The human resource strategy for HPKK-UKM

One of the biggest challenges for any new hospital is getting new staff members. There is a long list of needs i.e. the nurses, the radiographers, the laboratory technologists, the therapists for the rehabilitation centre, the assistant nurses, the porters, the ambulance drivers, and the whole line-up for the administrative staff to handle the human resource, the finance, the public relations, the hospital information system and the medical records.

For our children’s hospital, there is certainly a need for new staff members. We are at least fortunate as there are already staff members who are giving full time services in the paediatric wards and clinics. We hope that with the permission of the top management of the university and also the Hospital Canselor Tuanku Muhriz (HCTM), the staff nurses and the support staff who are currently involved full time with paediatric services will be allowed to be seconded to the HPKK-UKM until the new posts are given to us. However, there is still the need to recruit new nurses for the neonatal intensive care unit, the bone marrow transplant ward, the day care centres, the operating theatres, the CSSU, and a few others.

There is currently a freeze, or a big reduction, in the number of new posts in government service. We all have to understand the current economic situation and strategise well for the HPKK-UKM. The key approach is to be as lean as possible without compromising on the quality of service. For the nursing component, we need to retain the ratio of 1:5 for the general wards and 1:1 for the intensive care areas. We must also remember that we need to mobilise and utilise the nurses based on the bed occupancy ratio (BOR). If one ward has a BOR of 50% then, some of the nurses should be mobilised to a ward which has an 80% BOR for example. Consultants and heads of nursing for each ward must understand that they don’t own the nurses. Nurses, just like beds, are considered a vital resource to run a hospital, hence the Chief of Nursing Services should be empowered to mobilise resources based of BOR to ensure each ward will have the optimum number of nurses servicing the patients at any time.

Some of the consultants or heads of nursing may not agree with this, especially those handling the intensive care units, but times have changed. Most top hospitals mobilise nurses based on service needs. It is a waste to assign the maximum number of nurses on days where the BOR is only 40% (which is the current BOR for the paediatric wards at HCTM). Our nurses must be trained to be ready to serve in any setting except for the really highly specialized units. There must be a pool of nurses in the general wards who are also adept at handling intensive care cases too. We must make a paradigm shift for the HPKK-UKM. This culture of ‘the-beds-and-nurses-belong-to-me’ should be a thing of the past.

Discussions have started with the heads of radiology, nursing, rehabilitation and the laboratory services from HCTM and each of them have been very helpful and accomodative in terms of planning for the human resource needs for HPKK-UKM. We have worked out a clear plan for the worst case scenario if there are no posts approved by the Jabatan Perkhidmatan Awam.  Hopefully that will not happen, but if it does, we believe we can still operate the HPKK-UKM come 2019 with the current resources which we have and will a lot of help from the sister hospital, HCTM.

We have submitted our list of posts required for the HPKK-UKM to the JPA via the UKM’s Human Resource Division. The first batch of new positions will be released to UKM once the progress of the project reaches 25%. These positions are trade-offs of existing vacant positions in UKM.

For the clinicians, it is crucial at this stage to bring in more talent into each sub-specialty either local or international. If we are really good, then we should be able to attract the best talent pool from the Ministry of Health even if the perks and career pathway are better there. Currently, we do not have specialists in paediatric gastroenterology, nephrology, infectious diseases and cardiothoracic surgery. We also need extra numbers in some other specialties like cardiology, neurology, respirology, endocrinology, child psychology, and also in oncology and haematology (to run the bone marrow transplant services).  Let’s work together to bring in the best talent and also retain the best we have.

Last but not least, let us work to improve on the bed occupancy rate to reach the most efficient level which is at 80%. We need the numbers to justify the use of the new and state-of-the-art resources at the new hospital as well as to get enough case-mix for teaching and for research.