Why compete when you can collaborate?

A representative from the Newborn Care Centre, Royal Hospital for Women, Australia, leading a workshop on neonatal resuscitation. Photograph: Penang Skills Development Centre

By Poh Heem Heem

In what is a first for the highly competitive Penang healthcare sector, private hospitals that compete neck to neck have come together to form the Allied Health Centre of Excellence to address a common problem – shoring up the skills of the nursing and allied health talent pool in the face of increasing clinical demands and generating a sufficient pool of experienced talent to counteract the outflow of highly qualified talent to other countries.

In an unprecedented move, five of the larger private hospitals in Penang have come together to form the Allied Health Centre of Excellence to enhance the competency of nurses and health professionals. From a concept which took shape in late 2008, the limited-by-guarantee company was officially incorporated in March 2010 and to date has taken 455 healthcare personnel through 14 different courses.

This scenario – competing private hospitals putting aside commercial agendas to create a platform for knowledge transfer – is promising. It highlights two pertinent points:

(a)    awareness of competent talent as a prerequisite for any successful industry; and

(b)   realisation of a naturally occurring synergy which comes with high agglomeration of hospitals, as is the case in Penang.

With Penang Adventist Hospital, Gleneagles Medical Centre, Island Hospital, Loh Guan Lye Specialist Centre and Pantai Hospital Penang as its founding members and representation on the Board of Directors, the centre stands head and shoulders above other run-of-the-mill training providers. With access to first-hand industry comings and goings, the management is constantly in pole position to devise talent intervention programmes that accurately address persistent problems.

Hospital chief executive officers head the organisation and have a direct say in its policies and strategic direction, and assign their chief-of-staff to be involved in something called the Training Sub-Committee. This committee is responsible for the identification of programmes, programme content development and in the programme delivery system. In what was once a highly competitive industry, the players openly share experiences and recommend common solutions.

Directors of the Allied Health Centre of Excellence contemplating the centre's vision and positioning during its Annual Strategic Meeting exercise.

The problem statement
The players in the industry are drawn together by a similar set of problems. Increasing complexities of clinical demands place higher standards on fresh nursing hires and very often require additional on-the-job training for curriculum gaps to be covered. Significant amounts of time and resources are spent in retraining fresh hires. Further along the skills spectrum we find the problem that lies within the experienced nurse category – the limited capacity of post-basic training placements. Private hospitals in Malaysia must fulfil the Ministry of Health requirement where each of their units of specialisation must have a minimum number of post-basic trained and certified skilled nurses. Placements in these programmes are limited in nature, with the government providing the bulk of the training. Hospitals currently face an acute shortage of such nurses and a widening backlog of nurses who require training. Nurses become very much in demand after having gone through this training. However, many have chosen to explore job opportunities in Middle Eastern countries. There is also an acute shortage of allied health professionals in Malaysia, with the problem boiling down to a lack of awareness of the career prospects.

The core purpose
The core purpose of this institution is to upgrade skills and competencies of the talent pool to provide quality healthcare; and its areas of intervention are limited to skills upgrading initiatives in areas the existing formal structure is unable to address. With that in mind, the Allied Health Centre of Excellence does not compete with existing allied health educational players, where around 90% are found in the business of providing basic care education such as nursing schools. Instead the centre intends to focus on providing highly specialised training programmes and aims to proliferate post-basic training in the Northern Region in order to address the widening backlog.

Operating principles
The centre operates on a demand-driven model, providing courses only where a genuine need exists. It builds a network of special interest groups, allied health professionals and doctors, and uses this platform to proliferate highly specialised training programmes within the healthcare industry. It has been able to secure funding from the federal government to invest in capital infrastructure.

Breakthrough initiatiatives
Three areas across the skills spectrum requiring intervention have been identified. (See Product Portfolio.)

Challenges faced
The challenges lie in establishing its role within the complex nature of regulatory requirements across the various ministries, and in convincing the powers that be for recognition of its programmes for national rollout. As in the case of its post-basic programmes, the centre hopes to become the recognised partner of the Ministry of Health to provide these courses in the Northern Region, and hence alleviate the pressure on government resources and overcome the widening backlog of nurses in queue for specialised training.

Moving forward
Within a few months of its conception, the centre has collaborated with various special interest groups such as the Penang Paediatrician Network (PPN), and forged strategic alliances with established universities such as International Medical University (IMU), the Parkway Group and Sime Darby Nursing and Health Science College. The PPN is the private initiative of a group of paediatricians across various hospitals with a similar goal to raise the calibre of paediatric nurses and personnel and it was easy to marry both sets of objectives, utilising the centre as a platform.

Dr Pong Kwai Meng, a neonatologist, leading a group of nurses on procedures of resuscitation on a neonate, done on a manikin during a neonatal resuscitation programme session organised by the centre.

In the long run, the Allied Health Centre of Excellence aims to churn out a larger pool of highly competent and specialised healthcare professionals. It will do this by positioning itself as a non-competing but complementary skills upgrading institution to existing players; by integrating the training needs of public and private healthcare personnel; by establishing a shared services facility that will house fully equipped simulation labs, libraries and resource networks; by engaging industry experts to join the panel of trainers and content developers and by proliferating first on a regional basis, the ease of accessibility to high-end specialist training.

Poh Heem Heem is the senior manager for Special Projects & Consultancy at the PSDC.