EMERGENCY RESPONSE EXERCISE @ IOT Management

Today, at 2:30 pm I attended 2nd Fire Drill exercise conducted by Independent Oil Terminal Management (IOTM) at their LPG Terminal at Senari Port. The exercise took 1 hour with participation from Jabatan Bomba Dan Penyelamat and Kuching Port Authority. As a whole, the exercise has improved compare with last year exercise. Congratulation to IOTM!

Self-Compliance

Last week, I asked my ordinary grass cutter came to do his job at my house compound. He knows the hazards of his job and he voluntarily used all the necessary Personal Protective Devices(PPD/PPE) according to his own standard. (Cover his face&head, using google, using long sleeve and using PCK safety boot). His self-compliance without even knowing the existence of OSHA 1994 is very much appreciated.

When come to safety, our inner self is fully aware to protect ourself from dangers. However, a lot of the time we see people totally ignorance about their safety especially on the road and at their workplace. They do unsafe acts and create unsafe conditions (the two culprits of accident) and it becomes their routine or behavior. Their mindset already corrupted by false satisfaction they get from the non accident consequences they get from their actions and conditions. This false satisfaction is like 'atomic bomb waiting to explode'. The vital question is : Can we change their practices or behaviour?

Definitely........ we need to change their mindset first....changing their mindset means changing their perception or to be accurate change their 'world view'. We only can change their 'world view' by giving them 'knowledge' (ilmu) using simple language that they can understand. By changing their mindset, only then they will change their behavior. In another word, we are talking about 'Behavior Based safety'. We have to use a lot of approaches including religion approach. In religion there are a lot of safety values we can practice.

REFLECTION

I attended the briefing session on H1N1 infection organised by Sarawak Health Dept. on 7th May, 2009 at 2:30 pm. The session was attended by about 30 people, representatives from all hospitals (including private hospitals) and Divisional Health Depts. in Sarawak. I am impressed that Sarawak Health Dept. has a very effective Emergency Response Plan (ERP) to handle any possible infectious diseases outbreak in the state. The briefing on the H1N1 infection was given by Dr Rohani Mahbah, Public Health Physician and Dr Chua Hock Hin, Infectious Disease Physician.

The following are my reflections after handling the case mentioned in my previous posting.

1. In this Era of Globalisation; the world is already a global village. We cannot be too complacent if there is crisis in other part of the world because it can affect our place any time. In this case, WHO put the pandemic alert level to phase 5 on 30 April 2009, we in Sarawak already got the suspected case on the 4th May 2009 (only 4 days later). Praised to God, the case was cleared of H1N1 virus.

This is also reflected in the current world economy crisis.

2. Emergency Preparedness Plan (ERP); must be in place all the time to face any crisis. Proper and clear flow chart and guidelines are all important in handling any crisis. To get,the document on the Recommendations for Influenza Pandemic Preparedness for Industry, click here. Adopt and customise it for your industry.

3. Effective Communication; all guidelines must be communicated to all employees especially those who are front line employee. Never ASSUME.

4. Update the knowledge; we need to update our knowledge on the current issue. Read all the informations and instructions provided by the authority body. It is our responsibility to help the authority to control the crisis.

4. At all the time, we must adhere to the universal principle of precaution,droplets precaution, cough etiquette and personal hygiene practice. This simple practices will safe your day from the infections.

Last but not least, check with your management, are your industry already has its ERP and contingency plan in facing any crisis and disaster. We need to emulate the aviation industry, they have all the 'what to do' manual in facing any crisis during the flight.

The man was cleared of H1N1 infection

Alhamdulillah, praised to Allah, the gentleman who was on newspaper headline has been cleared of influenza H1N1 after testing. Today, the home quarantine on me and other collegues was lifted. Now I am at work again :)

So everyone was relieved by the good news. So MALAYSIA is still free from H1N1 infection.

ALERT ON SUSPECTED H1N1 Infections

On the 4th May, I was involved in handling 31 year old gentleman who came to our Emergency Dept. with fever, sorethroat and Shortness of breath after 3 days returned from a visit to US. The fact that he visited US from 24th April 2009 to 1st May enough for us to suspect him of possibility of H1N1 infection. We alert Sarawak General Hospital about the case and he was rushed to Isolation Ward specifically prepared for H1N1 infection suspect case.

All of us who were working and has contact with the man was instructed by Ministry of Health to be on home quarantine until the blood test result which was sent to IMR KL ready. So yesterday 5th May, I have to stay at home.

KPJ National Patient Safety GOAL No. 2

IMPROVE EFFECTIVE COMMUNICATION

Effective communication is essential in any relationship including patient-care provider relationship. Communication is a two way pipeline. Effective communication means the message from the messenger perceived by the receiver accurately.

To improve effective communication we need to eliminate communication barriers. There are a lot of communication barriers but I would like to highlight three barriers as follows:

1.Assumption : Never assume the receiver understand technical term without checking their understanding

2. Avoid Curse of Knowledge(COK): COK is a condition when you become expert in particular subject,but it is hard to imagine not knowing what you do.

3. Closed Mind :  a condition when you are resistance to new ideas or informations.

Spanish Philosopher,Jose Ortega Y Gasset called it  'the barbarism of specialization' in one chapter of his famous book:  Revolt of The Masses

KPJ National Patient Safety GOAL No. 1

IDENTIFY PATIENTS CORRECTLY

The first step in patient safety goals in healthcare service is to identify patients correctly. This is the most important goal because without proper and correct identification of the patient, the patient safety is in danger - the medical treatment will be given to wrong patients. Imagine you are given radiotherapy but you are not having any indication for it. Imagine the doctor is operating on the wrong patient and the consequence is very costly.

Identification of patients correctly need a simple , accurate and standard process. One of the way is by identifying them using their National Identification Card (NRIC). Call the name written in NRIC and compare the image in the NRIC to the patient. Then register the patient by giving them unique Registered Number. Dont use location such as room number to identify the patient correctly. 

KPJ National Patient Safety GOALS

On 30th November until 2nd December, 2008 I represented Kuching Specialist Hospital together with  Medical Director, Dr. David Ling, General Manager, Mdm Mah Lai Heng, Nursing Chief Officer, Mdm Ting Lay Hua, one Staff nurse and physiotherapist, attending KPJ Annual Health Conference @ PERSADA Convention Johore Bharu.

Amongst the presentations at that conference was KPJ National Patient Safety Goals as stated in the left image. As OH Practitioner, I am proud that KPJ has dwelled deeply in pioonering this field ahead of other hospital in Malaysia.

SELAMAT KAH RUMAH ANDA?

Baru-baru ini rumah rakan sekerja saya telah diceroboh masuk oleh 4 orang penyamun pencemar Ramadhan (kerana mereka membuat kerja durjana dalam bulan Ramadhan). Rakan saya baru balik bekerja sekitar jam 12: 30 tengah malam. Beliau masuk beradu (tidur) sekitar jam 1 pagi setelah mempastikan semua pintu rumah dikunci. Tiba-tiba sekitar jam 3 pagi dia terjaga dari tidur setelah 4 penyamun ini menceroboh masuk  kamar tidurnya dengan memecah pintu. Penyamun-penyamun ini bersenjatakan parang dan pisau dan mengarah rakan saya dan isteri serta anak sulongnya supaya diam, setelah isteri dan anaknya menjerit kerana terkejut dengan pencerobohan biadap tersebut. Tangan rakan saya telah diikat dengan wayar manakala tangan isterinya diikat dengan kain. Kesemua barang kemas, 2 laptop dan barang-barang berharga termasuk tali pinggang dan kasut rakan saya disamun. Sebelum penyamun-penyamun durjana itu melesapkan diri, seorang dari mereka mengawal rakan saya sekeluarga di kamar tidur tersebut manakala  3 penyamun lagi meratah semua makanan persediaan untuk sahur puasa Ramadhan. 

Menurut rakan saya, sebiji nasi pun tidak tertinggal di dapur apabila beliau membuat pemeriksaan, setelah beliau dapat membuka ikatan di tangannya selepas 4 penyamun melesapkan diri. Nasib baik rakan saya sekeluarga tidak mengalami kecederaan parah. Dan nasib baik penyamun-penyamun ini tidak menculik anak sulongnya yang berusia 5 tahun itu.

Saya empati mendengar cerita malang rakan sekerja saya ini kerana 3 tahun lepas rumah saya juga kena ceroboh pada ketika saya dan keluarga tiada di rumah.

Dari cerita ini, saya ingin mengajukan pertanyaan : Adakah rumah anda selamat dari pencerobohan pencuri atau penyamun?

Adakah anda telah melaksanakan langkah pengawalan hazad pencerobohan ini secara "ALARP - As low as Reasonably Practiable".

Dari pengalaman sendiri dan rakan saya, kedua-dua kami tidak memasang pagar besi (Grill) di pintu dapur rumah. Dari situlah penyamun-penyamun ini menceroboh masuk dengan memecah atau membuka paksa pintu tersebut.

Inilah langkah pengawalan ALARP yang dapat dilakukan tetapi kerana tidak membuat penilaian risiko, maka langkah pengawalan ini terlepas pandang. 

Keesokan harinya, sekitar jam 5 pagi rumah seorang Menteri Muda beberapa kilometer dari rumah rakan saya, pula diceroboh penyamun.

Rumah anda bagaimana, adakah ianya selamat? 

Nampak gaya kita tidak boleh bergantung kepada pemantauan (surveillance) pihak polis semata-mata, kita juga perlu proaktif membuat 'HIRAC - Hazard Identification, Risk Assessment and Control" terhadap hazad pencerobohan pencuri/penyamun ini. HIRAC ini sudah pasti berada dalam "Quadrant II" dalam Matriks segi empat "First Things First" ciptaan Stephen R. Covey.