KUALA LUMPUR, July 8 — The Covid-19 outbreak has forced the healthcare industry to confront unprecedented challenges.
Closer to home, ever since the virus started its spread across South-east Asia, followed by the local implementation of the movement control order (MCO) which was put in place on March 18, many hospitals including the National Heart Institute (IJN) had to postpone non urgent operations and inform elective patients to stay put in order to keep unnecessary movements at a minimum.
In fact, according to recent statistics, IJN saw up to 75 per cent drop in the number of patients seeking treatment at the hospital in April when the MCO was in place.
However, as things slowly return to normal, the hospital is now facing the challenge of avoiding being hit by an influx of patients daily.
To control and prevent any potential risks to their patients — who are mostly considered “high-risk” as a majority of them undergo cardiovascular treatments — IJN has implemented stringent guidelines and standard operating procedures (SOPs) for staff, patients and visitors.
According to its chief clinical officer Dr Hasri Samion, the hospital quick to set up an in-house infectious disease control team to draw out a detailed plan on how to ensure everyone’s safety from January.
“Our in house infectious disease control team conducts routine surveillance to assess the internal risk of infection within the hospital and the potential risks from outside.
“This is an ongoing effort to ensure the hospital is protected,” added Dr Hasri, who is also a senior consultant paediatric cardiologist.
In fact, when the news report of the daily cases is announced by the Health Ministry officials, Dr Hasri said the infectious disease team will reassess their strategy to ensure the hospital is on the right track.
The new normal
The hospital resumed its normal operation at full capacity from early May when the government announced the conditional movement control order.
Although some patients still tend to avoid seeking care at healthcare facilities due to the fears of the pandemic, Dr Hasri said they now see about 85 per cent of patients confidently visiting hospitals for their regular screening and treatment.
However, Dr Hasri noted that various SOPs are in place to mitigate the crowd, reduce the patient’s waiting time and ensure social distancing is observed throughout the hospital.
“Although we are now back to normal, every visitor and staff are still required to undergo a temperature check and sign a digital declaration form upon entry.
The hospital has also restructured the admission and registration process at the ground floor to ensure the crowd remains under control at any given time throughout the day.
“Our appointment centre representatives will advise the patients about their appointment time to make sure they are present at the clinic on time.
“We also advise those with symptoms to stay at home until they are fit enough to come for their appointment,” he added.
For patients who are required to undergo a surgical procedure, Dr Hasri said they have to be tested for Covid-19 to ensure that they are free of the disease before they proceed with the treatment.
“But for the emergency cases that require an immediate surgical procedure, the patients will be taken through the emergency pathway to undergo rapid antigen swab test.
“We will continue with the intervention immediately while waiting for the rapid testing result, which takes half-an-hour,” he added.
If the patient’s Covid-19 result is negative, Dr Hasri said they will proceed with the treatment accordingly.
However, if the test turns out positive, the patient will be put in an isolation ward while waiting for the operation with strict measures.
“For positive patients, we will have to examine the risk and benefit to decide whether we should continue with the procedure or treat the patient for Covid-19 disease first.”
Dr Hazri said if a Covid-19 patient comes in with serious conditions such as coronary artery disease that needs an urgent operation, they have to treat the heart first as the risk of dying from the heart disease is higher than Covid-19.
The hospital has set up six dedicated negative-pressure intensive care beds for Covid-19 patients in critical condition and two 30-bedded isolation wards to keep any potential Covid-19 patients separated from the rest.
To date, IJN has recorded three Covid-19 patients who were undiagnosed and referred to the hospital from other healthcare centres for heart treatment.
Post- MCO medical tourism
Although the government has eased the international borders for foreigners seeking medical treatment during the recovery MCO, Dr Hasri said there are stringent procedures set by the Malaysia Healthcare Travel Council and the immigration department to ensure the country remains protected.
“As far as I understand the guideline only allows foreigners that are coming from countries with a controlled Covid-19 situation like Malaysia.”
Dr Hasri also pointed out that they now have to be very mindful of accepting foreign patients as the number of cases in some countries is still high and it may put Malaysia at risk if such patients are allowed in the country.
“We can only consider those coming from countries with tight SOPs where the Covid-19 disease is almost contained.
“The government and Health Ministry has done a wonderful job containing the spread of the virus, hence we have to be very careful about our border control SOPs to make sure the situation here is under control,” he added.
To keep their existing foreign patients in check, Dr Hasri said the doctors at IJN conduct regular online consultation with their patients overseas via video conferencing while the travel restrictions remain in place.
Moving forward
To further reduce the patient’s waiting time at the hospital and avoid crowding, IJN is working on a new system to offer home delivery of medications.
“Traditionally, after patients visit their respective doctors, they are required to go to the pharmacy to collect medications.
“But with the new system, they can head back home immediately after their consultation session is done at the doctor’s clinic.
Dr Hasri hinted that the system is expected to be up and running in September after sorting out the logistic matters.
He also noted that the hospital’s tight safety measures will be in place until the Covid-19 disease is fully contained worldwide.
However, he said their guidelines may change according to the situation in the country.
