The new two-hour waiting time target, established as a key performance indicator (KPI) in the Green Zone of hospital emergency departments (EDs) nationwide, is a pivotal component of the Ministry of Health’s (MOH) efforts to enhance service efficiency.
This initiative is designed to complement our recent undertakings, such as extended service hours in health clinics (KKs) and the Madani Medical Scheme involving general practitioners (GPs).
Against the backdrop of a rising disease burden encompassing communicable and non-communicable diseases, setting such a KPI is a timely measure to alleviate congestion at public health facilities and improve patient access to healthcare.
Aligned with the Health White Paper’s principles, it represents an initial step in health care reform in Malaysia, optimising existing resources and strategically mobilising the workforce. This initiative not only breaks down silos, but also presents a golden opportunity to strengthen interdisciplinary partnerships within public health facilities.
Failure to make bold changes to departmental culture at this juncture could compromise the efficiency of the health system and the delivery of optimal patient care.
The targeted two-hour waiting time in the Green Zone is deemed realistic and practical. It is supported by data indicating that many hospitals have achieved it even before the KPI was set.
However, disparities in average waiting times across hospitals highlight challenges faced by major hospitals with high patient burdens, leading to extended waiting times beyond two hours and patient complaints.
In consensus with top MOH management and senior medical practitioners, there is an acknowledgment of the need to mobilise manpower beyond reliance on EDs alone.
Reducing waiting times in the Green Zone strategically aims to decongest hospitals, recognising that most patients seeking ED care have minor ailments.
Increasing workforce allocation to the Green Zone facilitates smoother ED traffic, allowing the existing ED workforce to focus on more critical cases in the Yellow and Red Zones when necessary.
This initiative, combined with a recently improved triaging system, is considered a critical step in reducing mismanagement and facilitating faster admissions or transfers to other cluster hospitals.
While concerns about strategic mobilisation of “non-clinical” medical officers (MOs) doing more harm than good are raised, it is worth highlighting that the Green Zone primarily deals with mild, non-critical cases requiring basic expertise.
In fact, this approach is viewed as a workforce optimisation strategy, distributing the responsibility of patient care more equitably among health practitioners. It encourages all MOs, regardless of their usual roles, to contribute to this initiative and share the responsibility of patient care.
Looking ahead, the MOH plans to further decongest major hospitals by decentralising certain services and specialties to secondary hospitals and KKs. Major hospitals will focus on complex cases requiring specialised care, while clinic-based, elective, and supportive services will be mainly handled at secondary hospitals and KKs.
The extension of hospital clusters to include KKs and the placement of resident internal medicine and ED physicians at secondary hospitals are also part of this comprehensive plan to enhance health care quality and access.
The MOH remains committed to optimising resources without compromising the health care of Malaysians. Priority is also given to the well-being of health care staff during strategic mobilisation, ensuring that they receive what they rightfully deserve.
We believe that by standing united, we can achieve significant progress in consolidating health care delivery.
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