelengkapan (jumlah dan jenis) yang
mencukupi untuk menyokong kerja anda?
Do you have sufficient equipment (number and type) to support your work?
<Jawapan/ Answer>

2. Adakah terdapat penyenggaraan/kalibrasi secara berkala untuk
peralatan/kelengkapan tersebut? being carried out for the
Is there any regular maintenance/calibration

equipment?
<Jawapan/ Answer>

3. Adakah terdapat unit/pegawai yang bertanggung jawab untuk penyenggaraan
alatan?
Any particular unit/officer in charge of the equipment maintenance?
<Jawapan/ Answer>

4. Adakah terdapat bajet yang diperuntukkan untuk penyenggaraan/naik taraf
alatan?
Is there any budget allocated for equipment maintenance/upgrade?
<Jawapan/ Answer>

5. Adakah anda berpuas hati dengan kualiti dan jangka masa respons oleh staf
yang bertanggung jawab untuk penyenggaraan alatan apabila laporan
kerosakan dibuat?
Are you satisfied with the quality and speed of action taken by the staff in charge
of equipment maintenance once a report for breakdown has been made?
<Jawapan/ Answer>

KATEGORI DANA/BAJET
FUND/BUDGET CATEGORY

Definisi: Bajet membolehkan CTC untuk memahami dengan lebih baik sumber dana
untuk sesuatu projek atau bahagian tertentu dan berapakah jumlah perbelanjaan
yang sepatutnya.
Definition: A budget allows CTC to understand better which funds can be spent on a
specific project or section and how much spending should be allotted to each.

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1. Bagaimana anda melihat situasi semasa kewangan, peruntukkan bajet dan
perbelanjaan di CTC?
How do you view the current financial situation, budget allocation and

expenditure of CTC?
<Jawapan/ Answer>

2. Pada pandangan anda, bagaimanakah cara untuk

mengurangkan/mengoptimumkan kos operasi CTC/jabatan anda?

In your opinion, how to minimize/optimized the operational cost for CTC/your

department?

<Jawapan/ Answer>

3. Pada pandangan anda, adakah CTC berupaya untuk menjana pendapatan
yang mencukupi daripada perkhidmatan kesihatan dan mampu bergerak
sendiri?
In your opinion, can CTC generate sufficient amount of income from the
healthcare services and be self-sustainable?
<Jawapan/ Answer>

KATEGORI BERJUMPA DENGAN PELANGGAN DAN PENYAMPAIAN SERVIS
CUSTOMER INTERFACE AND SERVICE DELIVERY CATEGORY

Definisi: Perjumpaan dengan pelanggan merupakan komponen yang menunjukkan
bagaimana CTC berinteraksi dengan pesakit (pesakit dalam, pesakit luar dan
peneman/penjaga)
Definition: The customer interface (CI) is a component that describes how CTC

interacts with its patients (in-patients, out-patients, and companions/caretakers).

<Jawapan/ Answer>

1. Bagaimana anda melihat kepuasan pelanggan terhadap perkhidmatan
kesihatan yang ditawarkan oleh CTC?
How do you view the customers' satisfaction towards healthcare services provided
by CTC?
<Jawapan/ Answer>

2. Adakah anda tahu tentang mana-mana saluran yang diguna pakai untuk
pemasaran perkhidmatan yang ditawarkan oleh CTC?
Are you aware of any channel used for marketing of services offered by CTC?
<Jawapan/ Answer>

3. Adakah anda tahu tentang mana-mana saluran yang diguna pakai untuk
menerima maklum balas pelanggan?
Are you aware of any channel used for customer feedback?
<Jawapan/ Answer>

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4. Adakah terdapat sebarang isu yang anda ingin kongsikan melalui pengalaman
anda sendiri apabila berurusan dengan pelanggan/pesakit di CTC?
Any issues that you want to share from your personal experience when dealing
with CTC customers/patients?
<Jawapan/ Answer>

5. Sila kongsikan dengan kami sebarang cadangan bagaimana untuk
memperbaiki/menambahbaik kualiti perkhidmatan yang ditawarkan oleh CTC.
Please share with us any suggestions on how to improve the quality of services
offered by CTC.
<Jawapan/ Answer>

KATEGORI UTILITI
UTILITIES CATEGORY

Definisi: Servis dan kemudahan yang disediakan yang dianggap penting terhadap
prestasi jangka panjang CTC dan membantu untuk menarik para pesakit dan
pelawat ke CTC.
Definition: Services and facilities provided that are considered as essential for CTC's
long-term performance and help to attract patients and visitors.

1. Bagaimanakah anda melihat tentang keadaan semasa mengenai utiliti dan
kemudahan yang tersedia kepada pesakit dan staf di CTC?
How do you view the current utilities and facilities available for patients and staff
in CTC?
<Jawapan/ Answer>

2. Sebarang cadangan untuk penambahbaikan?
Any suggestion for improvement?
<Jawapan/ Answer>

3. Adakah anda berpuas hati dengan kualiti dan jangkamasa respons yang diambil
untuk penyenggaraan utiliti apabila laporan kerosakan dibuat?
Are you satisfied with the quality and speed of action taken by the staff in charge
of the maintenance of utilities once a report for breakdown has been made?
<Jawapan/ Answer>

KATEGORI PUSAT KEUNTUNGAN – SWASTA, PELAN STRATEGIK
PROFIT – CENTER, STRATEGIC PLANNING

Definisi: Pelan strategik didefinisikan sebagai pelan jangka panjang yang digunakan
untuk menyediakan formula kepada sesebuah organisasi tentang hala tuju dan cara
bagaimana untuk memperuntukkan sumber bagi mencapai tujuan utama

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sepanjang tempoh masa tertentu dalam pelbagai keadaan persekitaran yang
mungkin boleh berlaku
Definition: Strategic planning defines as a long-term plan used to provide the
formulation for any organization about the directions and how to allocate the
resources to achieve the main goals over a specific time in various possible
environmental conditions

1. Adakah anda menyedari tentang pelan strategik di CTC? Sila kongsikan dengan
kami beberapa perkara penting yang anda fahami.
Are you aware of CTC’s Strategic Planning? Please share with us some of the
important points that you understand.
<Jawapan/ Answer>

2. Bagaimanakah perbezaan servis kesihatan yang disediakan pada masa
sekarang di bawah servis kesihatan eksekutif (EHS) dibandingkan dari bahagian
awam CTC?
How different is the healthcare services currently provided under the executive
health service (EHS) compared to the public wing of CTC?
<Jawapan/ Answer>

3. Pada pendapat anda, apakah kelebihan dan kekurangan perkhidmatan
kesihatan yang ditawarkan oleh executive health service (EHS) dan bahagian
awam CTC untuk staf dan pesakit? (bagi situasi semasa)?
From your point of view, what are the advantages and disadvantages of the
healthcare services provided by the executive health service (EHS) and public
wing of CTC for both staff and patients (for current setting).
<Jawapan/ Answer>

4. Berdasarkan pengetahuan/pemahaman anda, adakah terdapat sebarang
permintaan/pasaran untuk perkhidmatan kesihatan swasta di CTC, terutama
sekali dalam kalangan komuniti setempat?
From your knowledge/understanding, is there any demand/market for private
healthcare services in CTC, particularly for the local communities
<Jawapan/ Answer>

5. Apakah langkah yang terbaik untuk CTC maju ke hadapan?
What is the best way forward for CTC?
<Jawapan/ Answer>

TAMAT/ THE END

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APPENDIX E – FGD PENCIL WRITTEN RESPONSES

LEADERSHIP CATEGORY
Q1 Sila terangkan tugas/tanggungjawab anda dan tempoh anda telah

bekerja di jabatan/jawatan ini?
Please describe your job/duties and how long you have been working in
this particular department/position?
R1 Ketua unit perubatan - menyelaras fungsi klinik pakar perubatan dan wad
pesakit dalam (4 tahun)
R2 Saya bertanggungjawab memulakan dan memperkasakan
perkhidmatan PID dan Alergi di IPPT. Saya
juga turut menyumbangkan peranan di dalam perjalanan perkhidmatan
Pediatrik di IPPT.
R3 Sebagai pakar perubatan dan pensyarah, saya memberi servis pesakit
luar terutama kepada penyakit kronik atau penyakit non communicable
disease. Saya juga terima referral daripada pelbagai klinik atau hospital
lain. Juga memberi konsultasi jika perlu kepada pegawai perubatan di
fasiliti USM. Saya sudah bertugas selama 5 tahun
R4 Menjalankan saringan kesihatan
R5 • Perkhidmatan dietetik klinikal – melaksanakan konsultasi dietetik untuk
pesakit luar dan pesakit dalam
• Perkhidmatan makanan – memantau penyediaan diet pesakit dan diet
staf
R6 Bertanggung jawab menjaga kebajikan pesakit yang merangkumi 2
elemen utama iaitu bantuan praktik (bantuan kewangan/peranti) dan
terapi sokongan (penempatan/kaunseling awalan)
R7 Ketua Seksyen Pembedahan dan Anestesiologi 1.4.2020 sehingga
31.7.2021
- Memantau perjalanan aktiviti Seksyen Pembedahan dan Anestesiologi,
menyelesaikan masalah pentadbiran sekysen.
-
Ketua Perkhidmatan Perubatan. 1.8.2021 sehingga sekarang
- Memantau aktiviti semua perkhidmatan perubatan
- Memantau aktiviti pegawai perubatan

R8 -

Since 2009 I was involved in establishing the Eye Specialist service at CTC.
This job entails:
1. Acquiring space, renovation, staff and purchasing of equipments.
R9 2. Training of staff.
3. Diagnostic and treatment.
4. Social and community engagement.
5. Future planning of eye service.

145 UNIVERSITI SAINS MALAYSIA

October
2021
FEASIBILITY STUDY: TRANSFORMATION OF CTC AS A PROFIT CENTER

Clinical Service
Practise as Consultant Obstetrician & Gynaecologist since I join IPPT in Nov
2018

- Thoroughly get the history, perform physical examination as well as pelvic
ultrasound for all referral patient in Specialist Gynaecology Outpatient
Clinic ( every Tuesday afternoon 2.00pm- 5.00pm and every Thursday
morning 8.30am-1.00pm)
-Infertility Clinic in LPPKN Bertam every Monday and Wednesday (
appointment letter from LPPKN- starting August 2021)

- Doing ward round and review patient at anytime if needed for all
gynaecology cases in ward / In patient care

-Perform Gynaecology surgical cases in AMDI operating theatre every
Tuesday morning

- Combined Gynae and Oncology team clinic for patient with cancer
need chemotherapy and radiotherapy treatment

- Antenatal follow up for IPPT staffs upon request or referral cases

Administration

- Head of Gynaecology Services in AMDI USM

- Coordinator for MSQH Accreditation Programme- to ensure AMDI USM
comply with MSQH Accreditation standard (MSQH is ISQUA certified)

Academic Section : Teaching & Supervision

- Involved in academic teaching to master student ( student seminar,
journal club)

-Supervising master students in their dissertation (either as main supervisor
or co-supervisor)

-Involved in programme Master of Medicine in Transfusion Medicine and
MSc Transfusion Medicine (TTS 503)

-Prepare examination questions and involved in vetting exam question for
MMed ,MSc and Medical entrance Postgraduate Examination (MedEx)

-Chairperson for phase 2 MD Programme
R10

Research & Publication

146 UNIVERSITI SAINS MALAYSIA

October
2021
FEASIBILITY STUDY: TRANSFORMATION OF CTC AS A PROFIT CENTER

- Principal investigator for Short term Grant: Human Papilloma Virus
Cervical Self-Sampling For Cancer Screening: Knowledge & Its
Acceptability Among Women

- Co PI for Book Publication Grant from RCMO USM- Myth and Fact for
Cervical Cancer

- Principal Investigator in Industrial Sponsor Research (ISR) with Venn
" VOCAL STUDY" based in Hospital Seberang Jaya since 2018- finishing.

- Co PI in study from School of Technology Industry USM entitled " Use of
Probiotic for the prevention of Re Occurrence Vaginal Candidiasis in
pregnant women"- completed, manuscript accepted for publication ( as
co author)

- PI in study "Use Of Probiotic To Modulate Vaginal Microflora And General
Women’s Health "

-Develop collaboration with other lecturers for research projects or
community projects

Community Services/ Collaboration with Governmental Institution/ NGO
- appointed as Visiting ObsGyn Consultant In LPPKN Bertam
- Community and outreach Program
Monday – On call (Morning), On call (Evening)
Tuesday – Clinic Pakar (Morning), On call (Evening)
Wednesday – Surgery (Morning), Surgery (Evening)
Thursday – On call (Morning), On call (Evening)
Friday – Clinic Pakar (Morning), On call (Evening)
Saturday – On call (Morning), On call (Evening)
R11 Sunday – On call (Morning), On call (Evening)
Bidang surgeri diadakan pada tahun 2013 dan pada ketika itu, hanya
ada pembedahan “local anaesthesia”. Saya dan Dr Zainab (Pakar Bius)
telah bersama-sama mengadakan rawatan surgeri dalam keadaan bius
penuh (general anaesthesia) pada tahun 2015-2016. Setakat ini, bidang
surgery (HPB – Dr Leow dan breast/ endokrin – Dr Hasmah dan Dr Fitreena)
telah banyak melakukan pelbagai jenis pembedahan “major” seperti liver
resection, Whipple operation, colonic resection (laparoscopy/ open),
thyroidectomy dan mastectomy/ reconstruction Pembedahan “minor”
seperti laparoscopic cholecystectomy, chemoport insertion, hernia repair,
lumps and bumps dan sebagainya. Bidang surgery turut bekerjasama
dengan rakan-rakan sekerja Dr Salina (Pakar Gynakologi) dan Dr Cyrill
(Pakar Urologi) dari semasa ke semasa dalam kes-kes yang rumit.

Saya juga mengadakan bidang endosckopi sejak tahun 2016-2017. Untuk
memulakan servis endoskopi, saya juga berurusan dengan Dato Mr Wan
R12 Kamizar/ Mr Regunathan Ketua Jabatan Surgeri Hospital Sultanah Bahiyah

147 UNIVERSITI SAINS MALAYSIA

October
2021
FEASIBILITY STUDY: TRANSFORMATION OF CTC AS A PROFIT CENTER

dan Mr Manisekar Subramaniam, Ketua Perkhidmatan HPB Negara, untuk
menghantar staf-staf endosckopi IPPT ke Hospital Sultanah Bahiyah untuk
latihan endoskopi. Kini, kami telah melakukan banyak kes-les setiap
minggu terutamanya OGDS dan colonoscopy. Prosedur-prosedur seperti
ERCP, SpyGlass laser lithotripsy, PEG procedure, Lithoveu laser lithotripsy
serta memasukkan “oesophageal probe” untuk esophageal
brachytherapy juga kian banyak dilakukan.

Menjalankan tugas sebagai pakar perubatan (Radiologi) sejak 7 tahun
R13 dan tugas-tugas pentadbiran di dalam unit Imejan.

Radiation oncologist, in-charge of the radiotherapy and oncology
R14 services. Been working here for past 8 years in this position.

1)Pegawai Perlindungan Sinaran bagi lesen Perkhidmatan Perubatan
Nuklear di IPPT di bawah Akta 304 yang diuruskan oleh Kementerian
Kesihatan Malaysia
2)Pegawai Sains Fizik Unit Perubatan Nuklear yang menajalankan semua
aktiviti QAP yang telah ditetapkan oleh KKM menurut Akta 304
3) Merancang, menyelaras, memantau dan melaksanakan pengurusan
aset di Unit Perubatan Nuklear
4)Melaksana dan menyelia aktiviti pengajaran dan pembelajaran
5)Membimbing pelajar dalam menjalankan penyelidikan di Unit
Perubatan Nuklear.
6)Merancang, memantau dan menyelia aktiviti pengurusan kewangan
dan perolehan
R15 Tempoh bekerja di IPPT adalah selama 17 tahun.
Lead Blood Transfusion Unit in term of service management and quality
R16 activity for ISO 15189 acreditation
Bertugas sebagai Pengarah makmal atau Ketua Seksyen (2018-2020) dan
Timbalan Pengarah Makmal (2021 – sekarang).
Secara keseluruhanya, tugas ini adalah melibatkan pengurusan makmal
(termasuk makmal di luar bidang kepakaran disebabkan ketiadaan pakar
patologi yang berkaitan bidang tersebut e.g genetic, molekular, makmal
imunologi dan Covid-19). Kebanyakan masa bekerja adalah bertumpu
kepada pengurusan makmal dan penyelesaian masalah berkaitan
penyampaian perkhidmatan, peralatan, kakitangan makmal, staf
R17 competency, purchasing serta delivery and supplies
PEGAWAI SAINS DI UNIT MIKROBIOLOGI ; VERIFIKASI UJIAN SEROLOGI DAN
BAKTERIOLOGI,
MEMATAU KUALITI DALAMAN DAN LUARAN UNTUK UNIT MIKROBIOLOGI,
PENGURUSAN
PEROLEHAN BAHAN PAKAI HABIS, REAGEN, BAHAN KIMIA DAN EXTERNAL
QUALITY
R18 ASSURANCE UNTUK ADL. 2007-2021 : 14 years

148 UNIVERSITI SAINS MALAYSIA

October
2021
FEASIBILITY STUDY: TRANSFORMATION OF CTC AS A PROFIT CENTER

Saya mempunyai beberapa tanggungjawab di ADL, diantaranya
sebagai Pengurus ADL yang bertanggungjawab dalam pentadbiran dan
pengurusan ADL (day to day) secara keseluruhan. Selain itu saya juga
Pengurus Unit Genetik yang bertanggungjawab dalam operasi unit.
Sebagai Pegawai Sains saya terlibat sebagai Pengurus Teknikal bagi
perkhidmatan sitogenetik darah. Tugas ini perlu menjalankan analisis
karyotype dan pelaporan keputusan ujian. Saya telah mula berkhidmat di
R19 ADL sejak Februari 2009.
Saya bertanggungjawab menyelia dan mengurus operasi Bahagian
Pemulihan Carakerja,
menjalankan penilaian dan rawatan pemulihan kepada pesakit mengikut
protokol dan proses perawatan, menguruskan tatacara perolehan
Bahagian, terlibat dalam pengurusan aset Unit serta mengetuai projek
inovasi (KIK) Unit Rehabilitasi. Saya telah berkhidmat disini hampir 13
R20 tahun.
1. Providing consultation and treatment to orthodontic patients
2. Involve planning and monitoring of delivery of the orthodontic and
other related services
R21 3. Organising Cleft and Craniofacial Deformities Multidisciplinary Clinic
R22 Perkhidmatan klinikal; rawatan pergigian kepakaran (ortodontik)
R23 Merawat pesakit pergigian am di kalangan staf dan pesakit luar.
I have served as Head of Dental Section (Mac – Dec 2015), Head of
Dental Specialist Unit (2016-2017), Head of OMFS & Rehab Section (2020).
Tasks in monitoring staffs activities in relation to duties, tasks, services in
R24 clinical section including attendance, TAMS, eCUTI, SOP, CPD/CDE, HCMS.
Consultation of patients related to oral medicine, oral pathology and
R25 reporting of oral histopathology slides
I have been working in this department for 8 years. I do clinical work
related to my specialty. I also have hold a few position as the unit
R26 coordinator for the dental section.

Merawat pesakit yang dirujuk ke Klinik Pakar Pergigian Prosthodontik
Memantau kualiti perkhidmatan yg diberikan di Klinik Pakar Prosthodontik
(pengurusan bahan yg digunakan, pengurusan staf dan pengurusan
R27 makmal Prosthodontik yang efisien)
Memberikan perkhidmatan pakar ortodontik kepada pesakit yang
melibatkan rawatan seperti fixed appliance, removable appliance,
interceptive dan orthognathic surgery. Kebanyakan kes adalah dirujuk
oleh pegawai pergigian USM dan juga dari KKM. Saya telah bekerja
selama 4 tahun.

Saya dilantik sebagai Ketua Unit Pergigian Am sejak 2 tahun yang lalu,
dan tugasnya melibatkan penyelarasan perkhidmatan pergigian am di
IPPT,latihan staf pergigian, aktiviti promosi kesihatan pergigian, aktiviti 5S
R28 dan pengurusan risiko.

149 UNIVERSITI SAINS MALAYSIA