Extend Hours At Klinik Kesihatan To Relieve Overcrowding: Zaliha

Dr Zaliha Mustafa says 70% of emergency room visits are non-critical cases that can be treated at public health clinics; most clinics currently operate from 8am to 5pm.

PUTRAJAYA, Jan 6 – Health Minister Dr Zaliha Mustafa has urged public health clinics (klinik kesihatan) to extend their operating hours and take in more non-critical patients to help ease the load on overcrowded hospital emergency departments.

Dr Zaliha said the overuse of emergency rooms for non-critical cases at public hospitals has resulted in overcrowding, long waits, overworked medical personnel and compromised care for people with serious emergencies. 

Citing the Auditor General’s (AG) 2019 report, Dr Zaliha said overcrowding at MOH hospitals were primarily driven by a high uptake of non-critical or green zone cases, which formed 70 per cent of emergency room visits. This has led to an average waiting time of over 6 hours.

“This is contrary to the actual scope or function of a hospital emergency department which should only accept critical cases,” Dr Zaliha said in her 2023 new year address to MOH staff here today. Most public health clinics currently operate from 8am to 5pm. 

Dr Zaliha said she found public health clinics in Klang operating until 10pm based on her visit to the Tengku Ampuan Rahimah Hospital (HTAR) last week.

In addition to an extension of operating hours at clinics, Dr Zaliha said hospital directors should also ensure that the opening of new services is expedited once their requests for additional human resources, positions and financial allocations are approved.

“This needs to be done with careful planning so that human resources, financial allocations and facilities are distributed administratively to avoid serious resource constraints.”

State health directors are also advised to align staffing or human resources with work rotations, such as placing medical officers from health clinics to hospitals. The health minister said this can help reduce long working hours and reduce the occurrence of burnout.

Speaking from her own experience of working in an emergency department as a medical practitioner, Dr Zaliha said long work hours can negatively impact a person’s mental health.

CodeBlue reported last month that critically ill patients, including ventilated cases, are stranded for up to six days in the emergency department of Raja Permaisuri Bainun Hospital (HRPB) – a general hospital in Ipoh, Perak – due to insufficient critical care beds and staff.

HRPB doctors said most of the seriously sick patients coming into the ED are presenting with advanced non-communicable diseases (NCDs) – such as heart disease, kidney failure, and stroke – after the disruption of care from two years of Covid lockdowns.

They also said the situation in HRPB’s emergency room this year has worsened from pre-pandemic days, when patients back then waited one and a half days at the most for a bed in a ward.

An emergency medicine doctor had previously suggested that the government run public health clinics 24 hours a day to reduce overcrowding in hospital emergency departments.

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