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3.5.1.2 Instrument for Inpatient

The instrument used for the inpatient survey consisted of 8 variables. The responses
were recorded on a five-point Likert Scale to measure patient experience,
satisfaction, and CTC brand equity. The final list of items used for the survey is in Table
3.5.

Table 3. 5: Instrumentation for Inpatient

No Instrument Scale

1. Access & Admission 1= Poor

i. Arrangement during admission 2= Fair

ii. Time waiting for admission 3= Good

iii. Time waiting to be taken to the ward 4= Very Good

iv. Clarity of information given for admission 5= Excellent

v. Helpfulness of staff during admission

vi. Responsiveness of in-ward nurses during admission

vii. Explanation of hospital routines (including ward

rounds, SOP, etc.)

viii. Consideration of patients’ needs and wants

ix. Patient being treated with respect

x. Time waited for a doctor if a patient needed to see

one in the ward

xi. Doctor answers to patient questions or concerns

xii. Nurses answer patient questions or concerns

xiii. Time waited for a nurse after using the call button

xiv. The communication between the patient and the

doctor

xv. The communication between patient and other

related medical staff (e.g., nurse etc.)

xvi. Nurses ask about current patient medication(s) in the

ward (if any)

xvii. Nurses ask about patient dietary needs in the ward

xviii. Nurses ask about patient cultural or religious beliefs

and concerns

xix. Brief about anything patient need to know in the ward

(TV system, how to use the call system, bed function,

food time etc.)

2. Treatment and Related Information

i. Doctors and nurses explain clearly about the

treatment

ii. Doctors and nurses assist well during treatment

iii. Doctors and nurses explain the purpose of the

medication and the results of the test

iv. Doctors and nurses explain the side effects of the

treatment and medications

v. The patient was given a chance to ask questions

about the treatment, medication, and side effects

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vi. Nurses give attention and care (drips, dressing etc.)
vii. Information is given about patient progress to

family/carer/companion
viii. Involvement in decisions about patient care and

treatment
ix. Doctors and nurses give support and reassurance
x. Access to visitors is done according to the hospital

regulations
xi. Time doctors spend on patient care and treatment is

sufficient
xii. The patient gets assistance whenever needed (going

to the toilet, sitting, standing, etc.)
xiii. The patient gets access to any extra support (if I need

it)
xiv. Nurse in charge introduce themselves at each shift

change
3. Physical Environment

i. Cleanliness of room
ii. Cleanliness of ward
iii. Quality of food
iv. Meals serve clean and hygienic
v. Meals serve hot and fresh
vi. Meals serve delicious
vii. Choice of the menu for meals served
viii. Privacy in the room
ix. Ward is quiet in the daytime
x. Ward is quiet at night-time
xi. Cleanliness of toilet and shower in the room
xii. The atmosphere in the ward is cozy
4. Discharge & Follow Up
i. Time waited for the doctor to discharge
ii. Arrangement for discharge
iii. Arrangement for medication during discharge
iv. Arrangement for post-discharge care/service
v. Information is given about post-discharge

care/service
vi. The convenience and flexibility of discharge time
vii. Time waiting for medication
viii. Overall discharge time
5. Inpatient Experience in CTC

i. The patient received health service as expected
ii. Relief from the pain patient had before coming to CTC
iii. Relief from symptoms patient had before coming to

CTC
iv. CTC visit made patient close to being healthy
v. CTC visit restored patient health

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vi. The patient feels confident and could manage health

after the CTC visit

6. Overall Condition of CTC

i. The reception counter is...

ii. The registration counter is...

iii. The canteen is...

iv. The toilet is...

v. The waiting area is...

vi. The lift is...

vii. The stairs are...

viii. The vending machine is...

ix. The carpark is...

x. The praying room (surau) is...

xi. The pharmacy is...

xii. The chairs and sofas are...

xiii. The changing room is...

xiv. The storage/locker to keep my belongings is...

xv. The recovery room is...

xvi. The signages are...

xvii. The lightings are...

xviii. The temperature in every place and room is...

xix. The scent/smell in CTC is...

xx. The medical instruments/infrastructures are...

7. Patient Satisfaction

i. How do you rate your overall experience with the

service you received in CTC?

ii. How do you rate the treatment you received in CTC?

iii. How do you rate the doctor service in CTC?

iv. How do you rate the nurse service in CTC?

v. How do you rate your waiting time in CTC?

vi. How do you rate the treatment charges in CTC?

8. Equity 1= Strongly

i. Even if another hospital has the same facilities as CTC, Agree

I will prefer to choose CTC 2= Agree

ii. If another hospital is not different from CTC in any way, 3= Not Sure

it seems wiser to choose CTC 4= Disagree

iii. If there is another hospital as good as CTC, I prefer to 5= Strongly

choose CTC Disagree

iv. It makes sense to choose CTC instead of any other

hospitals, even if they are the same

3.5.1.3 Instrument for Non-Patient

The instrument used for the non-patient survey consisted of 7 variables. The responses
were recorded on a five-point Likert Scale to measure CTC brand value and
perception. The final list of items used for the survey is as in Table 3.6.

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Table 3. 6: Instrumentation for Non-Patient

No Instrument Scale

1. CTC Brand Awareness 1= Strongly

i. I can quickly recall CTC as a health service provider Agree

ii. I can recognize CTC among other competing health 2= Agree

service provider 3= Not Sure

iii. I am aware of CTC as a health service provider 4= Disagree

iv. I am quite familiar with CTC as a health service 5= Strongly

provider Disagree

v. I can recognize CTC as a health service provider

among other providers (e.g., Hospital Seberang Jaya,

KPJ Perda, Lam Wah Ee, Gleneagles Hospital etc.)

2. CTC Brand Associations

i. USM brand came to my mind quickly when I heard

about CTC

ii. I can easily imagine USM when I heard about CTC

iii. I admire CTC because I associate it with USM and the

Ministry of Higher Education

iv. I associate CTC strongly with USM as a

public/government brand

v. I can quickly recall the symbol, logo or colour of CTC

as a health provider

3. CTC Brand Trust

i. I trust CTC is genuinely concerned about community

wellbeing

ii. I trust CTC is honest and sincere in addressing

community health concerns

iii. I trust CTC is trustworthy

iv. I trust the information provided by CTC

v. When I am making important decisions, I trust CTC

could take care of my welfare and wellbeing

CTC Brand Image

i. CTC is trusted because it is managed by USM and the

Ministry of Higher Education

ii. CTC has reputable doctors

iii. CTC has a modern medical infrastructure

iv. CTC charge a reasonable price

v. CTC is known to have friendly nurses & staffs

vi. CTC has a modern and conducive ward

5. CTC Brand Equity

i. Even if another hospital has the same facilities as CTC,

I will prefer to choose CTC

ii. If another hospital is not different from CTC in any way,

it seems wiser to choose CTC

iii. If there is another hospital as good as CTC, I prefer to

choose CTC

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iv. It makes sense to choose CTC instead of any other
hospitals, even if they are the same

6. Word-Of-Mouth Communication
i. I heard and known about CTC before from my friend,
family, or colleagues
ii. I heard about CTC excellent services
iii. I heard about CTC reliability in medical treatment

iv. I heard about CTC as a trustworthy health provider
v. I heard that CTC is a trusted, reputable, and credible

name
vi. Within a healthcare provider, I heard that CTC is

among the best
7. CTC Perceived Quality

i. I believe in CTC as a health service provider that offers
good service quality

ii. I believe in CTC as a health service provider that has
excellent health service facilities

iii. Compared to other health service brand, I believe
CTC offer high service quality

iv. I believe that I can always count on CTC for consistent
high health service quality

v. I believe CTC as a health service provider that lives up
to its promises

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CHAPTER 4 | PRELIMINARY FINDINGS

4.1 PREAMBLE

This chapter presents preliminary findings gathered from three (3) methods of data
collection as depicted in Table 4.1. The matters that were of concern and relevant to
this analysis are:

i. the workforce of CTC
ii. staff and output performance monitoring system
iii. payment of services
iv. management support and planning
v. fund/ budget allocation
vi. leadership and governance

Table 4. 1: Summary of Preliminary Data Collection

Roundtable discussion The roundtable discussion was conducted on 26 April
with key stakeholders of 2021. In attendance at the roundtable discussion were
CTC four (4) members from top management of CTC, six (6)
heads of clusters, six (6) officers and four (4) clinical
Interviews with selected consultants.
senior staff
In-depth interviews were conducted on 28 April 2021
Observations on premises where some selected senior staff comprising nurses (2),
of CTC and its daily attendant (1), cooks (2) and kitchen manager (1) were
functions interviewed.

Observation of service space of CTC was conducted
on 28 April 2021, where the project team did visits of
premises and various localities in CTC.
This is a qualitative method where site visits and
interactions with the clinical departments’ workforce
were conducted.

4.2 FINDINGS

Communication and discussion with the top management and key persons of CTC
are vital on related issues to assess CTC's current business performance and readiness
to be self-sustainable or as a profit centre hospital. The summary of findings are
explained in Table 4.2 and 4.3.

Table 4. 2: Major Findings from the Round Table Discussion

1 Problems in terms of policies and top governance – original objectives of IPPT
were not fulfilled

2 There have never been any studies before to address the above issues

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3 Charging system – issues charges too low, no charges for those GL and USM
staff, existing issues for fees implementation (with the Bursary)

4 Workforce (career development) - skills not optimally utilized

Table 4. 3: Major Findings from the In-Depth Interview

1 Workforce (training) – no personnel in relevant services
2 Performance monitoring system – IPPT still using the current system LPP/SKT
3 Payment for those working under EHS - payment is not transparent to all staff

involved working in EHS
4 Management of CTC- there is not much connectivity and direction from the

upper level of management, dilution of vision, mission and direction of CTC
among staffs
5 Budget - budget is approved but not enough
Governance - Policy, guidelines, direction, the status of the land, vision and
mission need to be reviewed all over again to see where CTC is aiming to be
in the future
6 IPPT implements 5S work culture – which is good, but budget-wise is a
limitation where at times the staff used their own money for this intention
7 Opinion on privatization of CTC, IPPT – staffs agree to go for a transformation
as a private identity since IPPT has much to offer, but if CTC can provide
services for those who have insurance, CTC can attract more customers to
come to IPPT
8 Staff’s attitude - attitude and teamwork issue - require training for the staff,
some staff use social media to express/rant their feeling about their
workplace
9 Facilities – some facilities need to be provided and upgraded (kitchen, café,
lifts, covered walkways etc.)

Table 4. 4: Major Findings from Observation of Service Space

1 The poor state of kitchen facilities – do not meet the specifications for a
hospital

2 There is no common cafeteria for staffs, patients, customers – currently just a
shabby shed with tiny cooking area, morale and wellbeing of staff are being
neglected

From all THREE methodologies applied, in general, the areas of concern that may
affect CTC progress to move forward as a profit centre are summarized in Table X.

Table 4. 5: Area of Concern Affecting CTC Progress Based on Preliminary Findings

Output There has never been any output measurement – based on the
Ratio between doctors: patients: nurses

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Staff Inadequate performance tracking system – currently using
Performance SKT/LPP from umpteen years and has never been changed
System
Kitchen The poor state of kitchen facilities – do not meet the specifications
for a hospital
Inventory There is no inventory monitoring system – could not monitor the
System flow of resources between input vs output
Utility There is no common cafeteria for staff, patients, customers –
currently just a shabby shed with a tiny cooking area, morale, and
Land Status wellbeing of staff is neglected.
The land status of CTC – initially for farming & agriculture, not for
Pricing services -> difficult for an investor to collaborate with CTC
Pricing of services – since umpteen years remain the same, never
Costing changed and do not follow the current market price
Waste Lack of operation costs analysis – for utilities, electricity, water, etc.
Management Lack of waste management monitoring system – how much waste
Marketing and cost resources underutilized/ defects were not measured.
ROI Marketing and business development unit for CTC – not available.
Measurement There is no proper measurement of ROI for every activity organized
IT by CTC
Development Lack of latest IT and technology integration – data backup system,
health informatics system, patient’s information system, hospital
Management information system.
Coordination No, synchronize policies and guidelines between HUSM and main
campus – hospital practice relies on HUSM, employment relies on
Hospital USM main campus.
Management Hospital administrator – should have a specific team to investigate
Insurance business & strategic development of CTC
Patients with insurance coverage – potential big market to explore
Workforce as high demand. We need to collaborate with insurance
organizations, now not yet available in IPPT.
Marketability Placement of staffs – must be fit with right skills, background,
experience, and talent, must have a recruitment system that
Financial reflects the needs of CTC
Management There is no holistic market analysis – segmentation, targeting,
positioning, branding, market share
Health There is a lack of coordination between financial management
Expenses bet the main campus and CTC. The income generates by CTC has
USAINS not been revealed and never put in CTC, IPPT account, no
Involvement transparency
Transparency Ballooning of health expenses by CTC – staff & spouses are under
GL, IPPT must cover for their cost, seems CTC is like a welfare body
Usain’s arrangement and agreement of charges and payment to
Finance should be disclosed to IPPT and not just via USM
Finance – lack of transparency system of payment, invoice,
revenue. What percentage and to whom? (Inequality,

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transparency, price fairness is not there) thus, so must have a
special task force to investigate this matter.

4.2.1 Samples of Raw Data for Preliminary Study

Roundtable Discussion
26 April 2021

Respondents:
i. Top management - 4 members
ii. Head of Clusters - 6 members
iii. Officers - 6 members

iv. Consultants – 4

Findings Discussion/Action Taken

Policies & Governance • Meeting with UMMC – Discussion
• Problem in terms of policies and
top governance – many factors on key success factors
are not fulfilled from the original
objectives • Look into current situation, critical
• No study has ever been done
before to look thoroughly of success factors, impact of
these issues
capabilities, impact of
Charging System
• IPPT (CTC) is tied with the competitive advantage and how
authorities and charging system
– has no power in management both can contribute to the long-
• Charging here is too cheap
compared to other competitors term strategic planning of CTC
– registration fee, IV drip are way
cheaper • Meeting with UMMC – To come out
• IPPT does not charge the staff
and GL for the materials used – with one more department
facing shortage of money
• IPPT covers most of the (Jabatan Pembangunan
treatment for free as not many
outsiders come to IPPT Perniagaan) that is in charge of
• Delay payment for MRI, CT scan
and lab tests the marketing which will generate
• Ongoing problem for fees
implementation, claim charges more income, licensing and
and limited utilization of the
budget provide proper market

segmentation

• Suggestion – Gives training to staff

to keep them busy, allow renting

the spaces, encourage

engagement with public, gives

free talk, conduct specialized lab

tests for other companies and

marketing staff

• Full load cover – Convert into

monitory that looks into the

number of staff per month, type of

treatments, initial amount of

money, resources that can

generate income, revise the fees

(staff can pay 50% back) as

everything need to be charged so

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CTC can monitor which

department used the most tests

and what type of tests – By the end

of the year, board of directors can

decide to give incentive/bonus for

good performance

• Free services – IPPT can charge all

patients for the materials that are

used in the treatment to generate

more income

• Strategy for pricing – Charge within

the type of services to cover the

money that have been spent – low

pricing based on seasonal

Workforce (Career Development) • CTC factors – Look into
• Less benefits in term of profit wise
due to the number of advantages that CTC has, facilities
dependent IPPT staff – full load
covers of facilities and limited for the public, generates income,
budget
• IPPT is far behind – skills are not manpower/resources issues, role of
fully utilized; doctors prioritize
their professional development academicians, managers and
and career – might opt for
another places clinicals (Look into the gap too)

• Conduct workshops for

recommendation/ suggestion

after the finding stage to gather

information

• Social media feedback – Look into

the engagement with customers

and does IPPT staff have the

capabilities/ knowledge to answer

customers’ questions accurately

In-depth interview
Date: 26 April 2021

Respondent:
i. A staff nurse, Oncology department

Topics Matters Discussed
Staffing
Training more staff as for now, IPPT does not have enough
workforce in Oncology Department.
Staff empowerment as well as their creativity are limited.
The arrangement of the staff depends on the Head of Department
– including the number of staff.
There are no physicians in IPPT.
Sometimes, there are no doctors available, so it is hard for the
patients to receive treatments.
Overwork staff – one staff has more than two job scopes that need
to be done at the same time.

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Performance IPPT is still using SKT to monitor the staff’s performances – old
Monitoring employees staff performance measurement.
System Issues regarding marks for SKT: There are complaints on why the
marks given are inconsistent.
Payment SKT is an old system: There is no other measurement tool to view
nurses’ performances.
Management Statistics and duty schedule are made based on staff’s initiative –
not standardized or directive from top management. No proper
Budget guidelines.
For the collection of statistics, the data will be given to Record Unit
Governance and Statistic staff. However, the same data/report submitted will
be requested again and again. No proper data management
system/ unit in place.
Working at EHS. Unclear payment system. Staff are unclear how
they have been paid. Amount of payment remains the same
despite overwork. Suggestion - Payment must be transparent to all
staff involve working in EHS.
Issues regarding payment system: There is no specific bill for the
staff to know as the money is only transferred and no longer using
cheques
Issues regarding payment from the patients: Doctors and nurses in
the department will only receive payment once the patient pays
for the treatment (which results on the staff’s motivation)
Process on buying medicines/equipment: For medicines/medical
purchases at CTC, IPPT must go through HUSM. For academic
purposes, IPPT must go through the main campus – causing
confusion among the staff.
Suggestion: It is better if CTC, IPPT can run on its own management
system – it is easier for the staff to purchase medicine and
equipment, and for planning too.
There are not many connectivity and direction from the upper
level of management. Dilution of vision, mission, and direction of
CTC among staff.

There are budgets that have been given for each year. However,
most of the time the budget is not approved so there was not
enough budget for certain things.
The staff use their own money and effort to make/decorate the
boards in the unit and the banner outside the unit for customer
engagement, awareness, and information gain. No specific
budget for marketing activities been given.
Maintenance cost is too high if any of the medical machines broke
down, hence why the staff prefer to buy the machines straight
from the company – if any issues occur, they can always refer to
the company’s maintenance team for a slightly cheaper price

Policy, guidelines, direction, status of the land, vision and mission
need to be reviewed all over again to see where CTC, IPPT is
aiming to be in the future.

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In-depth interview
Unit Dietetik & Pemakanan
Date: 28 April 2021

Respondent:
i. Respondent 1 & 2 – Cooks
ii. Respondent 3 - Kitchen Manager

No. Matters Discussed
1. Limited space

There is only small space for us to cook for the patient and it is very limited
The office was originated as an empty space – IPPT does not has enough
space for this unit so they added walls so this space can work as the office
The cooks can prepare 50 set of food for the patients at one time – max
2. Issues with the storage room
The store was originally functioned as an office for 5 people – which is too
small and crowded and later was transformed into a storage room to keep
all the dry food
We don’t have the trouble with the food supply; however, it is quite a
problem with food preparation place – bigger space is suggested
3. Issues with the working space
The kitchen was never had an approval/license – there is no SOP and will
trouble the firefighter if they need to come to check.
The gas cylinder is not at the right place, and it is quite dangerous if any
sparks can cause huge fire explosion.
The situation of the kitchen has been going on for 5 years – the cooks are
worried about the wet ingredients as they might go bad faster (the storage
space is small).
The office space is not convenient at all as it is too suffocated and does not
have enough space for Muslim staff to pray.
The toilets that haven’t been used in a long time are desperately turned into
a storage room due to not having enough space.
There were plans made long ago, to build a proper kitchen and meet the
hospital specification, but no actions have been taken since then.
Audit doesn’t come to check the environment here.
4. Career Development
One of the cooks here have chosen to go work at other places – more
opportunity to grow -> poor career development for staff to retain in CTC.
Understaff in the unit – there are talented cooks, but the situation isn’t
helping.
Suggestions: There should be more staff hired in this unit, bigger space, and
a complete ISO compliance.

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4.3 CONCLUSION AND RECOMMENDATIONS
In this analysis, areas that involve physical capital (equipment, fund/ budget, utilities),
human capital (employees, customer interface, organizational capital) and
leadership, governance is of major concern. It is recommended that the relevant
management of USM focus on the issues raised here since, if neglected, staff morale
and well-being can be jeopardized. These issues may affect the plan for CTC to be a
profit centre.

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CHAPTER 5 | FINDINGS ON FOCUS GROUP DISCUSSION (FGD)

5.1 PREAMBLE

Focus Group Discussion (FGD) involves gathering people from similar backgrounds or
experiences to discuss a specific topic of interest. It is a form of qualitative research
where questions are asked about their perceptions, attitudes, beliefs, opinion or ideas.
The researchers have decided to use the pencil-written feedback approach instead
of face-to-face group discussion to avoid the disruption of the hospital operation and
adhering to strict SOPs of Covid-19 movement control order (MCO) imposed during
the data collection. Respondents were the workforce of CTC, IPPT and referred to as
the Key Informant Person (KIP). The KIP represents the unit of analysis of the unit/
department in the health centre. The KIPs were selected based on their position and
job functions, and roles. KIPs were given TWO (2) weeks to complete and return their
responses effectively from 15 – 30 August 2021. The survey questionnaire was emailed
to all the selected respondents with two follow up reminder notifications.

The thematic analysis method was performed in two stages:
i. Transcripts of FGD
ii. Category and theme search

The thematic analysis method means that the researcher obtains the main themes
(primary meaning units) to understand the current scenario, then answer the
objectives and research questions. Data categorization was made based on themes
to answer the research questions of the study as explained in Table 5.1.

Table 5. 1: Theme & Data Categorization

No Theme Definition

1 Leadership (Vision, Refers to how the CTC’s leaders or decision-makers

Aspiration, Leadership, (executives) administer and monitor contractual

Top Management) relationships.

2 Workforce People related to CTC services whose primary

intent is to enhance healthcare delivery 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.

3 Equipment(Maintenance, The equipment in CTC that is used in diagnosis,

Utilization, Efficiency, laboratory analysis or treatment for patients.

Assets, Suppliers, SOP)

3 Fund/ Budget 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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4 Customer Interface The customer (CI) is a component that describes

how CTC interacts with its patients (in-patients, out-

patients, and companions/caretakers).

5 Utilities Services and the facilities provided are considered

essential to CTC's long-term performance and help

attract visitors.

6 Based Budget Procedure based budget is defined as

strengthening the links between the funds

provided to CTC entities and their outcomes

through formal performance information from the

allocation decision-making.

7 Competency Skills, experience, and knowledge of the workforce

in managing the health and safety of the patients

to achieve optimal performance outcomes, i.e., to

prevent patient harm while improving clinical

outcomes.

8 Skills & Talent Skills in the healthcare system are defined as

specific health professions disciplines that will help

to facilitate work and aim to optimize the roles and

responsibilities to improve patient care

9 Service Delivery The ability to design, develop, deliver, and operate

Performance the services effective, predictable, reliable, and

meets the expectations of

customers/stakeholders.

10 Competitive Advantage- Competitive advantage is defined as the ability

Performance gained through attributes and resources to

perform at a higher level than others in the same

industry or market.

11 Profit-Center & Strategic A long-term plan is used to provide the formulation

planning 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

5.2 FINDINGS

The general objective of this FGD was to gather the views of the CTC workforce
regarding their in-depth understanding of SEVEN (7) categories related to CTC
services. CTC's critical success factors must be identified to ensure that AMDI has a
competitive advantage in healthcare service delivery performance. Thus, questions
pertaining to whether CTC is ready to become a self-sustainable entity towards
becoming a profit medical centre are addressed. The workforce’s perceptions,
attitudes, beliefs, opinions, or ideas are the following:

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Leadership Workforce Equipment Fund/Budget
Capability

Customer Utilities Profit Centre
Interface & Planning
Service Quality
Orientation

5.2.1 BACKGROUND OF RESPONDENTS

In this category, information gathered were:
i. Categories of staffs
ii. Years of working at CTC
iii. Grade

iv. Position
v. Unit/Section
vi. Numbers of training attending that related to job functions in a year

(Frequency)
vii. Past job experience before joining CTC, IPPT (in years)

Table 5.2 indicates a total of key informant person (KIP) 44 are involved where there
are 38 female and 6 male staffs. They are specialists and officers from the medical
and dental fraternity, nurses, science officer, pharmacists, dietician, social worker,
and physiotherapist with different levels of seniority from grade 48 to 56. Their roles or
job functions vary from policymakers, management/ administrative and functional.
23 out of 44 are either medical (15) or dental (8) specialists of the total respondents.
Their duties include heads of service or unit where they hold administrative posts and
their core duties. Other categories of staff are dietitians (1), Medical social workers (1),
Scientific officers (3), Pharmacists (5), Physiotherapists (1), Dental officers (4), Nurses
(6). Their roles include the managerial and functional level, such as head of units or
sections in the health centre.

The KIPs working years at CTC range from 2 to 15 years, with the majority working for 7
years. Most of the KIPs mentioned that the minimum number of trainings they usually
attending related to job functions is two (2) times per year. Some KIPs have past job
experience between 1 to 10 years before joining CTC, such as in HUSM, KKM hospitals,
and other private health-related sectors. The summary of summary findings on
demographics is in Table 5.2.

Table 5. 2: Demographic profile of Key Informant Person

Variables Demographic profiles No of Samples
Gender 6
Males 38
Females

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TOTAL 44
2
Unit/Section Pediatrics 1
1
Ophthalmology 1
1
Anesthesia 1
2
Oncology and Radiotherapy 2
1
Nuclear Medicine 2
12
Transfusion Medicine 1
1
Family/Com. Medicine 1
3
Surgery 1
5
Orthopedic 6
1
Imaging 2
3
Dental 4
2
O&G 5
3
Dietetic 5
1
Social health 6
1
Diagnostic Laboratory 1
2
Physiotherapy 4
2
Pharmacy 2
15
Nursing 8
4
Years of working at CTC 1 1
1
(years) 2 3
1
3
2
4 1
1
5 1

6

7

8

9

10

11

12

13

14

15

16

Position/Grade Medical Specialist (DU

51/54/55/56)

Dental specialist (DUG 51/54//56)

Dental officer (UG 48/54)

Dietician (U44)

Social Health officer

Scientific officer (C44)

Physiotherapist (U32)

Pharmacist

UF 52

UF 41

U36

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Job functions at CTC U32 1
Primary/ Secondary Nurses 5
Numbers of training
attending that related to U44 30
job functions in a year U32 14
(Frequency) 1
Primary 6
Past job experience before Secondary 11
joining CTC, IPPT (in years) 5
0 5
1 6
2 1
3 1
4 0
5 2
6 2
7 0
8 4
9 1
10 8
11 11
12 4
0 20
1-5
6 - 10
More than 10
No information

5.2.2 LEADERSHIP CAPABILITY

Key issues and questions asked and discussed were:
i. Please describe your job/duties and how long you have worked in this
particular department/position?
ii. What is your opinion regarding the current organizational structure of CTC and
the leadership? You can also include some information at your department
level.
iii. Any particular challenges/problems that you have faced with the
leaders/management?

iv. What do you think about the approach/action taken towards problem-solving
(at the organizational or department level)? Can give examples if necessary.

v. What do you think of the support given by the current top management of
USM?

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Table 5. 3: KIPs Responses for Leadership Capability

Please describe your job/duties and how long you have worked in this particular

department/ position?

Response In this category 18 out of 44 staff is either Head of Sections or Units

with administrative posts in various fields.

Academics who are clinicians have additional tasks as researchers

and academics expected from other USM academics.

Among the duties:

1) Lead Blood Transfusion Unit in terms of service management

and quality activity for ISO 15189 accreditation

2) Social and community engagement - Community Services/

Collaboration with Governmental Institution/ NGO, develop

collaboration with other lecturers for research projects or

community projects

3) Acquiring space, renovation, staff and purchasing of

equipment

4) Training of staffs

5) Future planning of clinical service

What is your opinion regarding the current organizational structure of CTC and the

leadership? You can also include some information at your department level.

Response Twenty-one (21) staff give positive feedback that the current

organization and leadership are good, and the latest structure is

leaner. The leadership administration is also competent for the limited

resources.

Twenty-three (23) staff have raised significant concerns that need to

be looked at by the higher management level.

Issues The issues raised are:

concerning 1) Needs change in leadership management.

current CTC 2) Not firm in decision making – may be due to lack of

structure experience and cannot accept opinions of others.

3) The organization chart at the top-level management is a bit

blur. Staff is unsure how CTC is even directly or indirectly put

under HUSM Kubang Kerian? There’s no black-and-white issue;

however, the Deputy Director (Clinical Division) is now

answering to the Director of HUSM KK. How is this possible when

we do not receive any financial assistance from them? Are we

being bullied?

4) There is an administrative gap in the office of the clinical

division where the Assistant Registrar is not in the proper

location/office (logistics issues)

5) Nursing matron taking care of the administrative work due to

above issue - affects the efficiency

6) Too many heads/for different levels of staff, mostly staff will only

listen to their PPP or PPK, e.g., a staff nurse will not follow

instructions from the Matron because their PPP/PPK are the

Sisters or senior Sisters/head of section.

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7) Some immediate supervisors become defensive/territorial of

their ‘minions’, therefore would not obey another section’s

request for assistance even though they have staff to spare –

not good for CTC, not the best intention

8) An organizational structure like other regular hospitals like

PPUM, HUSM, HUKM etc. need to be studied and adapted for

CTC

9) The organizational structure of IPPT is complicated, direction

and focus of clinical service keep changing - probably lack of

leadership and strategy in determining the focus and direction

of clinical service in IPPT.

10) The overall organization is acceptable; however, the nursing

department warrants a relook.

11) It’s good if upper-level management discuss with the staff

involved before making any decision

Any particular challenges/problems that you have faced with the

leaders/management?

Response Only 14 staff gave a favorable response. There is a major concern

here where most staff have voiced complaints or raised about the

leaders and management matters.

Challenges/ 1) There is no transparency in communication, bureaucratic

Problems issues

2) Supervisors need to manage by walking to see the real

problems faced by staffs

3) Communications from the office are sometimes confusing, i.e.,

the email sender sometimes sent multiple emails, which are

often retracted and re-sent – need the right team (problem

with administration)

4) Need more patients for surgery. Management should focus

more on marketing/branding.

5) Need more staffs in certain selected areas

6) Management is not promoting the good work that staff have

done.

7) Lack of guidance and facilitation from management - A lot of

uncertainties in many work procedures.

8) There should be more support towards dental services,

especially matters related to human resources and facilities.

9) Challenges/Problems: ensuring staffs have integrity in

recording TAMS

10) Lack of supporting staff

11) Unclear work directives

Other related At times the management team is not clear of a problem or issue,

issues and the head of the unit makes their own decision without

consultation with the subordinates. This action can create a conflict

of interest and dissatisfaction between associates.

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What do you think about the approach/action taken towards problem-solving at the

organizational or department level? Can give examples if necessary.

Response In this category, only 15 respondents are happy with the current

action taken towards problem-solving at the organizational or

department level. Problems are discussed at meetings with clear

direction and solved amicably. With the appointment of the new

Director, the highlight of the planning and progress is shared with all

staff.

Issues 1) SOPs that are different for different categories of visitors – seem

to favor VIPs where the laid SOPS are not followed when it

comes to VIPs or people with status

2) Staff are directed to do jobs, not within their job scope

3) Decisions about some matters take a long time to be settled

4) Different locations of certain premises

5) There is a need to have a regular Clinical Management

Meeting to monitor service delivery performance and discuss

and deliberate issues.

6) There should be more discussion in the meeting, not a one-

person decision

7) Not sure how problems are being solved. Most issues are not

being raised in the open for fear of being reprimanded by the

immediate supervisor.

8) Communication from top to bottom seems to be

unsatisfactory - Input from top management input has not

been adequately dispersed timely to the staff.

9) In small units, such as nursing service, communication

between the leaders and staff needs to be improved.

Any particular 1) Dental services – the recurring problem is the insufficient staff –

issue Dental surgery assistants (DSA), PPK.

unanswered. 2) Most problems are not being raised in the open for fear of

being reprimanded by the immediate supervisor:

3) The issue of staff nurses working at the Dental division has been

festering very long but has never been resolved. No wonder

people are dissatisfied and end up sending a ‘mysterious

letter’ (surat layang).

4) PPV issue not solved - but no solution is being offered, making

those who volunteer have to sacrifice more than they should.

These are some examples of problems not being solved.

What do you think of the support given by the current top management of USM?

Response This category scored the lowest in terms of favorable (8) views. Some

KIPs decline to comment.

Support of Among the responses:

current top 1) There is no/poor support except only demands and failure to

management understand. The worst part is asking CTC to look for help/

direction to HUSM KK

2) Some misperception was saying clinical facilities used USM

money without making much profit. The reality is CTC still cover

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Any particular and give free services to USM staffs, students and all
issue government GL holder (CTC did not get budget from Ministry
unanswered. of Finance.
3) Top management sees IPPT as a financial burden because
CTC spending too much of operational budget on health
services
The top management has been scrutinising and criticising IPPT
mostly. It is hoped this feasibility study can be an eye-opener to
them as well.

Top management sees IPPT as a financial burden because CTC
spending too much of operational budget on health services

5.2.3 WORKFORCE CAPABILITY

Key issues and questions asked and discussed were:
i. What is your opinion regarding the current workforce at CTC/your department?
(In terms of number, competency, and experience).
ii. Have you or your colleagues ever experience burnout, depression, overwork or
underwork?
iii. Do you require continuous training to improve your competency/skills? Any
training program provided currently?

iv. In your opinion, what kind of motivational exercise will help to enhance your
job performance?

v. Are you ready to serve CTC if it is being transformed into a fully private entity?
YES/NO. Please briefly explain the reason for your answer.

vi. Were there any motivational courses organized for the staff? If yes, who were
the organizers? Do you think it was relevant to your job?

Table 5. 4: KIPs Responses for Workforce Capability

What is your opinion regarding the current workforce at CTC/your department? (In

terms of number, competency and experience).

Response The response here is mixed between adequate (14 out of 44) and

inadequate (30 out of 44) workforce.

Current staff 1) Some staffs are underworked

competency 2) Too many staffs, but patients are too few

3) Range of staffs between efficient and not efficient

because exposure to few patients

4) Staff not enough in some sections – dental, oncology,

Pharmacy Section

5) There are too many staffs/overstaffed for the number of

patients served

Have you or your colleagues ever experience burnout, depression, overwork or
underwork?

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Response The majority of staff do not experience burnout, depression, or
overwork.

1) However, some say staffs are underwork in some sections
like the non-clinical staff.

2) Some say they are stressed when they need to settle
things outside their expertise and when facing
management uncertainty and human attitudes.

3) Specialists are underworked clinically but spending more
time on research and administrative management.

4) Generally supporting staffs has adequate workload with
some underwork.

Do you require continuous training to improve your competency/skills? Any training

program provided currently?

Response Majority said yes

Examples of 1) Clinicians are required to fulfil yearly training as per

training requirements by the dental council

2) Other training about specific job descriptions

In your opinion, what kind of motivational exercise will help to enhance your job

performance?

Examples of 1) Sense of belonging and appreciation

Motivation 2) Team building

exercise 3) Teamwork and respect each other

4) Client satisfaction, self-satisfaction with the quality services

5) Appearance and etiquette courses, team building

exercise

6) Motivational talks

7) Be happy and always smile

8) Leadership courses etc.

Are you ready to serve CTC if it is being transformed into a fully private entity?

YES/NO. Please briefly explain the reason for your answer.

Response A majority agree with significant concerns.

Readiness for a 1) KIPs are afraid that CTC cannot run smoothly as a fully

profit-centre - private entity with a current workforce. A suggestion

YES answer would be to follow PPUM, HUKM, HUSM, HUPM systems.

2) Everyone else should work as a private practice

3) Need time to prepare ourselves and improve our service

4) Staff need to be clear on the transformation of the

business model as a profit-centre.

Readiness for a For those who say no, their concerns are:

profit-centre - • As a general principle, how can a government-funded

NO answer clinical centre with paid staff and facilities be turned to

total private? If it’s a hybrid set-up, then staff would gladly

consider accepting the transformation.

• The academic and research divisions would also utilize the

facilities and resources at CTC for academic (specialty

training) and research activities.

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• AMDI was built to cater for the public for the northern

region with the strength for cancer treatment, and we

can still plan for a financial generation with that status and

the facilities we have for cancer treatment and

diagnostic

Were there any motivational courses organized for the staff? If yes, who were the

organizers? Do you think it was relevant to your job?

Response A majority said yes, but frequencies and numbers need to be

increased.

5.2.4 UTILITIES CAPABILITY

Key issues and questions asked and discussed were:
1. How do you view the current utilities and facilities available for patients and
staff in CTC?
2. Any suggestions for improvement?
3. 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?

Table 5. 5: KIPs Responses for Utilities Capability

How do you view the current utilities and facilities available for patients and staff in

CTC?

Response only 15 out of 44 respondents gave the feedback as satisfactory

or adequate.

Existing utilities 1) No proper café for patients to dining in or buy proper

and facilities are food, very limited choice of F&B – a primary concern

BELOW PAR 2) Small prayer rooms for male and female

3) Limited toilet availability for patient

4) No person in charge at main entry if a patient needed

help with wheelchair etc.

5) No proper outside waiting area for children or

recreational area

6) No suitable wheelchair pavement from CTC to KP

7) Not enough parking lots for staff because patients always

park in our parking areas

8) Small pantry for staff

9) No emergency exit door for the dental clinic

10) No mart for staffs/patients/relatives

11) There is a need to expand the dental specialist clinic – to

prepare for the influx of new students of the new program

12) Corridor to link dental clinic to the new building - needed

13) Cleanliness and proper arrangement of utilities needed

Any suggestion for improvement in utilities and facilities required?

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Response 1) Café or kiosk for food (especially for family members or

waiting patients)

2) No proper café available)

3) Homestay or room/ hotel/ hostel in CTC compound for the

patient who needs daily treatment but no need to be

admitted

4) Nursing care home for advanced disease patients

(palliative house) to improve family support and aid

patients for proper care

5) Small mart for essential utilities such as shoes, soap etc.

6) Lovely garden for the patient to be able to exercise

7) Playground/playroom for the pediatric patient

8) Kindergarten or nursery for staff children

9) Improve facilities such as PET scan and another LINAC

(radiotherapy machine)

10) Community Pharmacy

11) Gym, field, court – can rent for community

12) Proper area/lobby for loading and offloading patients

13) Provide parking areas for patients, and good and

standard signage within CTC is required rather than

handwritten by the staff

14) Larger pantries for

15) Provide emergency exit door for dental clinics

16) Spacious surau for staff and visitors etc.

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?

Response Mixed responses. The majority are satisfied (32 out of 44).

However, in general, those satisfied complain about the time

taken for the speed of action that needs improvement.

Issues 1) Not satisfied with the speed of action but quality-wise,

satisfactory

2) It sometimes takes two weeks to be repaired or repaired

but then problem again within two or three days

3) IPPT staff should do the maintenance and repair instead

of passing it on to vendors

5.2.5 EQUIPTMENT CAPABILITY

Key issues and questions asked and discussed were:

1. Do you have sufficient equipment (number and type) to support your work?
2. Is there any regular maintenance/ calibration being carried out for the

equipment?
3. Any particular unit/person in charge of the maintenance?
4. Is there any budget allocated for equipment upgrade/maintenance?

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5. Are you satisfied with quality and speed of care taken for maintenance to be
done when the staffs are contacted?

Table 5. 6: KIPs Responses for Equipment Capability

Do you have sufficient equipment (number and type) to support your work?

Lifespan CTC has sufficient number and type of equipment to support
daily operation

Most of the equipment are more than 10 years old

Often breakdown. This has significant effect on staff motivation

a) Is there any regular maintenance/ calibration being carried out for the
equipment?

b) Any particular unit/person in charge of the maintenance?

c) Is there any budget allocated for equipment upgrade/maintenance?

Maintenance Minor repair/maintenance should be able to be carried out by

& technical staff/JPPA technicians.

Budget

Continuous training maybe helpful.
Equipment in laboratories with ISO accreditation are well
maintained, basically due to the requirement of the
accreditation. The system can be adopted by other non-ISO labs
as well.
A planned maintenance program must be introduced.
The staff are aware of the need to be prudent with the use of
consumables and equipment. Booking system need to be
improved.
There are issues of inaccessibility to high end instruments/shared
facilities.
There is shortage of specific equipment for clinical application,
such as ultrasound machine and hysteroscope for O&G clinics
and paediatric and therapeutic scopes for surgery.
Recommendation: Since this equipment are basic needs for
practice, the management must put up a proposal for special
budget and include this in the next rolling plan.
Are you satisfied with quality and speed of care taken for maintenance to be done
when the staffs are contacted?

Staff satisfaction Currently the maintenance is being delayed/not performed due
to insufficient budget.
Response time for breakdown report is not satisfactory.

5.2.6 FUND AND BUDGET CAPABILITY

Key issues and questions asked and discussed were:

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1. How do you view the current financial situation, budget allocation and
expenditure of CTC?

2. From your point of view, how to minimize/optimize the operational cost for
CTC/your department?

3. From your point of view, can CTC generate sufficient amount of income from
the healthcare services and be self-sustainable?

Table 5. 7: KIPs responses for Fund & Budget Capability

How do you view the current financial situation, budget allocation and expenditure

of CTC?

Budget Most of the staff highlighted insufficient budget for operational
and development activities

a) How to minimize/optimize the operational cost for CTC/your department?

b) Can CTC generate sufficient amount of income from the healthcare services

and be self-sustainable?

Project CTC must prioritize projects and expenditure and must also
prioritization consider short term and long-term implications when doing this.
Individual based project should be the least priority.
Target market Invest on revenue-generating projects, especially those
already working.
Payment Majority of CTC’s patients are USM staff. The current practice for
mechanism patients using GL is not practical. CTC is not being reimbursed
& for the treatment and medication. A way for reimbursement
Income channel must be introduced.
A comprehensive mechanism for collecting payments from
patient is not available. CTC must establish a payment
collection system as soon as possible (either using an
independent system or the current CODA system).
CTC has a number of high-end machines such as MRI and
Linear Accelerator (LINAC). The use of these high-end
instrument must be maximized since they have potential
market.
Support services may be offered to private hospitals or
government hospitals with long waiting list. Patients can
continue their treatment at the respective hospitals after
getting the images from CTC.
There are some issues regarding inefficiency in energy
management. Sustainable energy and water resources are the
way forward. Bulk purchasing may also help to reduce cost. All
department must submit a list of all required consumables for a
period of one year and offer sebutharga/tender. Company will
offer the best price to compete.

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Readiness for a The dental services are quite ready for private practice.

profit center However, prices for each treatment must be revised to ensure

cost recovery while being competitive.

However, the medical services are not ready for a full fledge
private services, mostly due to limited equipment (old and not
up to date), expertise, beds and ER.
Even though there are limitations, most of the staff believed that
with proper management, promotions and correct strategic
planning, CTC may be able to generate more income and
attract more public patients.

5.2.7 CUSTOMER INTERFACE AND SERVICE DELIVERY

Key issues and questions asked and discussed were:

1. How do you view the customers' satisfaction towards healthcare services
provided by CTC?

2. Are you aware of any channel used for marketing of services offered by CTC?
3. Are you aware of any channel used for customer feedback?
4. Any issues that you want to share from your personal experience when dealing

with CTC customers/patients?
5. Please share with us any suggestions on how to improve the quality of services

offered by CTC.

Table 5. 8: KIPs Responses for Customer Interface & Service Delivery

How do you view the customers' satisfaction towards healthcare services provided

by CTC?

Customer Based on the client satisfaction survey and other feedbacks

satisfaction (Borang Aduan Pelanggan; emails, text messages), most of

& the customers are satisfied with the medical and dental

Issues services provided by CTC.

However, due to limited type of services and equipment, few

patients must be referred to other hospital. This can be a

setback for potential customers.

There are some issues related to miscommunication between
the service provider and customers, particularly the Taksiran

counter.

A more systematic method for invoicing and collecting

payment from patients must be developed as soon as

possible. The system must be able to identify those who have

paid or not.

As an example, patients must show proof of payment before
getting their medication, both for inpatient and outpatient.

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The current system in use is easily abused and patients can get

away without paying.

Facilities in CTC, such as cafeteria and surau must be

upgraded. The current state is not at par and caused

inconvenience for patients and staff.

The quantity and quality of food being served at the cafeteria

are not satisfactory.

A small convenience store within the hospital building is very

much in need.

Basically, a good hospital should provide a ‘self-sufficient’

environment for all patients and staff.

Are you aware of any channel used for marketing of services offered by CTC?

Marketing channel Currently there is no marketing in place for all services offered

by CTC.

A good website, local listing and promotional healthcare

packages are necessary to promote the medical and health

services offered by CTC.

Investment in marketing promotional activities is a must e.g.

search engines may also be helpful.

Any issues that you want to share from your personal experience when dealing with

CTC customers/patients?

Personal USM staff have high expectation/demand when getting their

experience treatment from CTC.

Few patients had displayed inappropriate behaviour, which

may affect the motivation of CTC staff.

5.2.8 PROFIT CENTRE AND STRATEGIC PLANNING

Key issues and questions asked and discussed were:

1. Are you aware of CTC’s Strategic Planning? Please share with us some of the
important points that you understand.

2. How does the healthcare services currently provide under the private wing
(EHS) is different from the public wing of CTC?

3. From your point of view, what are the advantages and disadvantages
between the private wing (EHS) and public wing in CTC for both staff and
patients (for current setting).

4. From your knowledge/understanding, is there any demand/market for private
healthcare services in CTC, particularly for the local communities.

5. What is the best way forward for CTC?

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Table 5. 9: KIPs Responses for Profit Centre & Strategic Planning

Are you aware of CTC’s Strategic Planning? Please share with us some of the

important points that you understand.

Most of CTC staff are not aware of any strategic plan and the

direction of CTC.

Few have heard about rebranding of CTC to HUSM@Bertam

and aware of the idea to privatize the healthcare services.

Majority supported this idea and would like to understand the

business plan better from the top management

In depth interview is required to ensure the readiness and

willingness of the healthcare officers to work during odd hours,

like the current practice in other private hospitals.

a) How does the healthcare services currently provide under the private wing (EHS)

is different from the public wing of CTC?

b) What are the advantages and disadvantages between the private wing (EHS)

and public wing in CTC for both staff and patients (for current setting).

Advantageous There are concerns regarding the quality of services provided

& through EHS versus the price charged.

Disadvantageous As for now, the only advantage for EHS patient is shorter waiting

period to see the specialist.

EHS patients will be treated within the same environment with

the public patients, but at higher cost.

Value added products/features for EHS services is inevitable.

The team must also work towards insurance coverage for

inpatients.

The dental clinics are well equipped and have been serving

many private patients through EHS. However, they need

additional dental assistants to run concurrent clinics.

Services to public (non-EHS) will be affected due to limited

manpower.

There are suggestions to revise the price for dental services,

especially for non-EHS patients. The new rate should also

consider patients’ income status (B40, M40 or T20).

a) From your knowledge/understanding, is there any demand/market for private

healthcare services in CTC, particularly for the local communities.

b) What is the best way forward for CTC?

Opportunity There are demands from local communities for medical and

dental services.

CTC is strategically located at the northern part of Penang and

easily accessible for patients from Kedah and Perlis.

Limited number of private hospitals and high number of middle-

class communities within these regions are the major

advantages for CTC.

Among immediate actions for way forward is to focus on the

strength, consolidate manpower and improve facilities.

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A thorough market analysis must be carried out by the EHS team
to ensure that the packages are attractive, competitive and
affordable.

5.3 RECOMMENDATION AND CONCLUSION

The findings from FGD indicate that:

i. Major concerns are in the leadership category regarding the current
organizational structure of CTC and the leadership, existing particular
challenges/problems that the workforce have faced with the
leaders/management and the approach/action taken towards problem-
solving. Staffs think there is a need for a leadership change, where the
leadership is seen as not firm in decision making. The organizational structure of
IPPT is seen as complicated, direction and focus of clinical service keep
changing.

ii. Staff also think the current top management of USM gives very little support.
iii. Staff highlighted that there is no/poor support except only demands and failure

to understand. The worst part is asking CTC to look for help/ direction to HUSM
KK.
iv. The current workforce at CTC, the number, competency level, and staff
experience is adequate in the workforce capability category.
v. Generally, no staff has experience burnout, depression, overwork or underwork.
vi. Continuous training to improve competency/skills is required.
vii. Staffs are ready to serve CTC if it is being transformed into a fully private entity,
but they need a clear sense of job directives.
viii. There have been motivational courses organized for the staffs but very limited
and they entirely need training.
ix. In the utility’s category, respondents most voiced that utilities and facilities are
below par. The main concern is there is no proper café for patients to dine in
or buy proper food, and other facilities for staff are needed.
x. The speed and response time taken by the staff in charge of the maintenance
of utilities is acceptable, but still can be improved. For cost saving, AMDI staff
should be trained to carry out basic maintenance and repair instead of passing
the work to vendors.
xi. It is worthy of stressing that some issues mentioned by the workforce in this
survey have been recurrent and raised by the workforce earlier but have not
been rectified.
xii. Most of the equipment are more than 10 years old and often breakdown. There
are equipment that were not properly maintained due to limited budget. A
rotation-based maintenance should be introduced to reduce the frequency
of breakdown.
xiii. Few clinics are lacking basic equipment for treatment. CTC must put up a
proposal to request for special budget since this equipment are vital for patient
care.

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xiv. A systematic payment collecting system is not in place. This issue must be
rectified urgently.

xv. Majority of patients are USM staff using GL. A reimbursement method for
treatment received by USM staff should be introduced.

xvi. Most patients are satisfied with the healthcare services provided by CTC.
However, few facilities must be upgraded, such as a good cafeteria,
comfortable surau and a convenience shop.

xvii. CTC must engage with an aggressive marketing strategy.
xviii. EHS must offer high end and high-quality healthcare services to private

patients.
xix. Dental services have the highest potential to be fully privatized. However, the

price for dental treatment should be revised.
xx. Top management must ensure that staff are actively involved in the strategic

planning of CTC in order to create a dynamic team. Make them feel heard,
respected and appreciated for their contribution.
xxi. The findings gathered from this FGD analysis are consistent and match
preliminary findings conducted earlier, involving human, physical and
organizational capitals.
The major concerns are leadership quality and style, workforce capability, financial
stability and inconsistent direction of CTC/AMDI. Remedial actions should be taken by
USM Top Management to ensure these issues are being rectified. The performance
and morale of the workforce may be affected in the long run and may eventually
hampered any effort to transform CTC into a profit centre. Even though there are
some limitations, most of the staff still believed that with proper management,
promotions and correct strategic planning, there is still future for CTC as a profit centre.

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CHAPTER 6 | CUSTOMER INTERFACE FINDINGS

6.1 PREAMBLE

In the demographic analysis of data, we present the distribution of respondents by
age, gender, religion, location, education level, monthly income, employment status,
and USM affiliation. The data is presented in the form of frequency and percentage
where outpatient having N=241, inpatient having N=51 and non-patient having
N=323.

Given that the goal of the quantitative method is to analyze CTC's present
performance in healthcare service delivery, we focus on the distribution of variables
to determine the scope of analysis. We use the Cronbach Alpha (CA) > 0.70,
Composite Reliability (CR) >0.60, and Average Variance Extracted (AVE) >0.50
indicators to illustrate the instruments' reliability and validity. We also looked at the
relationships between all the variables. The correlation coefficient, which runs from +1
to 0, reflects how closely the variables move in perfect agreement and in a linear
fashion. In order to evaluate the strength of impact variables on CTC, regression
analysis was utilized to precisely determine which factors/variables matter the most
and how these factors affect others. The R square value is used to determine the
strength of a relationship and is expressed as 0.75 (substantial), 0.50 (moderate), and
0.25 (weak) (weak).

6.2 FINDINGS FOR OUTPATIENTS SEGMENT

6.2.1 Outpatient Profiling

The demographics profile of the respondents is presented in Table 1. The profiling was
based on age, gender, religion, education level, monthly income, location,
employment status, and affiliation for outpatient respondents (additional data is
attached in Appendix H). The largest group of respondents, 60.2%, were female, and
39.8% were male. The majority of the respondents are 36 – 45 years old (38.6%), and
the minority comes from the age of 65 years and above (5.8%). Muslim respondents
account for 94.6% of the total. Most of the respondents (57.7%) are from Penang. The
largest proportion of respondents (30%) have a bachelor’s degree. Detail of the
outpatient profiling is explained in Table 6.1.

Table 6. 1: Demographics Profile of Outpatient

Variables Frequency % Variables Frequency %
Age Gender
18 - 25 years old 27 11.2 Male 96 39.8
26 - 35 years old 43 17.8 Female 145 60.2
36 - 45 years old 93 38.6 Religion

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46 - 55 years old 32 13.3 Islam 228 94.6
56 - 65 years old 32 13.3 2.9
> 65 years old 14 5.8 Buddha 7 1.2
Location 0.8
Perlis 6 2.5 Hindu 3 0.4
Kedah 42 17.4
Penang 139 57.7 Christian 2 1.2
Perak 23 9.5 14.9
Selangor 8 3.3 Other 1 21.6
Negeri Sembilan 3 1.2 29.9
Education
Melaka 1 0.4 13.3
Primary 3
Johor 2 0.8 19.1
Terengganu 2 0.8 Secondary 36
Kelantan 10 4.1 24.1
Pahang 3 1.2 Diploma 52 18.3

Sabah 1 0.4 Bachelor's 72 23.7
Degree 32
WP Kuala Lumpur 1 0.4 Master’s 46 14.9
Degree
Employment Status 27 11.2 Ph.D. 10.4
10 4.1
Unemployed 153 63.5 Monthly Income 8.7
Self-Employed
Government 20 8.3 <RM2,000 58 8.3
21 8.7
Private 10 4.1 RM2,001 - 44 49.8
Student RM4,000 - 57 38.6
Housewife RM4,001 - 36 3.3
RM6,000 - 25
RM6,001
RM8,000 21
RM8,001
RM10,000
> RM10,001

Affiliation

USM Staff 20

(Retired)

USM Staff 120

Not USM Staff 93

USM Student - 8
Local

6.2.2 Outpatient Visitation and Payment Method

We also collect the data for the frequency of visits to CTC and the reason for the visit.
Table 6.2 shows the frequency and percentage for both data, while Figure 6.1
denotes the cross-tabulation result between these two data. We could conclude that
referred, and plan-to-go patients visit IPPT around 2 to 5 times a year.

Table 6. 2: Visitation to CTC as an Outpatient

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Reason for your visit? Frequency of Visit 22
Referred 62 Always 66
Transferred 26 Frequently (6 to 10 times a year) 130
Plan-to-Go 153 Occasionally (2 to 5 times a year) 23
241
TOTAL One time only
241

One time only

Occasionally (between 2 to 5 times a year)

Frequently (between 6 to 10 times a year)

Always

0 10 20 30 40 50 60 70 80 90

Plan to Go Always Frequently (between 6 Occasionally One time only
Transferred to 10 times a year) (between 2 to 5 times
Referred 11 16
1 47 a year) 1
10 6
81

12

18 47

Figure 6. 1: Cross Tabulation between Reason to Visit & Frequency of Visit

The respondents were also asked to specify the type of treatment they received from
CTC and the form of payment they used. These two sets of data were combined, and
the results revealed that USM employees make a significant contribution to CTC since
they are the primary patients who seek dental and medical care. Table 6.2 has the
specifics.

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140

120

100

80

60

40

20

0 Dental Medical Laboratory Surgical Others
Treatment Treatment Services
USM Staff 2 2 5
Public - Guarantee Letter 97 89 1 1 1
Private - Through EHS 13 27 1 2
0
18 11

Figure 6. 2: Treatment & Payment Outpatient

6.2.3 Outpatient Satisfaction Index

As depicted in Table 6.3, the patient satisfaction index calculates how happy or
dissatisfied patients are with CTC services on average. It is graded on a five-point
scale. The satisfaction index of each attribute is calculated using the Likert scale mean
value. As a result, the index explained in Figure 6.3 to 6.9 denotes 1 as Poor, 2 as Fair,
3 as Good, 4 as Very Good, and 5 as Excellent. This indicator is utilized in both inpatient
and outpatient satisfaction analyses.

Table 6. 3: Satisfaction Index

INDEX 1.00 - 2.33 Low Satisfaction
2.34 - 3.67 Moderate Satisfaction
3.68 - 5.00 High Satisfaction

Modern-looking medical equipment neat, and Mean SD Interpretation
Clean, neat, and well-maintained 4.203 0.809 High
Cozy atmosphere 4.311 0.784 High
Physical facilities are visually appealing 4.170 0.871 High
Staff appearance is clean, nice, 4.021 0.933 High
professional looking 4.237 0.855 High

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5.0000 Physical facilities are
visually appealing,

4.0207

4.0000 Modern-looking Cosy atmosphere,
3.0000 medical equipment,
2.0000 4.1701
4.2033
Staff appearance is

Clean, neat, and clean, nice, neat,
well-maintained,
and professional
4.3112
looking, 4.2365

1.0000 4 5
123

Total Mean Value: 4.188 (High Satisfaction)

Figure 6. 3: Service Tangibility Satisfaction Index

Provide services as promised Mean SD Interpretation
Perform services as expected 4.158 0.894 High
Bill patients accurately 4.071 0.966 High
The medical record is kept correctly 4.203 0.859 High
Medical treatments are well explained 4.261 0.802 High
4.237 0.870 High
5.0000

4.0000 Provide services as Perform services as Bill patients Medical record is
promised, 4.1577 expected, 4.0705 kept correctly,
3.0000 4.2614
accurately, 4.2033
2.0000 Medical
treatments are
1.0000 well explained,…
1
234 5

Total Mean Value: 4.188 (High Satisfaction)

Figure 6. 4: Service Reliability Satisfaction Index

Clear and easy to understand information Mean SD Interpretation
Give appropriate and prompt services 4.320 0.812 High
Explain the treatment that will be performed 4.195 0.912 High
Willing to help anytime 4.286 0.815 High
Always ready to respond to the request 4.241 0.899 High
4.191 0.916 High

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5.0000

4.0000

3.0000 Clear and easy to Give appropriate Willing to help
2.0000 understand and prompt Explain about the anytime, 4.2407
treatment that will
information, 4.3195 services, 4.1950
be performed, Always ready to

4.2863 respond to request,

4.1909

1.0000 2 34 5
1

Total Mean Value: 4.246 (High Satisfaction)

Figure 6. 5: Service Responsiveness Satisfaction Index

Have the knowledge to answer my questions Mean SD Interpretation
Explain how much the treatment will cost 4.328 0.793 High
Instil confidence in me 4.075 0.955 High
Consistently courteous 4.187 0.877 High
Support personnel are knowledgeable, skilful, and 4.286 0.825 High
helpful 4.178 0.898 High

5.0000

4.0000 Have the knowledge Consistently
3.0000 to answer my courteous, 4.2863

questions, 4.3278

2.0000 Explain how much the Instil confidence in Support personnel are
treatment will cost, me, 4.1867 knowledgeable, skilful,
1.0000 4.0747
1 3 and helpful, 4.1784
2
45

Total Mean Value: 4.211 (High Satisfaction)

Figure 6. 6: Service Assurance Satisfaction Index

Doctors and nurses understand my needs Mean SD Interpretation
Doctors and nurses give individual attention 4.216 0.877 High
Doctors and nurses have my best interest at heart 4.162 0.882 High
Doctors and nurses learn about my specific needs 4.141 0.883 High
CTC has convenient operating hours 4.120 0.912 High
3.921 1.048 High

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5.0000

4.0000 Doctors and nurses

Doctors and nurses learn about my

3.0000 understand my specific needs.,

2.0000 needs., 4.2158 Doctors and nurses 4.1203 CTC has operating
Doctors and nurses have my best hours that are

give individual interest at heart.,

1.0000 attention., 4.1618 4.1411 convenient, 3.9212
3 4
12 5

Total Mean Value: 4.112 (High Satisfaction)

Figure 6. 7: Service Empathy Satisfaction Index

Has a variety of pricing plans Mean SD Interpretation
Easy to change pricing plans that meet my need 3.876 0.914 High
Offers the best possible pricing plan that meets my 3.784 0.910 High
need 3.838 0.882 High
Charges are reasonable
Reasonable pricing compared to other hospitals 3.913 0.878 High
Fair to increase the price based on market value 3.834 0.879 High
3.606 0.978 Moderate

5.0000 Easy to change pricing plans that
4.0000 meet my need, 3.7842

3.0000 Has variety of Charges are Fair to increase the
pricing plans, reasonable, 3.9129 price based on
2.0000 market value,
3.8755 Offers the best Reasonable pricing 3.6058
1.0000 possible pricing compared to other
1 56
plan that meets my hospitals, 3.8340
need, 3.8382
4
23

Total Mean Value: 3.808 (High Satisfaction)

Figure 6. 8: Service Fee Fairness Satisfaction Index

Reception counter Mean SD Interpretation
Registration counter 4.257 0.736 High
Canteen 4.311 0.700 High
Toilet 3.340 1.029 Moderate
Waiting Area 4.108 0.794 High
4.187 0.787 High

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Lift 4.266 0.649 High
Stairs 4.216 0.698 High
Vending Machine 4.029 0.834 High
Carpark 3.917 0.967 High
Surau 3.867 0.899 High
Pharmacy 4.315 0.730 High
Chairs and sofas 4.203 0.804 High
Changing room 3.884 0.896 High
Storage/locker 3.722 0.914 High
Recovery room 3.855 0.846 High
Signages 4.021 0.901 High
Lightings 4.237 0.746 High
Temperature 4.261 0.685 High
Scent/smell 4.104 0.720 High
Medical instruments/infrastructures 4.253 0.688 High

5.0000 Registration Vending Machine, Pharmacy, 4.3154 Medical
4.0000 counter, 4.3112 4.0290 instruments/infrastructure…

Lift, 4.2656 Recovery room,

3.8548

Stairs, 4.2158 Temperature,
4.2614

3.0000 Reception Waiting Area, Lightings,
2.0000 counter… 4.1867 4.2365
1.0000
Surau, 3.8672 Changing
room,…

Toilet, 4.1079 Signages,

4.0207

Carpark, 3.9170 Chairs and sofas,Storage/locker ,

Canteen, 3.3402 4.2033 3.7220 Scent/smell, 4.1037

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

Total Mean Value: 4.068 (High Satisfaction)

Figure 6. 9: Infrastructure and Facilities Satisfaction Index

6.2.4 Factors Influencing Outpatient Satisfaction
The CTC outpatient satisfaction index in healthcare service delivery & performance is
depicted in Figure 6.10. Based on statistics from outpatients, we may draw the

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following conclusions about CTC's present performance in healthcare service
delivery:

i. The outpatient data reveals a high level of satisfaction with CTC's service
quality and performance.

ii. Service responsiveness receives a high degree of satisfaction, whereas fee
fairness receives a moderate level of satisfaction.

iii. Fee fairness (outpatient is not keen if CTC were to increase the fee based on
the current market value of health service provider) and infrastructure and
facilities (emphasis should be given to canteen/dining area) are two specific
issues that require attention.

iv. Overall, CTC's service tangibility, reliability, empathy, fee fairness, and
infrastructure & facilities substantially influence outpatient satisfaction with
CTC's service quality and performance.

Satisfaction CA CR AVE P Values Result
Service - Tangibility à Satisfaction 0.916 0.935 0.708
Service - Reliability à Satisfaction 0.913 0.935 0.743 0.007 +
Service - Responsiveness à 0.923 0.942 0.765 0.020 +
0.969 0.976 0.891 0.102 -
Satisfaction
Service - Assurance à Satisfaction 0.943 0.957 0.815 0.737 -
Service - Empathy à Satisfaction 0.956 0.966 0.852 0.023 +
Service - Fee Fairness à Satisfaction 0.943 0.956 0.785 0.000 +
Infrastructure & Facilities à 0.96 0.963 0.57 0.000 +

Satisfaction 0.939 0.954 0.775 0.116 -
Word-of-Mouth à Satisfaction 0.74

R Square

5

4 Service - Reliability Service -

3 , 4.188 Service -Assurance , 4.211 Service - Fee
Fairness , 3.808
Responsiveness ,
Infrastructure &
2 Service - 4.246 Service - Empathy Facilities , 4.068
Tangibility, 4.188 , 4.112

1 Satisfaction, 4.212

1234567 8

Figure 6. 10: CTC Outpatient Satisfaction Index in Healthcare Service Delivery &
Performance

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6.2.5 Data Visualization for Outpatient Feedbacks
Outpatients were also asked to provide additional feedback at the end of the
questionnaire. Using open-ended questions, the comments received are summated
using text data visualization. The image of the word cloud below presented in Figure
X reveals simple text analysis from the prominent words that appear. The bigger and
bolder the word appears, the more often it is mentioned within a given text and the
more critical it is. The most often used words in the comments are "services," "staff,"
"treatment," "patients," "waiting time," "canteen condition," "parking space," "lack of
OKU friendly environment," "clinic appointment," and "upgraded dentistry treatments."

Figure 6. 11: Text Data Visualization for Outpatient Feedbacks

6.3 FINDINGS FOR INPATIENTS SEGMENT
6.3.1 Inpatient Profiling
The demographics profile of the respondents is presented in Table 6.4. The profiling
was based on age, gender, religion, education level, monthly income, location,
employment status, and affiliation for inpatient respondents (additional data is
attached in Appendix J). The largest group of respondents, 64.7%, were female, and
35.3% were male. The majority of the respondents are at the age of 36 – 45 years old
(31.4%), and the minority comes from two age groups that are 18 – 25 years and 65
years and above (7.8%). The religion with the most adherents is Islam (90.2%). 66.7%
have a diploma and above, with 35.2% in the B40 category (below RM2,000). Pulau
Pinang had the highest percentage of respondents (49%), followed by Kedah (17.6%)

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and Perak (9.8%). Unaffiliated respondents from USM make up 61% of the population.
Detail of the inpatient profiling is explained in Table 6.4.

Table 6. 4: Demographics Profile of Inpatient

Variables Frequency % Variables Frequency %

Age 7.8 Gender 35.3
19.6 64.7
18 - 25 years old 4 31.4 Male 18
15.7 90.2
26 - 35 years old 10 17.6 Female 33 7.8
7.8 2.0
36 - 45 years old 16 Religion
3.9 7.8
46 - 55 years old 8 17.6 Islam 46 25.5
49.0 27.5
56 - 65 years old 9 9.8 Buddha 4 17.6
5.9 9.8
>65 years old 4 5.9 Others 1 11.8
2.0
Location 5.9 Education 35.3
21.6
Perlis 2 27.5 Primary 4 23.5
7.8 5.9
Kedah 9 47.1 Secondary 13 7.8
3.9 5.9
Pulau Pinang 25 7.8 Diploma 14
5.9 11.8
Perak 5 Bachelor's Degree 9 25.5
54.9
Selangor 3 Master’s Degree 5 5.9
2.0
Kelantan 3 Ph.D. 6

Pahang 1 Monthly Income

WP Kuala Lumpur 3 < RM2,000 18

Employment Status RM2,001 - RM4,000 11

Unemployed 14 RM4,001 - RM6,000 12

Self-Employed 4 RM6,001 - RM8,000 3

Government 24 RM8,001 - RM10,000 4

Private 2 > RM10,001 3

Student 4 Affiliation

Housewife 3 USM Staff (Retired) 6

Currently USM Staff 13

Not USM Staff 28

USM Student-Local 3

USM Student- 1

International

6.3.2 Inpatient Visitation & Payment Method

The respondents were also asked to describe the type of treatment they received
from CTC and the payment method they utilized. These two sets of data were
merged. The results indicated that those who come to the ward with a guaranteed

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letter contribute significantly to CTC since they are the primary patients seeking
medical treatment. The specifications may be found in Figure 6.12.

30

25

20

15

10

5

0 Public - Guarantee USM Staff
Private - Through EHS Letter
4 5
Surgical 1 11
Medical Treatment 5 19 1
Dental Treatment 2 3

Figure 6. 12: Treatment & Payment for Inpatient

6.3.3 Inpatient Satisfaction Index

As shown in Table 6.5, the patient satisfaction index determines how happy or
unsatisfied inpatients are on average with CTC treatments. A five-point scale is used
to assess it. Using the mean value of the Likert scale, the satisfaction index for each
characteristic is determined. As a result, the scale is labelled in Figure 6.13 to 6.20, with
1 signifying Poor, 2 Fair, 3 Good, 4 Very Good, and 5 Excellent.

Table 6. 5: Satisfaction Index

INDEX 1.00 - 2.33 Low Satisfaction
2.34 - 3.67 Moderate Satisfaction
3.68 - 5.00 High Satisfaction

Arrangement during admission Mean SD Interpretation
Time waiting for admission 4.078 0.891 High
Time waiting to be taken to the ward 3.961 0.871 High
Clarity of information given for admission 4.098 0.806 High
Helpfulness of staff during admission 3.882 0.973 High
Responsiveness of in-ward nurses during admission 4.118 0.931 High
Explanation of hospital routines (ward rounds, SOP, 4.177 0.817 High
etc.) 3.824 1.090 High

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Consideration of patients’ needs and wants 3.941 1.066 High
Patient being treated with respect 4.137 0.980 High
Time waited for a doctor if I needed to see one in the 3.902 1.044 High
ward
The doctor answers my questions or concerns 4.177 0.888 High
Nurses answer my questions or concerns 4.118 0.864 High
Time waited for a nurse after using the call button 4.000 0.980 High
The communication between the doctor and me 4.157 0.880 High
The communication between other related medical 4.059 0.947 High
staff and me
Nurses ask about my current medication(s) in the 3.922 0.956 High
ward (if any)
Nurses ask about my dietary needs in the ward 3.902 1.082 High
Nurses ask about my cultural or religious beliefs and 3.824 1.034 High
concerns
Brief about ward facilities (TV, call system, bed 3.824 1.034 High
function, etc.)

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5.0000 Arrangement Patient being The communication
4.0000 during admission, treated with between me and other
respect, 4.1373 related medical staff (e.g.,
4.0784

Helpfulness of staff Nurses answer to nurse etc.), 4.0588

during admission, my questions or

4.1176 concerns, 4.1176 Nurses ask about

my dietary needs

in the ward, 3.9020

Clarity of

information given Doctor answers to Nurses ask about
for admission, my questions or my current
3.8824 concerns, 4.1765

3.0000 Responsiveness of Time waited for a medication(s) in
in-ward nurses nurse after using the ward (if any),
the call button,
during admission, 3.9216
4.1765 4.0000
Nurses ask about

Time waiting to be Consideration of my cultural or
taken to the ward, patients’ needs religious beliefs
and wants, 3.9412 and concerns,
4.0980 The 3.8235

2.0000 Explanation of communication
between me and

hospital routines the doctor, 4.1569

(including ward Brief about anything I

rounds, SOP, etc.), Time waited for a need to know in the
3.8235 doctor if I needed ward (TV system, how to
to see one in the use the call system, bed
Time waiting for function, food time etc.),
admission, 3.9608 ward, 3.9020
3.8235
1.0000

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

Total Mean Value: 4.005 (High Satisfaction)

Figure 6. 13: Access and Admission Index

Doctors and nurses explain clearly about the Mean SD Interpretation
treatment 4.255 0.717 High
Doctors and nurses assist well during treatment
Doctors and nurses explain the purpose of the 4.216 0.832 High
medication and the results of the test 4.157 0.880 High
Doctors and nurses explain the side effects of the
treatment and medications 4.098 0.878 High

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I was given a chance to ask questions about the 4.137 0.917 High
treatment, medication, and side effects
Nurses give attention and care (drips, dressing etc.) 4.177 0.865 High
Information is given about my progress to 3.843 1.065 High
family/carer/companion
I involvement in decisions about my care and 4.000 1.020 High
treatment
Doctors and nurses give support and reassurance 4.137 0.939 High
Access to visitors is done according to the hospital 4.039 0.979 High
regulations
Time doctors spend on patient care and treatment is 4.039 0.958 High
sufficient
I got assistance whenever I needed it (going to the 3.941 0.988 High
toilet, sitting, standing, etc.)
I get access to any extra support (if I need it) 3.902 1.005 High
Nurse in charge introduce themselves at each shift 3.569 1.100 Moderate
change

5.0000 Doctors and nurses I get assistance
explain clearly whenever I
about the Nurses give Doctors and nurses
attention and care give support and needed it (going
treatment, 4.2549 to the toilet, to sit,
(drips, dressing reassurance,
etc.), 4.1765 4.1373 to stand, etc.),
3.9412
4.0000

Doctors and nurses Time doctors spent
explain the side
effects of the on patient care
treatment and
medications, and treatment is
4.0980
I was given a sufficient, 4.0392

3.0000 chance to ask I get access to any

questions about extra support (if I
the treatment, need it), 3.9020

Doctors and nurses medication, and Nurse in charge
explain about the side effects, 4.1373 introduce

purpose of the I involvement in themselves at
medication and
2.0000 the results of the decisions about my each shift change,

test, 4.1569 care and 3.5686
treatment, 4.0000

Information is given Access to visitors is

Doctors and nurses about my progress to done according to
assist well during family/carer/companio the hospital
treatment, 4.2157
n, 3.8431 regulations, 4.0392
1.0000
1234 5 6 7 8 9 10 11 12 13 14

Total Mean Value: 4.036 (High Satisfaction)

Figure 6. 14: Treatment and Related Information Index
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Cleanliness of room Mean SD Interpretation
Cleanliness of ward 4.235 0.839 High
Quality of food 4.294 0.807 High
Meals serve clean and hygienic 4.020 0.905 High
Meals serve hot and fresh 4.177 0.888 High
Meals serve delicious 4.039 0.979 High
Choice of the menu for meals served 3.882 0.952 High
Privacy in the room 3.667 1.013 Moderate
Ward is quiet in the daytime 3.863 1.059 High
Ward is quiet at night-time 3.745 1.055 High
Cleanliness of toilet and shower in the room 3.863 1.000 High
The atmosphere in the ward is cosy 4.059 0.947 High
4.059 0.925 High

5.0000 Cleanliness of room, Meals serve Privacy in the Cleanliness of toilet
4.0000 4.2353 delicious, 3.8824 room, 3.8627 and shower in the

room, 4.0588

3.0000 Meals serve clean The atmosphere in
and hygienic, the ward is cozy,
4.1765
4.0588
Quality of food,
4.0196

Ward is quiet in the
daytime, 3.7451

2.0000 Meals serve hot
and fresh, 4.0392
Choice of the Ward is quiet at
Cleanliness of menu for meals nighttime, 3.8627
ward, 4.2941 served, 3.6667

1.0000 6 7 8 9 10 11 12
12345

Total Mean Value: 3.992 (High Satisfaction)

Figure 6. 15: Physical Environment Index

Time waited for the doctor to discharge Mean SD Interpretation
Arrangement for discharge 3.804 0.939 High
Arrangement for medication during discharge 3.843 0.967 High
4.000 0.917 High

97 UNIVERSITI SAINS MALAYSIA

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

Arrangement for post-discharge care/service 3.980 0.905 High
Information is given about post-discharge 3.980 0.883 High
care/service
The convenience and flexibility of discharge time 4.059 0.881 High
Time waiting for medication 3.902 0.922 High
Overall discharge time 3.882 0.973 High

5.0000 Time waited for the doctor Overall discharge time,
4.0000 to discharge, 3.8039 3.8824

3.0000 Arrangement for The convenience
post-discharge and flexibility of
care/service, discharge time,

3.9804 4.0588

Arrangement forInformation is given

2.0000 dAisrrcahnagregme,e3n.8t4fo31r mdeiscdhicaargtioen, 4d.0u0ri0n0g about post- Time waiting for
discharge medication, 3.9020

care/service, 678

3.9804

1.0000 5
1234

Total Mean Value: 3.931 (High Satisfaction)

Figure 6. 16: Discharge and Follow Up Index

I received health service as expected Mean SD Interpretation
Relief from the pain I had before coming to CTC 4.216 0.856 High
Relief from symptoms I had before coming to CTC 4.118 0.840 High
CTC visit made me close to being healthy 4.118 0.864 High
CTC visit restored my health 4.177 0.817 High
I feel confident that I could manage my health 4.137 0.849 High
problem after the CTC visit 4.137 0.825 High

98 UNIVERSITI SAINS MALAYSIA

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

5.0000 CTC visit restored my health,
4.0000 4.1373
3.0000
2.0000 Relief from the pain

I had before CTC visit made me I feel confident
coming to CTC, close to being that I could
healthy, 4.1765
4.1176 manage my health
Relief from problem after the
I received health symptoms I had CTC visit, 4.1373
service as before coming to

expected, 4.2157

CTC, 4.1176

1.0000
1 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6

Total Mean Value: 4.150 (High Satisfaction)

Figure 6. 17: Hospital Experience in CTC Index

Reception counter Mean SD Interpretation
Registration counter 4.157 0.809 High
Canteen 4.118 0.816 High
Toilet 3.667 1.013 Moderate
Waiting Area 4.216 0.832 High
Lift 4.059 0.925 High
Stairs 4.196 0.749 High
Vending Machine 4.196 0.775 High
Carpark 4.000 0.917 High
Surau 4.020 0.905 High
Pharmacy 4.020 0.836 High
Chairs and sofas 4.255 0.771 High
Changing room 3.980 0.948 High
Storage/locker 4.020 0.905 High
Recovery room 3.980 0.948 High
Signages 3.922 0.845 High
Lightings 3.902 0.964 High
Temperature 4.020 0.836 High
Scent/smell 4.020 0.860 High
Medical instruments/infrastructures 3.980 0.761 High
4.059 0.835 High

99 UNIVERSITI SAINS MALAYSIA