Publication: THE CRITICAL HOUR: FAST TACK SURGERY AS A STRUCTURED RESET AT PANTAI HOSPITAL LAGUNA MERBOK (PHLM)
| dc.contributor.author | DR. MUHAMAD ASYRAF BIN AHMAD AZHARI | |
| dc.date.accessioned | 2026-07-29T00:27:58Z | |
| dc.date.available | 2026-07-29T00:27:58Z | |
| dc.date.issued | 2026 | |
| dc.description.abstract | Malaysia’s private healthcare sector is approaching a critical inflection point. Rising medical inflation, increasing surgical demand, constrained bed capacity, and tighter insurer utilisation controls have exposed the limitations of traditional inpatient-centric surgical care models. Medium-sized hospitals face growing difficulty sustaining efficiency and financial viability while maintaining clinical standards. This Management Project explores fast-track surgery as a strategic response to these pressures, using Pantai Hospital Laguna Merbok (PHLM) as the reference case. Grounded in Enhanced Recovery After Surgery (ERAS) principles, fast-track surgery restructures perioperative care by optimising preoperative preparation, standardising intraoperative practice, accelerating postoperative recovery, applying objective discharge criteria, and strengthening post-discharge follow-up. International evidence consistently demonstrates that such models can safely reduce length of stay (LOS) while improving throughput and patient experience. Analysis of PHLM’s operational data from 2023 to 2025 reveals average LOS ranging from 1.7 to 2.9 days, fluctuating bed occupancy between 56% and 82%, and continued inpatient utilisation for procedures increasingly managed as short-stay or day-case elsewhere. Insurer feedback further indicates heightened scrutiny of admission appropriateness and LOS compliance. These findings suggest that even modest LOS reductions across high-volume procedures could release meaningful bed capacity and improve operational flow. In response, this project proposes a phased 18-month fast-track surgical implementation framework, adapted to PHLM’s infrastructural limitations, including the absence of a dedicated Daycare Centre and Ambulatory Care Centre (ACC). The framework emphasises early LOS optimisation within existing inpatient pathways, followed by gradual expansion supported by outpatient-based follow-up and structured evaluation. While centred on PHLM, the project reflects broader national challenges, including uneven ambulatory capacity, cultural expectations of inpatient recovery, and the absence of a standardised fast-track framework in Malaysia. The study concludes that fast-track surgery represents a necessary structural reset for private hospitals. In an environment where inefficiency is increasingly unsustainable, the critical hour for surgical care redesign has arrived. | |
| dc.identifier.uri | https://hdl.handle.net/20.500.14377/37819 | |
| dc.language.iso | en | |
| dc.publisher | IMU University | |
| dc.subject | Enhanced Recovery After Surgery | |
| dc.subject | Time Factors | |
| dc.subject | Perioperative Care | |
| dc.subject | Patient Safety | |
| dc.subject | Quality Improvement | |
| dc.subject | Clinical Protocols | |
| dc.subject | Hospitals, Private | |
| dc.subject | Workflow | |
| dc.title | THE CRITICAL HOUR: FAST TACK SURGERY AS A STRUCTURED RESET AT PANTAI HOSPITAL LAGUNA MERBOK (PHLM) | |
| dc.type | Thesis | |
| dspace.entity.type | Publication | |
| oairecerif.author.affiliation | #PLACEHOLDER_PARENT_METADATA_VALUE# |