Neurology Unit Head of Unit: Dr Law Wan Chung INTRODUCTIONhus.moh.gov.my/bm/wp-content/uploads/2019/02/ANNUAL-REPORT-SGH-2017-2... · Total number of Pembantu Perawatan Kesihatan

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Neurology Unit

Head of Unit: Dr Law Wan Chung

INTRODUCTION

The Neurology Department Of Sarawak General Hospital was set up in 2011 to provide comprehensive neurological service to the citizens of Sarawak. Neurology diseases are estimated to contribute 25% of total medical ward admission in any general hospital. Most states in Malaysian had established neurology service. However, Neurology service in Sarawak occurs via sporadic visiting neurologist from Hospital Kuala Lumpur. Neurologic conditions like stroke contribute to major morbidity and mortality. Recent advancement in the understanding of neurologic disorder and introduction of thrombolysis treatment in acute stroke and acute neurologic conditions and also rehabilitation for patient with neurologic disorder had led to better outcome for patients. It is vital to develop the neurology services with trained personal involving multidisciplinary treatment teams with state of the art equipment in order to provide quality management for patient. The geographical location of Sarawak necessitates the development of its own neurology service with the necessary facilities and to manage neurologic condition including acute Stroke. It is logistically almost impossible to refer every acute stroke or sick patient to peninsular Malaysian for further management. By setting up the Neurology Unit in Sarawak, we can improve the health care system in the state. In long term, it is also a more economically away of providing a continuous and comprehensive service to the people of Sarawak and cutting the expanses to import service from other states or to send patient to other state to receive treatment. More, ever we could also provide training to the local clinical and hence encourage more researches and opportunities in future.

SERVICES

The department offers :

i. Neurology Ward inpatient service Located at Medical 3(Combine with 3 discipline ). 4 bed for acute stroke and 8 bed for general neurology.

ii. Outpatient clinic ( Level 2 Room R) iii. Acute Thrombolysis service iv. Neurology Day Care v. Neurophysiology services ( Level 2 Room R ) vi. Neurologist visiting at Hospital Bintulu and Miri every 3 months

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ACTIVITIES NEUROLOGY DEPARTMENT

1. Neurology update : 09 – 10 April 2016 ( Pusat Jantung Kota Samarahan) 2. Parkinson’s Disease awareness day : 7 May 2016 (KK Batu Kawa ) 3. Majlis Ramah Tamah Aidilfitri: 25 July 2016 ( Dewan Kenyalang) 4. Neurology Family Gathering Dinner : 17 Disember 2016 ( Kingwood Inn) 5. Neurology Gathering Dinner: 18. Disember 2016 (Topspot Kuching )

Neurology Update 09 – 10 April 2016

Parkinson’s Disease Awareness 07 May 2016

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ACHIEVEMENT

Workload 2016 ( attendances )

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ISSUE

With the development of Neurology Unit at the Sarawak General Hospital, is an undeniable increase in the number of patients referred to the Neurology Unit. But , there are some problem at Neurology as deficiency will interfere with the work process in Unit run smoothly.

Lack of equipment in Neurology unit also one of the issues that need to be handled to ensure the care and services provided to patients more successfully.

Insufficient room to perform the procedure and also to ensure patient privacy to kept more confidentially are expected to be handled immediately. This is also to ensure the comfort of patients and staff at neurology unit is guaranteed.

CONCLUSION

In an effort to improve the quality services at the Neurology Unit Sarawak General Hospital, various plan in the future that have been purposed. One of the plan is create Neurology Day Care Center and also creat the Neurology ward for neurology patient. Therefore, in ensuring quality care and good quality services, we sincerely hope to always have the support and attention.

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DEPARTMENT OF REHABILITATION MEDICINE HEAD OF DEPARTMENT: DR. LEONG BE KIM

INTRODUCTION Department of Rehabilitation Medicine at Sarawak General Hospital provides rehabilitation medical services to patients who suffer from physical disabilities. Our services include Neurological Rehabilitation, Amputee Rehabilitation, Spinal Rehabilitation, Cardiac Rehabilitation, Paediatric Rehabilitation and General Rehabilitation

OBJECTIVES 1. To improve quality of life for patients who suffer from physical disabilities 2. To reduce the incidence of medical complications among patients who receive

rehabilitation medicine treatment 3. To enhance the functioning of rehabilitation medicine patients in order to facilitate the

reintegration into community with full potential 4. To manage medical and psycho-social issues among rehabilitation medicine patients 5. To raise public awareness about diseases associated disability issues 6. To increase the number of medical and allied health professionals trained in the

management of patients with disabilities

SERVICES PROVIDED 1. Rehabilitation medicine management of hospitalized patients suffering from neurological diseases, spinal cord injury, amputation, cardiac diseases and others. 2. Provide inpatient rehabilitation medicine services at Rehabilitation Medicine Ward and consultation to other departments in the hospital for rehabilitation medicine treatment. 3. Provide outpatient rehabilitation medicine services at Rehabilitation Medicine Clinic. 4. Assist patients in the application of medical equipment such as wheelchairs, prosthesis, suction machine, ripple mattress and others. 5. Assist patients to be registered as "Persons with Disabilities" by Social Welfare Department. 6. Conduct "Family Conference" to discuss the case with the patient's family and provide health-related education. 7. Visiting Clinic at Sarawak Heart Center for Cardiac Rehabilitation Services. 8. Visiting services to major hospitals in Sarawak State which do not have rehabilitation physician. 9. Consultation regarding rehabilitation treatment for non-government organizations which work closely for people with disabilities. 10.Community Outreach Program to provide rehabilitation health screening program at Community Based Rehabilitation Centers around Kuching area. 11.Collaboration with Social Security Organization (SOCSO) for Return to Work Program. STAFFING Category of Staff Total Rehabilitation Physicians 3 Medical Officers 6 Nursing Sisters 2 Staff Nurses 19 Health Attendants 5

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ACHIEVEMENTS 1. Malaysian Society of Quality in Health (MSQH) has accredited Sarawak General Hospital in recognition of compliance with Malaysian Hospital Accreditation Standards. Rehabilitation Medicine Services achieve substantial compliance to standards of MSQH Accreditation. 2. Successfully organized Conjoint 6th National Cardiac Rehabilitation Conference & 9th Malaysian Rehabilitation Medicine Conference

Conjoint 6th National Cardiac Rehabilitation Conference & Opening Ceremony By Director of Medical Development 9th Malaysian Rehabilitation Medicine Conference Division, Ministry of Health

DEPARTMENT ACTIVITIES Training Program (Collaboration with Industrial Companies)

Month Date Topic Person In Charge (Company)

January 11/1/2017 Wellness Recovery Jason Jong (Appeton Healthcare Sdn Bhd)

February 22/2/2017 Lyrica Claudia (Pfizer Malaysia Sdn Bhd)

March 22/3/2017 Colostomy Care Mildred (ConvaTec Malaysia Sdn Bhd)

April 21/4/2017 Iodosorb James (Smith & Nephew Healthcare Sdn Bhd)

May 30/5/2017 Advanced Wound Care Management

Joseph (Sterling Profile Sdn Bhd)

August 9/8/2017 Shoulder Examination and Ultrasound of Shoulder Joint

Dr. Jee Rou Chen (Department of Rehabilitation Medicine)

16/8/2017 Benefits of Foam Dressing Margaret (Fusion Medic Sdn Bhd)

16/8/2017 Disorders of Consciousness- Coma Recovery Scale

Dr. Liew Lin Kiat (Department of Rehabilitation Medicine)

September 29/9/2017-30/9/2017

Conjoint 6th National Cardiac Rehabilitation Conference & 9th Malaysian Rehabilitation Medicine Conference

National Conference -Jointly Organized By Department of Rehabilitation Medicine, Sarawak General Hospital & Department of Cardiology, Sarawak Heart Center in Collaboration with Malaysian Medical Association (Sarawak Branch) & Malaysian Association of Rehabilitation Physicians

November 22/11/2017 Overactive Bladder Wesley (Pfizer Malaysia Sdn Bhd)

December 10/12/2017 Dysphagia Rehabilitation Dr. Jee Rou Chen (Department of Rehabilitation Medicine)

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Group Photograph with International Faculties for National Conference Photograph with Symposium Sponsor Aspen Medical Products S/B Case Discussion & Audit

FUTURE PLAN Department of Rehabilitation Medicine will continue to provide creative, innovative and meaningful services in future.

Month Date Topic Presenter/Medical Officer

January 13/1/2017 Return To Work Dr. Vishnodaya Mohan

February 22/2/2017 Guillain-Barre Syndrome Dr. Fazreen Nur Abdullah

April 12/4/2017 Spasticity Management Dr. Chang Jenn Wei

May 30/5/2017 Spinal Cord Compression Dr. V. Kalai Selvi

June 21/6/2017 Reproductive Health in SCI Dr. Mohd Zakuan

July 28/7/2017 Dementia Dr. Vishnodaya Mohan

October 25/10/2017 Pain in Children Dr. Davinna Ho Mei Szu

November 15/11/2017 Prognosis after SCI Dr. Wong Wu Ken Kelvin

December 6/12/2017 Fall in Elderly Dr. Daniel Gerard Nunis

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DEPARTMENT: PSYCHIATRY & MENTAL HEALTH HEAD OF DEPARTMENT: DR. SELVASINGAM RATNASINGAM

INTRODUCTION

The Department of Psychiatry and Mental Health is one of the clinical departments at

Sarawak General Hospital (SGH). SGH is also the main referral hospital for psychiatric patients

from peripheral clinics and hospitals who may need the specialised treatment offered by our

department.

This year, we had the first government Clinical Psychologist in Sarawak posted to our

department. Her psychological assessment and interventional skills would greatly help our

department to render a higher quality of service to our clients.

We highlight the importance of the sound management of each patient. We emphasise

other important quality activities such as support groups, supported employment, public forums,

courses, welfare programmes for the patients and their care givers. We also offer subspecialist

services in the fields of Child and Adolescent Psychiatry and Geriatric Psychiatry.

The department does its best to fulfil the requirements of the Mental Health Act 2001

especially focusing on the right of patients.

2. OBJECTIVE

Promote mental health, screen for mental illness and ensure early treatment.

Reduce stigma and discrimination.

Provide continuing treatment in an accessible manner in the community.

Provide rehabilitation and psychosocial interventions such as counselling, psycho

therapies, patient and family education.

3. SERVICES PROVIDED

General Adult Psychiatry

Child and Adolescent Psychiatry

Visiting Child & Adolescent Psychiatry:

o Sibu, Bintulu & Miri

Geriatric Psychiatry clinic by Visiting Psychogeriatrician from Hospital Sentosa

Clinical Psychology service

Consultation-Liaison Psychiatry service

Community Mental Health Centre (Mentari) located at Klinik Kesihatan Petra Jaya

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Community Psychiatry Service (Home-based treatment)

Psychosocial Rehabilitation & Occupational Therapy centre.(Mentari)

Outpatient Clinic and inpatient ward care

Electroconvulsive Therapy.

Methadone treatment programme

Training centre for Master’s program students, Elective Medical students, Medical

students from UNIMAS, Advance Diploma in Mental Health students from Kolej Sains

Kesihatan Bersekutu and as well as students from private or public University doing

Psychiatry/ Psychology.

4. NUMBER OF STAFF:

1. Total number of psychiatrists 5

2. Total number of Medical Officers 19

3. Total number of Postgraduate Trainees in Psychiatry 5

4. Total number of House Officers 0

5. Total number of Nurses 39

6. Total number Assistant Medical Officers 5

7. Total number of Clinical Psychologists 1

8. Total number of counsellors 0

9. Total number of Occupational Therapists 3

10. Total number of Medical Social Workers 0

11. Total number of Pembantu Perawatan Kesihatan (PPK) 6

TOTAL NUMBER OF STAFF

83

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5.WORKLOAD 5.1 PSYCHIATRY CLINIC Total number of patients from 2013-2017 Year New cases Follow-up visits Total 2013 712 8515 9227

2014 886 8362 9248

2015 1158 9512 10670

2016 990 10927 11917

2017 1041 12610 13651

TOTAL NUMBER OF PATIENTS IN PSYCHIATRY CLINIC FROM 2013 - 2017

Child and Adolescent Psychiatry 2017

New case Follow-up visit Total 271 1707 1978

General Adult Psychiatry 2017

New case Follow-up visit Total 656 9595 10251

Psychogeriatry from 2013-2017

Year Male Female Total 2013 39 71 110

2014 53 70 123

2015 57 80 137

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2016 63 68 131

2017 54 63 117

Substance abuse Psychiatry from 2013-2017

Year 2013 2014 2015 2016 2017 No. of cases 42 41 198 179 173

5.2 ACUTE PSYCHIATRY WARD Total number of patients admitted from 2013-2017 Year New cases Readmission Total 2013 N/A N/A N/A

2014 152 14 166

2015 184 64 248

2016 110 79 214

2017 154 94 248

TOTAL NUMBER OF PATIENTS ADMITTED TO PSYCHIATRY WARD FROM 2013 - 2017

(Remark: The Acute Psychiatry Ward started operation in 2014)

5.3 COMMUNITY PSYCHIATRY SERVICE (CPS) FROM 2013-2017

Year Total number of CPS patients Total number of home visits Number of discharge