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All Journal Media Publikasi Promosi Kesehatan Indonesia (MPPKI)
Suriya Kumareswaran Vallasamy
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Public Health

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Optimizing Discharge Processes to Alleviate Emergency Department Overcrowding: An Audit in a Central Malaysian Tertiary Hospital Naidu, Thaalitha; Abdul Kadir, Nurulalnissa; Suriya Kumareswaran Vallasamy
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 8 No. 7 (2025): July 2025
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v8i7.7272

Abstract

Introduction: Emergency Department (ED) overcrowding is a global challenge, often exacerbated by delays in discharging patients from inpatient wards. In Malaysia, this issue is especially pressing in tertiary hospitals, where prolonged discharge times hinder bed turnover and contribute to ED congestion. Methods: A 30-day cross-sectional audit was conducted in a medical ward of a central tertiary hospital in Malaysia, involving 109 consecutively discharged patients selected via total sampling. Discharge duration was measured from the point of medical fitness for discharge to actual bed vacancy. Data were analysed using descriptive statistics to identify patterns and sources of delay. Results: The mean discharge duration was 420 minutes—more than double the 180-minute target—with only 7% of patients meeting the benchmark. Key delay factors included insufficient pre-discharge planning, limited staffing, delayed documentation and pharmacy processes, poor IT infrastructure, logistical challenges, and social support issues. Complex cases requiring multidisciplinary input experienced the longest delays. Conclusion: To improve hospital efficiency and reduce ED overcrowding, hospitals should implement structured early discharge planning, enhance staffing, upgrade digital infrastructure, and establish a discharge lounge. Strengthening interdepartmental coordination and integrating social support services earlier in the discharge process are also crucial.
Exploring Novel Dimensions of Burnout Among Malaysian Healthcare workers: A Qualitative Thematic Analysis Suriya Kumareswaran Vallasamy
Media Publikasi Promosi Kesehatan Indonesia (MPPKI) Vol. 9 No. 2 (2026): February 2026
Publisher : Fakultas Kesehatan Masyarakat, Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/mppki.v9i2.8509

Abstract

Introduction: Burnout among healthcare workers (HCWs) has gained increased attention in the post-pandemic landscape due to its profound implications on workforce sustainability and patient care quality. Existing burnout assessment tools, such as the Maslach Burnout Inventory, were developed for general occupational settings and often fail to capture the unique emotional and cognitive stressors specific to healthcare environments, particularly in low- and middle-income countries. This study aimed to explore previously underrecognized dimensions of burnout among Malaysian HCWs to inform the development of a healthcare-specific burnout assessment instrument. Method: A qualitative study was conducted using a semi-structured focus group discussion with four expert participants specializing in mental and occupational health. Data were manually transcribed and analyzed using the framework method. Coding was performed collaboratively to ensure reflexivity, consistency, and reliability. Result: Two overarching categories, emotional exhaustion and cognitive exhaustion were identified, encompassing 11 subthemes, including hopelessness, medical errors, and cognitive dissonance. Conclusion: Findings highlight the inadequacy of existing generic burnout tools and underscore the need for a tailored assessment framework that encapsulates the psychological complexity of HCW burnout, especially in resource-constrained settings.
Co-Authors Abdul Kadir, Nurulalnissa Naidu, Thaalitha