No abstract

The paper explored factors affecting the choice of early warning score (EWS) card adoption using the case study of Malaysian hospitals. One hundred hospitals in Malaysia participated in a survey where CEO’s and nursing directors filled semi-structured questionnaires. A review of current literature confirms that deteriorating health following treatment of acute health is a critical issue undermining sustainable marketing in healthcare. Lack of sufficient and efficient measures to effectively care for these patients promptly has continued to present challenges to healthcare providers. Part of the problem is that it has always been problematic to detect early warning signs and calls when vital signs appeared. While early warning signs have been adopted to respond to calls of vital signs, difficulties arise in terms of efficient documentation, recording, interpretation and implementation of EWS. Hospitals with limited financial capabilities are compelled to use manual early warning scores. EWS is relatively affordable to acquire, install and maintain. They, however, lack in efficiency, timeliness and accuracy. The present study revealed that only seven hospitals had implemented manual early warnings signs. Findings indicated that no hospitals have implemented automatic warning signs, despite respondents indicating their understanding of the benefits and complexity associated with automation of EWS. The management of these hospitals revealed the high cost of implementing and maintaining automated EWS and inability to measure outcomes as the top reasons for not having automated EWS. However, the study noted that leadership and ethics, especially the leader’s attitude, employee’s engagement and perceived benefits of automatic EWS have a role in determining the successful implementation of EWS. To successfully implement EWS as a powerful marketing strategy, good management for implementation should be in place.

This case study investigated the nature of patient safety culture in a Malaysian private hospital. This was accomplished by studying the general perception of patient safety with a survey questionnaire and insights from open comments. The Donabedian framework of quality was used to further analyse the nature of patient safety culture from the perspective of millennials. Findings from the interviews were triangulated with data from observations and document reviews, which were interpreted based on the High Reliability Organisation (HRO) principles. They revealed that the structures and concerns in the practice environment regard the artificial intelligence (AI) system, human capital management, and manpower, while processes such as communication, teamwork and collaboration issues, and training and improvements are vital. Patient safety culture outcomes which depend on structures and processes indicated the need for improvements in the frequency of events reported. The main implication of this study is that to raise standards of care to those in an HRO and in a complex care environment, a paradigm shift from current reactive standards towards a more proactive safety system, based on flexibility and stability, would be necessary. This requires a strong case organisation to note appropriate structures and processes affecting eventual outcomes.