UNIVERSITI TEKNOLOGI MARA (UITM)

PUNCAK ALAM CAMPUS, SELANGOR BRANCH

FACULTY OF BUSINESS AND MANAGEMENT

BACSHELOR’S DEGREE OF HEALTH ADMINISTRATION (HONS)
HEALTH PLANNING AND EVALUATION (HSM575)

GROUP ASSIGNMENT 1 – MALAYSIA HEALTH POLICY AS PART OF

HEALTH PLANNING
“EMERGENCY MEDICINE AND TRAUMA SERVICES POLICY”

PREPARED BY
NAME STUDENT ID
NUR ALEA BINTI HARON 2022765277
NAMIERATUL AKMAR BINTI MOHD NASIR 2021849194
WAN MUHAMMAD ZULKIFLI BIN WAN SULAIMAN 2021480772
NUR ARIASHA FARHAYU BINTI NORHASIDAN 2021853948
DANIEL FITRI BIN ZAZALI 2022745223

CLASS
BA2354D

PREPARED FOR
MADAM LIATUL IZIAN BINTI ALI HUSIN

DUE DATE
26 MAY 2023
 Document Information

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Karamjit Kaur-1.pdf
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URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266969
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URL: https://www.moh.gov.my/moh/resources/Polisi/GUIDELINES_FOR_RESUSCITATION_TRAINING.pdf
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URL: https://doi.org/10.5812/ircmj.16319
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 ACKNOWLEDGMENT

In the name of Allah, the Most Gracious and the Most Merciful. First and foremost, all
praises and thanks to Allah, our God, for His abundant help, strength, and countless blessings that
He has given to us that we have successfully completed this group assignment. Special
appreciation goes to our HSM575 lecturer at University Teknologi Mara Selangor Campus Puncak
Alam Branch, Madam Liatul Izian binti Ali Husin, for her insightful comments, and practical
advice. Her priceless help of constructive comments and suggestions throughout the group project
works gives a huge impact to the success of this task. We are so grateful and glad that finally we
managed to complete this task before the deadline. Two weeks of intense sweat and tears
eventually paid off in the end.

Last of all and undeniably, the hugest appreciation we would like to dedicate to our own
team members for the great teamwork and brilliant ideas that have always helped tremendously in
doing this task. This task surely impossible to be complete without the effort and cooperation of
our team members.
 TABLE OF CONTENTS PAGE

1.0 INTRODUCTION .......................................................................................... 1-2

1.1 Health Planning

1.2 Health Policy
1.3 The Importance of Policy to Support Health Planning

2.0 HEALTH POLICY ........................................................................................ 3-10

2.1 Pre-Hospital Care

2.2 Emergency Clinical Care Services
2.3 Observational Policy
2.4 One Stop Crisis
2.5 Sub-Speciality Emergency Service
2.6 Ancillary Service
2.7 Training, Education And Personnel Development
2.8 Quality And Research

3.0 FINDINGS AND CONCLUSION................................................................. 10-20

3.1 The Impact of the Policy You Have Selected Towards Malaysia
Healthcare and Citizen.
3.2 Your View If MOH Does Not Include This Policy in Their Planning for
Malaysian Now.
3.3 Suggestions That May Be Much Better Theoretically to Replace This
Policy
3.4 How Do You Think the Policy Can Be Further Enhanced to Give a
Greater Impact to The Malaysia Healthcare?
3.5 Overall View of The Relationship of a Good Health Policy Towards the
Country’s Health Outcome.

4.0 REFERENCES ............................................................................................... 21-22

1.0 INTRODUCTION
1.1 Health Planning
Planning is an important step to meet the goals. It does help in many sectors of our
life including health. For instance, it provides a guide to achieve the goals by making a
clear path to reach the goals. The process of improving the health condition of
individuals and populations begins with health planning, which is the initial stage in a
well-organized process (Scutchfield et al., 2011). Health planning was implemented
during the preparation of the health program or intervention which with intent to increase
the health program to effectiveness to solve the trigger event (things that start the cycle
such as poor health of certain population). Health planning is coming along with the
evaluations which in part of the cyclical process. The stages are cyclical to the point
where the transition from one program or stage to the next or to the planning activity
follows naturally. The outcomes from one stage's learning, insights, and ideas are likely
to have an impact on the information that is accessible, which will then affect the
decisions and actions of another stage. (Issel & Wells, 2017)

1.2 Health Policy

Policy alone can be defined as a position taken on an issue by an organization or
individual in a position of authority (Baggott, R. 2007). Meanwhile, Health policy can
be described as the laws, regulations, activities, and decisions that have been used within
society or the healthcare system to ensure wellness and guarantee that particular health
objectives are realized (Seavey et al., 2014). Health policy would be used in most sectors
in order to provide a guide for the best way to handle things related to health. Health
policies are normally created by the government of the country, such as the Ministry of
Health (MOH), and implemented all around the country by either government or non-
government organizations. Before a health policy was created, MOH would do research
to make sure that the policy would contribute maximum benefits to society. For example,
the MOH of Malaysia has created a policy of resuscitation training to improve human
survival by training health care workers to perform effective resuscitation. By doing
research, MOH is able to use the best method for resuscitation and keep the policy
training up to date (Ministry of Health Malaysia, 2016).

1
1.3 The Importance of Policy to Support Health Planning
Health policy has the same purpose as health planning, which is to increase the
effectiveness of the health program. Both are closely related and will have a better impact
if practiced simultaneously. Since health policy includes various matters related to
healthcare, including cost, management, safety, and so on, it can have a huge impact on
the success of every program or project carried out by a health organization. For example,
a policy to protect the safety of workers was established, which is the occupational safety
and health (OSH) policy, which aims to guarantee the safety of workers in healthcare
who are exposed to various diseases and dangerous environments such as active
radioactivity and blood transmission diseases. By applying the OSH policy, every health-
related problem can be reduced immediately (Ztürk & Babacan, 2014).
Health planners can use these policies to build healthcare programs that prioritize
vulnerable populations regardless of their socioeconomic level, promoting fairness in the
healthcare industry. Everyone can then reach their full potential for health and well-
being. Health policies can be developed to involve communities in the planning of
healthcare services, assisting in making sure that the latter are available, appropriate, and
receptive to community needs. Additionally, a setting that supports the equity of
healthcare services can be enabled by health policy. policies that deal with social
determinants of health like poverty, gender inequality, and discrimination are part of the
deliberation process. For instance, in Malaysia, a Malaysian citizen only needs to pay
RM1 in order to receive treatment or a consultation at a government hospital, making
healthcare more accessible to all people, regardless of their socioeconomic status and
improving the general wellbeing of Malaysians.
In order to support effective health planning and guarantee equitable access to
healthcare services, health policy is essential. Fostering community involvement,
advancing health education, ensuring adequate funding, and fostering a supportive policy
environment all aid in this process. These actions are necessary to address population
health disparities and improve health outcomes.

2
2.0 HEALTH POLICY
2.1 PRE-HOSPITAL CARE
Pre-hospital care refers to the treatment given by medical professionals, such as
emergency medical services personnel, it is for those who require immediate medical
attention outside of the hospital. This could involve in providing the patient with simple first
aid, advanced life support procedures, and transportation to a hospital. Pre-hospital care's
main objective is to give patients prompt, high-quality medical attention that will increase
their chances of survival and enhance their outcomes. Nonetheless, the emergency unit and
trauma department must have an ambulance service with a primary responder, ambulance
response services, and inter-facility transfer. Pre-hospital care is included in various medical
specialties. Major medical incidents, mass gatherings, and medical emergency coordination
centers are some of the most common ones. Pre-hospital care is an important component of
emergency medicine and trauma services policy, with the goal of ensuring that patients in
need of immediate medical assistance receive the best care available as soon as feasible. An
emergency physician must be directly involved in all aspects of pre-hospital services in order
to assist the emergency patient.

- Medical Emergency Coordinating Centre (Mecc)

As mentioned above, the medical emergency coordinating centre (MECC) is one
of its services. The function of MECC is to control and must communicate clearly and
accurately without any additions that change a situation. Since, it shall take the
responsibility to deliver information for pre-hospital services of the emergency and
trauma department. It because of this center is very important, it required to be
operational 24 hours daily since it provides several important services.
The "999" system for managing emergency calls is one example. The MECC is
responsible for managing the emergency call, including carrying out post-dispatch
activities and acquiring mandatory information that assists in directing the ambulance
team to the location of an emergency, as well as other medical information deemed
essential to the provision of emergency care. However, another service that they provided
included ambulance dispatching. Studies of realistic settings show that the performance
of static policies, those that send the closest ambulance and pre-assign a location to each

3
 ambulance, can be quite poor (Maxwell et al., 2014). Prior to reaching the treatment unit,
the primary objective of emergency and trauma departments is to reduce the mortality
rate and assist patients with their recovery from severe wounds. Transfer of patients
within the same facility for any diagnostic procedure or transfer to another facility for
more advanced care, is going to be facilitated by intra- and inter-agency communication.

- Ambulance Services
Ambulance services for trauma and emergency department (ED) services involve
the transport of patients from where they were injured during an emergency situation to
the hospital for further medical treatment. In emergency situations, ambulance services
are frequently the initial point of communication for patients. Ambulance services are a
crucial component of the pre-hospital care system.
Trauma and emergency department ambulance services are typically staffed by
trained medical professionals, who can administer basic, stabilize patients, and transport
them to hospital emergency departments or trauma centers. These emergency medical
services may also help with the triage and transportation of critically injured patients to
specialized trauma hospitals. In the event of an emergency, the ambulance service must
keep the MECC informed of its movements. There is also an ambulance response service
that is responsible for updating its routine operating service scope to avoid any
misunderstandings. However, Ambulance services may be given orders to take action
outside the confines of their primary response when they are functioning under mutual
aid agreements specified by the central, or any state committee for pre-hospital services.
Ambulance services are an essential component of the emergency medical services
system and play a crucial role in ensuring that patients in need of immediate medical care
receive the care they require in a timely and effective manner.

- Mass Gathering and Major Event Medical Coverage

Medical coverage for massive crowds and significant events is an essential
component of emergency care and trauma services policy. When a huge number of
people gather for an event, the likelihood of persons becoming injured or requiring
medical attention is likely to be significantly raised. Medical coverage for large-scale

4
 events and meetings of a large number of people requires the provision of a variety of
medical services and resources to assure the attendees' health and safety.

2.2 EMERGENCY CLINICAL CARE SERVICES

Emergency Clinical Care treatments is a set of recommendations developed to
provide direction to emergency medicine practitioners and employees in order to guarantee
that patients receive emergency medical care and trauma treatments in a swift, effective, and
safe manner. It emphasizes the need for hospitals, other healthcare facilities, emergency
medical service providers, and emergency care providers to work together in a coordinated
and collaborative manner to offer patients with thorough and efficient care in emergency and
trauma circumstances.

- Triage Services System

In emergency care and trauma services policy, the triage services system is a method
of prioritizing patients depending on the severity of their illness and the immediacy of
their need for medical assistance. This system is used by ensuring that patients obtain
timely care at the appropriate level. Typically, trained medical professionals provide
triage services to determine the required level of treatment. The patients are then given a
priority level, which decides the order in which they will receive medical care.
There are two processes involved in the triage services system: primary and
secondary triage. Primary triage is the first evaluation of a patient to figure out how bad
their situation is and how quickly they need medical help. This evaluation is typically
carried out by a trained medical professional. It is to review of the patient's vital signs,
symptoms, and medical history. Secondary triage, on the other hand, is a more extensive
assessment of patients who have been assigned a priority level based on primary triage.
This evaluation is typically conducted by a physician or other advanced medical
professional and entails a more comprehensive evaluation of the patient's condition,
including diagnostic tests. The goal of secondary triage is to make sure that patients get
the right amount of care for their condition and to find out if they have any other medical
treatment that needs to be addressed.

5
 The outpatient emergency registration is handled by the reception and registration
services. As we all know, every hospitality establishment has a waiting area with a digital
numbering system that requires us to wait until our number appears on the screen.
Primary triage in emergency services is performed outside of a hospital to prioritize
patients for immediate care and evacuation.

- Emergency Clinical Care

Clinical emergency care is a crucial zone for important situations. Some aspects
of a critical injury require immediate treatment to preserve life, including resuscitation
and stabilization, a life-threatening condition, and the disposition of the patient.
The services included semi-critical care. This patient does not have a life-
threatening condition. Also, it does not pose a high danger, but he or she must arrive at
the hospital within 15 to 20 minutes to prevent any potential complications. Nonetheless,
non-critical care services are another service that should be included. Those who are
patient are not in imminent peril. In addition, their condition did not necessitate
immediate care or resuscitation. There should be effective treatment options for these
cases. In addition to the specialty area, there is an emergency facility for sudden cases.
This includes the emergency operating room, the cardiac care area, and numerous other
types of units.

2.3 OBSERVATIONAL POLICY

The goal of observation medicine is to prepare emergency physicians to be leaders in
acute care settings outside of the ED in the areas of education, research, administration, and
clinical care. In order to create and manage an observation unit, doctors trained in this
speciality have a broad knowledge base in clinical operations, quality improvement, patient
safety, observation patient selection, and patient flow. Observational medicine is a
diagnostic, stabilization, observation, and therapeutic centre for patients who need additional
observation, investigation, and intervention within a specified time frame up to 8 hours. It
also serves as a satellite. It will be available to monitor a specific group of patients who visit
the emergency room and are following a predetermined care plan. Patients who have received
emergency care and whose conditions are expected to improve or resolve quickly may be

6
accommodated in this section. The place chosen for observation purposes must be either
inside the department or close by. Until a safe disposition decision can be made, the patient's
clinical development will be closely monitored, supported by laboratory findings and
imaging examinations as needed. Adults and pediatric patients will have access to ample
beds and observation space. All patients seen in this area are managed by well-trained staff
nurses using a full monitoring system and resuscitation trolley.

2.4 ONE STOP CRISIS

An integrated and comprehensive service centre for the care of survivors of violence
and sexual abuse against women, children, and the elderly is known as a "one stop crisis
centre." Personnel from both government and non-government organizations participate in
the management, which is carried out in a multidisciplinary and intersectoral way. In this
case OSCC should provide privacy and secrecy for victims of rape, sexual assault, domestic
violence, child abuse, and sodomy, with full lavatory, cleaning, shower, and dressing room
facilities. The Emergency and Trauma Department should create a customer friendly One
Stop Crisis Centre to collect specimens, record them, label them, and seal them. Other nations
in the South East Asian region are adopting the Malaysia One Stop Crisis Centre (OSCC)
concept, which is rather unique in that it employs a large-scale model for violence-response
(Siti et al., 2011). Any victim of domestic abuse must have access to Emergency and Trauma
Departments' internal referral procedures or Non-Governmental Organizations (NGOs) to
satisfy their immediate housing and counselling requirements. It is advocated for emergency
and trauma departments to take part in collaborative, interdisciplinary techniques for
identifying, evaluating, and helping victims of domestic violence, such as creating
guidelines, rules, and connections with external organizations.

2.5 SUB-SPECIALITY EMERGENCY SERVICE

As an essential complement to its primary service, the EMTS should build, develop,
and be prepared to provide sub-specialty services and treatment, including:
− Acute interventional skills
− Trauma care and Traumatology
− Resuscitation and intensive care medicine (Emergency and critical care medicine)

7
− Pre-hospital care
− Disaster management
− Observational medicine
− Clinical Toxicology
− Hyperbaric and environment emergency medicine

The MOH will evaluate the proposed service entity to ensure that it meets the required
standards and regulations. Additionally, the formation of the service entity should align with
the national healthcare goals and objectives. Moreover, the sub-specialty services should also
be integrated with the existing healthcare infrastructure to ensure seamless delivery of care.
It is important to establish a system for continuous quality improvement and evaluation to
monitor the effectiveness of the sub-specialty services and make necessary adjustments.

2.6 ANCILLARY SERVICE

− Medical Emergency and Rapid Response Team
This includes organizing and managing medical emergencies within the
institution, such as cardiorespiratory arrest close to a hospital (code blue). Code Blue is
an emergency code used in hospitals to indicate when a patient goes into cardiac arrest
and needs resuscitation. When Code Blue is called, an on-call medical team staffed by
physicians and nurses is paged and rushes in to try to save the patient's life (Samrachana
et al., 2119). ETD will coordinate this service, which is provided by hospitals.

− Minor Emergency Medicine and Trauma Follow-Up Clinic

The aim for Emergency and Trauma Department of this service is to ensure that
patients receive appropriate care and support after leaving the hospital. This may include
medication management, wound care, and rehabilitation exercises. It was usually
conducted less than 6 weeks.

− After Office Hours Outpatient Services

To handle non-emergency situations, the Emergency and Trauma Department has
organized an after-hours clinic (Pekeliling KPK: Bill7/2007, Perlaksanaan Perkhidmatan

8
 Klinik Rawatan Pesakit Selepas Waktu Pejabat (KRPSWP) di Jabatan Kecemasan, for
example).

2.7 TRAINING, EDUCATION AND PERSONNEL DEVELOPMENT

The department must create a written orientation programme to introduce new staff
to the facilities. It must lay out the training, skill, and knowledge requirements for all
employees, provide access to appropriate programmes of instruction, and record their
involvement in the ministry's e-CPD programme. e-CPD is an online training system
designed to provide virtual training for primary school teachers (Rafiza et al., 2015).
Furthermore, the orientation programme should also include information on the department's
policies and procedures, as well as its goals and objectives. This will ensure that new staff
members are equipped with all the necessary information to effectively contribute to the
department's success. The department must make it possible for employees to participate in
relevant educational events, adhere to human resource standards, and have an equal, just, and
nurturing structure for hiring, credentialing, performance management, and staff retention.
All clinical staff must have basic life support training and certification, and all medical
officers must get advanced life support training and certification within six months of being
posted to ETD. In addition, regular training and development programs should be provided
to ensure that staff members are up to date with the latest medical practices and technologies.
Furthermore, performance evaluations should be conducted regularly to identify areas for
improvement and provide feedback for growth.

2.8 QUALITY AND RESEARCH

Quality and research are critical components of policy for emergency care and trauma
treatment. The level of care delivered to patients is referred to as quality, and it covers the
efficacy, security, and effectiveness of medical therapies and interventions. Quality
enhancement initiatives are intended to identify areas for improvement in the provision of
care and to implement methods that improve the quality of care provided to patients.
Policy in emergency care and trauma services is likewise heavily reliant on research.
Research studies are done to find out how well medical treatments and interventions work,
to find the best ways to give care, and to come up with new treatments that will help patients

9
 do better. The goal of research in emergency medicine and trauma services policy is to
improve the standard of care given to patients and lower the rates of illness and death.

3.0 FINDINGS AND CONCLUSIONS

3.1 The impact of the policy you have selected towards Malaysia healthcare and
citizen.
Malaysia has become known for having an effective and widely used health care
system. It has a long history of population health and established, significant health care
services. However, solid health policy may play a significant role in deciding and
monitoring how to provide better performance. There are several advantages to Malaysia's
existing policy structure for emergency medicine and trauma services. Emergency
medicine and trauma services (EMTS) are governed by current laws and regulations that
specify the roles and duties of important stakeholders. The policy framework places a
strong emphasis on the value of collaboration and coordination between trauma centres,
hospitals, and EMS providers. To guarantee high standards, accreditation procedures for
trauma centers have been devised. This policy implementation might make it easier to carry
out and adhere to the work of observing and upholding the standards, policy, and clinical
recommendations.

- People or patients can get per-hospital care.

One of the main impacts that can be pull out from this policy is that people or
patient can get pre-hospital care which are improved patient outcomes and response
times, The EMTS includes ambulance services that ensure quick response to health-
related emergencies. Early arrival and first care provided by qualified staff can drastically
shorten the period between the start of symptoms and medical attention, improving the
results for patients and raising chances of survival (Chen, April 14, 2022). To effectively
handle emergency calls and send the necessary resources, systems like Enhanced
Emergency Call Management, The Medical Emergency Coordinating Centre (MECC),
and 999 Emergency Call Management Systems are essential. The whole emergency
response system operates more efficiently when calls are managed effectively, ensuring
that the appropriate level of treatment is delivered immediately. Moreover, the impact

10
 this policy could bring is effective major medical incident and disaster management
(Wilson, 2021). In treating significant medical emergencies and disasters, EMTS is
essential. This entails coordinating with multiple agencies and organizations, setting up
incident command systems, triaging patients, and making sure resources are allocated
promptly and appropriately. In large-scale situations, EMTS is essential to the efficient
management and delivery of medical care, helping to reduce casualties and promptly
assist people who need it. Lastly, pre-hospital care can give impact on medical coverage
for mass gatherings and major events, EMTS offers medical coverage for large-scale
events like festivals, sporting competitions, and concerts. In order to do this, medical
stations must be put up, ambulances must be sent out, and medical staff must render on-
site treatment. By responding to any medical crises that might occur during such events,
EMTS ensures the security and wellbeing of guests.

The provision of medical coverage for large gatherings and significant events is
only one example of how these pre-hospital services in EMTS have reduced response
times, improved patient outcomes, effective emergency call handling, and efficient
management of big occurrences and disasters. These services help save lives, lower
morbidity, and mortality, and guarantee the prompt and proper delivery of medical care
in urgent situations.

- People or anyone who needs medical attention can have hospital-based services.
Another main impact from this policy is that people or anyone who needs medical
attention can have hospital-based services. There are several impactful outcomes which
are triage services, in emergency care, triage is a crucial process where patients are
evaluated and prioritized according to the seriousness of their conditions. The triage
services offered by EMTS assist in the effective allocation of scarce resources, ensuring
that patients with the most urgent requirements receive rapid attention. Reduced waiting
times for important patients, prompt interventions, and improved patient outcomes are
all effects of good triage. Next is emergency clinical care, patients with acute and life-
threatening disorders can receive emergency clinical care from EMTS in hospitals. This
care includes immediate and specialized medical interventions. This covers techniques
for providing advanced life support, resuscitation efforts, medicine administration, and

11
 other crucial treatments. Improved patient survival rates, fewer complications, and better
overall outcomes are all results of effective emergency clinical treatment provided by
EMTS. Last but not least, observational medicine, observational medicine is the
monitoring and treatment of individuals who need additional testing or observation prior
to receiving a final diagnosis or recommendation. In order to provide this service, EMTS
continuously monitors patients throughout the observation time, does diagnostic tests,
and revaluates their health. Early diagnosis, appropriate treatment choices, and fewer
hospital hospitalizations for patients who can be safely discharged are all effects of
observational medicine.

In general, patient care and results are significantly impacted by the hospital-
based services offered by EMTS, such as triage services, emergency clinical care, and
observational medicine. They make sure that patients are swiftly evaluate ailment and
appropriate interventions based on the seriousness of their ailment and are closely
monitored as necessary. These services aid in enhancing patient outcomes, resource
allocation, and overall emergency healthcare delivery efficiency. (Duncan, 2022)

3.2 Your view if MOH does not include this policy in their planning for Malaysian now.

If Ministry of Health did not implement Emergency Medicine and Trauma Policy
for their planning by Malaysia. There would be several potential implications which are,
our healthcare could have a delayed emergency response, the response time to medical
emergencies may be greatly delayed in the absence of a well-structured EMTS protocol.
Critical patients may not receive prompt medical care as a result of this delay, potentially
worsening their condition and raising morbidity and fatality rates. Next, there also would
be inefficient resource allocation. An EMTS policy assists in the efficient allocation of
emergency medical resources, including ambulances and qualified people. Without a
strategy like this, resources might be allocated inconsistently or ineffectively, which would
result in differences in emergency response capacities between various regions. This might
lead to inefficient resource utilization, lower productivity, and potential coverage gaps for
emergency medical services.

12
 Another potential that be pointed out is limited coordination and communication.
An EMTS policy establishes channels of communication and coordination between the
various emergency response participants, including dispatch centers, ambulance services,
hospitals, and healthcare professionals. Without this policy, there may be insufficient or
inconsistent coordination and communication between various entities. Confusion, delays
in patient transfers, and impaired continuity of care can result from this lack of
coordination. Next, by not implementing this policy could lead to reduced standardization
and quality assurance. EMTS policies establish standards and norms for emergency
medical care, guaranteeing consistency and quality assurance throughout the system. This
results in less standardization and higher levels of assurance. Lack of standardized training
for emergency medical staff, inconsistent patient care protocols, and insufficient service
quality monitoring may occur in the absence of such regulatory measures. The general
standard of emergency medical services and patient outcomes may suffer as a result. Lastly,
challenges in disaster and major incident management. Major incident and disaster
management presents a number of challenges. EMTS policies often include procedures for
handling these situations. Without a clear policy framework, it may be difficult to plan
ahead and respond to major catastrophes successfully. This may make it difficult to
mobilize resources, control patient influx, and coordinate emergency response activities,
thereby resulting in chaos and decreased disaster management effectiveness.
Overall, if the implement of EMTS policy strategy in Malaysia may result in a slow
emergency response time, ineffective resource management, poor coordination, a lack of
standardization, and difficulties managing significant crises and disasters. To provide
prompt and efficient emergency medical care, boost patient outcomes, and increase the
overall preparation and resilience of the healthcare system, it is essential to implement a
comprehensive EMTS policy.

3.3 Suggestions that may be much better theoretically to replace this policy.

There are several uncertain suggestions that might be taken into consideration as
prospective replacements if the existing Emergency Medical Transport System (EMTS)
policy in Malaysia is deemed insufficient or in need of change. Which consist of several
point such comprehensive EMTS policy framework. Develop a thorough EMTS policy

13
framework that covers all facets of emergency medical transport, including pre-hospital
care, hospital-based services, disaster management, and coverage for large-scale
gatherings. The policy should create norms and guidelines, clearly define roles and duties,
and ensure coordination and cooperation between parties. Next, enhanced pre-hospital
services, improved ambulance coverage and response times, particularly in remote and
underserved areas, to strengthen pre-hospital services. Invest in increasing the number of
ambulance fleets, outfitting them with the medical equipment and supplies they require,
and installing cutting-edge communication technologies for effective dispatch and
coordination. Moreover, another suggestion is standardized training and certification. All
healthcare workers participating in emergency medical care should get standardized
training, as well as certification criteria. EMTs, paramedics, and other pertinent staff should
be included in this to guarantee a uniform level of expertise, knowledge, and proficiency.
Next is quality assurance and monitoring, establishing strong quality assurance procedures
and ongoing monitoring programs will help us evaluate the effectiveness and performance
of the EMTS. Regular audits, data collecting and analysis, feedback channels, and
benchmarking against global best practices can all be a part of this. Continual quality
improvement programs should be put into place in light of the results and comments
received.
Another suggestion is by integrated communication and technology systems. EMS
providers, hospitals, dispatch centers, and other relevant institutions can exchange
information and communicate with one another easily thanks to an integrated
communication and technology system that is put in place. To promote efficient and
effective coordination, this can include a centralized electronic patient care reporting
system, real-time ambulance tracking, and interoperable communication technologies.
Next is by having community engagement and public education. Focus on community
participation and public education campaigns to raise public awareness of emergency
medical services, encourage prompt service use, and impart knowledge on fundamental
life support techniques. To enhance overall emergency response and bystander help, this
can involve campaigns, training initiatives, and collaborations with neighborhood
organizations. Lastly, another suggestion could be point out is by doing research and
evidence-based practices. To develop best practices, assess outcomes, and guide the

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 formulation of policies, promote and support research in the fields of emergency medicine
and trauma services. Encourage cooperation between academic institutions, medical
professionals, and policymakers to produce recommendations for ongoing improvement
that are based on evidence.
It is important to bear in mind that all of these suggestions are theoretical in nature
and should be carefully considered, modified, and put into practice taking into account the
unique context, resources, and healthcare system in Malaysia.

3.4 How do you think the policy can be further enhanced to give a greater impact to
the Malaysia Healthcare?

Emergency Medicine and Trauma Services Policy has developed rapidly in line
with the needs of the population in Malaysia, especially the highly growing population. This
policy is really important to ensure that emergency treatment in Malaysia can be given to
patients in a fast time. Therefore, we will give and explain several ways for Emergency
Medicine and Trauma Service Policy can be further enhanced to give a greater impact on the
Malaysia healthcare system.

- Increased funding

Emergency medicine and trauma services are often underfunded, which can lead to
delays in care, overcrowding in emergency departments, and a lack of access to specialized
care. So, one of the best ways to improve emergency and trauma services is to increase funds
for the service. Increased funding would allow for more resources to be allocated to these
services, which would improve the quality and timeliness of care for patients. Increased
funding also can be allocated to the development and improvement of infrastructure for
emergency services. Improving emergency trauma facilities may increase survival rates (O.
Kyokong et. al, 2008). This includes the construction and renovation of emergency
departments, trauma centres, and ambulance stations. There should be an emphasis on
emergency trauma care in the pre-hospital setting (A. Chandrasekharan et. al 2016).
Upgrading facilities with modern equipment, advanced imaging technologies, and
specialized units like resuscitation bays and trauma resuscitation rooms can enhance the

15
capacity and effectiveness of emergency care. In other views, increased funds can recruit
and retain qualified healthcare professionals specialized in emergency medicine and trauma
care. This includes emergency physicians, trauma surgeons, nurses, paramedics, and other
healthcare staff. Emergency physicians are well-placed to play a leading role in the
development and implementation of trauma systems (T. Rainer et al. 2003). Offering
competitive salaries, professional development opportunities, and incentives can help attract
and retain skilled professionals. Furthermore, additional funding can support research and
innovation in emergency medicine and trauma care. Investing in research grants and
collaborations with academic institutions encourages the development of new treatment
protocols, techniques, and technologies that can improve patient outcomes and optimize
resource utilization. Increased funding also can facilitate collaboration and partnerships with
other stakeholders, such as government agencies, non-governmental organizations, and the
private sector. These collaborations can leverage additional resources, expertise, and
innovative solutions to enhance emergency services in Malaysia. In addition, funding can
support initiatives for continuous quality improvement and patient safety in emergency
services. This includes establishing systems for monitoring and evaluating performance
indicators, conducting regular audits, and implementing evidence-based practices. Funding
can also be allocated to establish patient safety programs, incident reporting systems, and
patient feedback mechanisms to identify areas for improvement and enhance the overall
quality of care.

− Develop a national trauma training program

A national trauma training program would provide training for healthcare providers
on how to care for trauma patients. This training would help to ensure that all healthcare
providers are prepared to provide the best possible care for trauma patients. There are a few
ways in which such a program can be implemented. Firstly, conduct a comprehensive needs
assessment to identify the existing gaps and requirements in trauma training across the
country. Assess the current skill levels, available resources, and training opportunities for
healthcare professionals involved in trauma care. There is a significant burden on public
health systems from emergency surgical and trauma patients (S. Mathur et. al, 2018). Second,

16
develop a standardized curriculum for trauma training that encompasses both theory
knowledge and practical skills. The curriculum should be aligned with international best
practices in trauma care. It should cover topics such as trauma assessment, resuscitation,
emergency procedures, surgical techniques, critical care management, and communication
skills. Third, establish designated training centres across the country where trauma training
can be conducted. These centres should have appropriate infrastructure, simulation facilities,
and experienced staff members to deliver high-quality training. We strongly encourage
regionalization of trauma care and education of paramedics, emergency medical technicians,
and physicians in the rapid triage of high-risk patients to a major trauma centre (K. M.
Gilmore et. al, 1981). Collaborating with existing healthcare institutions, trauma centres, and
academic organizations also can leverage the expertise and resources. Fourth, create
simulation-based training in the trauma training program. Utilize high technology simulators,
task trainers, and virtual reality technology to create realistic scenarios for trauma
assessment, resuscitation, and procedural skills. The doctor in the Accident and Emergency
Department must be skilled in basic trauma care (O. Afuwape et. al, 2007). Simulation-based
training allows participants to practice skills, develop decision-making abilities, and enhance
teamwork in a controlled environment.

− Empowering One-Stop Crisis Center (OSCC)

One Stop Crisis Center (OSCC) is an integrated service centre between various
agencies that coordinate tasks to resolve criminal cases such as rape, child abuse, sexual
violence, and domestic violence in Malaysia. OSCC is located under the Emergency
Department of every government hospital where there are trained staff assigned to treat and
give proper care to victims who come to avoid serious trauma. Aimed at providing integrated
multi-level crisis intervention to women experiencing violence such as rape, One Stop Crisis
Centre (OSCC) in Malaysia is often located in the emergency department (K. Chew et. al,
2015). OSCC is a service provided in all government hospitals in Malaysia. The centre is
open 24 hours a day. Victims who come are not only given physical treatment but proper
protection including providing shelter and being separated from normal patients so that they
do not feel ashamed or afraid. This OSCC needs to be improved and empowered so that

17
emergency and trauma services can run excellently. Therefore, there are several steps that
can be taken to empower OSCC including ensuring sufficient funding is allocated to OSCC
to support their operations, infrastructure, staffing, and essential resources. Adequate funding
enables OSCC to provide comprehensive and high-quality care to individuals who
experience trauma. We have demonstrated a direct relationship between emergency
department visit counts for trauma with future trauma occurrence risk (Choi Yoonhae et. al,
2009). Next, develop and implement standardized protocols and guidelines for OSCC to
ensure consistent and evidence-based care. These protocols should cover many aspects,
including patient triage, assessment, resuscitation, trauma management, and psychosocial
support. Furthermore, foster community engagement and collaboration to raise awareness
about OSCC and its services. Conduct educational campaigns to educate the public on the
importance of seeking care at OSCC during emergencies and traumatic events. Engage
community leaders, local organizations, and non-governmental organizations to support
OSCC and promote community resilience. Last but not least, establish mechanisms for
continuous evaluation and feedback from patients and healthcare providers regarding OSCC
services. Regularly assess patient satisfaction, clinical outcomes, and adherence to protocols.
Use feedback to identify areas for improvement and implement necessary changes.

3.5 Overall view of the relationship of a good health policy towards the country’s health
outcome

There is a strong relationship between a good health policy and the country's health
outcome. Of course, there are other factors that can also affect a country's health outcome,
such as environmental situation, economic development, and social conditions. However, a
good health policy can play an important role in improving a country's health outcomes. It
encompasses a range of strategies, initiatives, and regulations aimed at improving and
maintaining the health of the population. Countries with good health policies tend to have
better health outcomes, as measured by indicators such as life expectancy, infant mortality,
and disease prevalence.

A well-designed health policy ensures that healthcare services are accessible to all
citizens, regardless of their socioeconomic status. It aims to reduce barriers to healthcare,

18
such as affordability, geographical distance, and availability of healthcare facilities. When
healthcare is easily accessible, people are more likely to seek timely medical attention,
leading to better health outcomes. Health policies often emphasize preventive measures,
including vaccinations, health screenings, and health education programs. By focusing on
prevention, countries can reduce the incidence of diseases and promote healthier lifestyles
among their populations. This approach helps in avoiding costly treatments and managing
chronic diseases effectively.

Health policies also provide guidelines for managing various diseases and
conditions. They promote evidence-based practices, treatment protocols, and standards of
care. Effective disease management strategies ensure early diagnosis of diseases, appropriate
treatment, and ongoing monitoring, leading to improved health outcomes and reduced
complications for the patients. Furthermore, a good health policy includes initiatives to
promote health and educate the population about healthy behaviors. These efforts can range
from public health campaigns to targeting people for specific health issues. By raising
awareness and providing knowledge, health policies can empower individuals to make
informed decisions and adopt healthier lifestyles, resulting in better health outcomes.

Health policies also address the need for robust health infrastructure, including
hospitals, clinics, and medical equipment. They also focused on developing a skilled
healthcare workforce, ensuring an adequate number of healthcare professionals and their
continuous training. A strong health infrastructure and skilled workforce are essential for
providing quality care, which positively impacts health outcomes. Health policies aim to
reduce health disparities and achieve health equity among different population groups. They
address social determinants of health, such as income, education, and access to resources,
that influence health outcomes. By prioritizing health equity, policies strive to ensure that
everyone has an equal opportunity to attain good health, regardless of their background. Last
but not least, health policies include mechanisms for monitoring and evaluating the
effectiveness of implemented interventions. This allows policymakers to assess the impact
of policies on health outcomes, identify areas for improvement, and make evidence-based
adjustments as needed. Regular monitoring and evaluation help in refining policies and
optimizing their impact on population health.

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 In summary, a good health policy is essential for ensuring that everyone has access
to quality, affordable healthcare. A good health policy covers various elements, including
healthcare access, disease management, health promotion, infrastructure development,
monitoring, and evaluation. By addressing these aspects, health policies contribute
significantly to improving a country's health outcomes and the overall well-being of its
population. Good health policy is an investment in the future of our society. It can help to
improve our health, our productivity, and our overall well-being.

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