Our sign is up!!

Our signboard is up. Make sure the majlis perbandaran license number is clearly indicated. It's on a light timer from 7pm till 11pm.

Inspection day!!

Today, MOH ckaps team came for inspection of my clinic. We prepared some drinks and simple food for them. They came in a group comprising of 2 doctors and 4 medical assistants with a laser measurement device. Unfortunately, we passed everything except for our treatment room which was short by 0.3m (required was 2.4m, ours was 2.1m) hence we have to alter the partition. Our contractor was compliant to the alteration. This goes to show that MOH is strict when it comes to the mandatory requirements of the structural planning. All I have to do now is alter, snap a picture and email them together with an updated floorplan. Then they will submit my application and we wait for their meeting to authorize the running of my clinic. Extra learning points is that they measure a clearing of a room, hence if there's a built in wall cabinet, they will measure from the cabinet to the wall. Extra forms that they requested were my resignation approval letter from MOH human resources putrajaya and an updated mmc certificate bearing my new clinic name. Phew!!! That was quite an experience.... 

Almost there!

Finishing touches done today. It's beginning to look more and more like a clinic. Hoping that the inspection will go smoothly. 

Finalization for inspection

The time is almost near. The date for MOH inspection is just around the corner and we have made efforts to clean the clinic area up and prepare the required resources for inspection. They will do an infrastructure inspection first so drugs are not required yet. If we pass this, next would be the pharmacy inspection. Then, we will be good for opening. We are praying that everything goes smoothly. I will update the progress as we go along. Wish us luck!! 

How to open a clinic part 2

6. MBSA license
Its imperative that the license is done as soon as possible. Mine was with MBSA. For your own clinic, its considered as a sole proprietor , hence a business association (sdn bhd) is not needed. There's no need for an SSM number. If you plan to open branches in the future, its recommended that you form a company to manage the clinics under you. For now, if you're opening the clinic on your own, all you need is your MMC number. Bring along your MMC and APC (annual practice) certificate with the other forms to MBSA. If you're willing to wait, the licence  process takes 5 weeks, but they also provide a 1 hour processing service which comes with a fee. The file number that comes with the license goes on your signboard.

7. MMC/APC
Change of address of APC. If you plan to open a new bank account for your clinic, and even for MOH registration, they would like your APC to be updated to your current clinic. Go to the Malaysian Medical Council in Jalan Cenderasawi with a copy of the KKM approval to open a clinic letter and request for them to amend the address on your APC. This will take 4 weeks to complete. This can be used to open a new bank account for the clinic and to register your clinic with UKAPS KKM.

Our counter

Our counter is complete. It looks exactly the way we want it. 

Closure!!

Our doors have finally arrived. As it was custom made, we were supposed to wait for 2 weeks but it took them 4 weeks to complete. As I said, expect unexpected delays. At least there's closure...

Our plastic bag, sticker, receipt and MC artwork format.

It has been finalized, our plastic bags, stickers, receipt and MC format. There are a few companies out there that provide this service to clinics. Look them via your drug rep. Prices may vary but they always sell in big bulks. Very big bulks. So choose wisely... 

Medical Supply

Our medical supply arrived on 5th dec 2013. This was just half of the things we need and it was costly however necessary. There are specific medical equipments that are mandatory to have in the clinic by MOH rules such as the oxygen tank, nebulizer, sterilizer, ECG machine and so on. A list is given. Some are best purchased, and some can be taken on a lease basis (especially the expensive ones like an ultrasound or fbc machine). Apparently, medical equipments are not cheap. So look around for used ones or substitutes that are within the requirements to save costs. And scout around from different medical suppliers who offer the best price. Ours are from 4 different companies. We are waiting for the other half of the supply soon. Hopefully, when everything arrives, then we can settle the drugs/medications. Phew!!! 

Pharmacy

The pharmacy is taking shape. Spent 5 hours building the shelves and chairs. Getting old and slow. But it was worth it.

Delays

Unexpectedly, there is a delay in renovation. Doors are still pending. There were leaks from the piping which needs rectifying. And small other tid bits that need addressing. All my drugs and medical equipments are put on hold waiting for the final completion of the clinic. Learning point: foresee delays in renovations. Plan for worse case scenario. 

Glass door installed

It costs a bomb to buy but gives the unique look and effect. Furthermore, it keeps the Aircond in.

New Least of Color.

Our owner was kind enough to paint the exterior of the shoplot. Now it looks new and stands out among the crowd with the new color scheme that he chose. Thank you!!

Arrival of Furniture

Furniture now slowly trickling in. 

Artist Concept for Front Counter

A 3d art concept was produced by our renovator. Needs a few more changes. 

Renovation Progress as of 31st October

Undercoat and painting. Air conditioning and lights installed. Toilet tiles replaced. 

A New Learning Point

Apparently, prior to obtaining a signboard license, we have to get the final confirmation certificate from MOH before applying. They are expecting the license number of the clinic to process the signboard forms. That was something new I learned today. The clinic is 80% complete. Hopefully everything goes as planned and I could start operations mid November. 

Signboards

Ok... I'm in the midst of obtaining a signboard. The application form is from the majlis perbandaran: lighted or non. There's a fee to pay: rm 180 non lighted. Rm 120 lighted. Then prepare a sketch or picture of the signboard with the intended words including their measurements. The name is then submitted to Dewan bahasa dan pustaka for proof reading (inclusive if the picture). This can be done online. They will email back the certificate of approval. Once everything is officially approved, get the signboard. So far I scouted, i costs rm1850 for an illuminated signboard. Phew!!! So much procedures...... 

Renovation Progress

Rooms completed. Unifi installed. Now skimming the surfaces. Next for lights, air conditioning, painting and doors. 

Majlis perbandaran.

Ok... I've made a mistake. MBSA partition and renovation license must be obtained first before renovation starts. I'm halfway into the renovations. Looks like I have to settle this with majlis perbandaran. I've learned something new....

Renovation progress

Pharmacy and treatment room partitions forming. 

Renovation progress 21/10/2013

Rooms are forming, partition frames erected. Janitor sink and closet completed. 

Requirements and regulations under Jabatan Kesihatan Negeri Selangor

A copy of the requirements and regulation by JKNS. Any differences to the requirements require a letter of cause by the owner or developer (Eg: my exit door cant be knocked down to 1.2m due to the beams, hence my owner released a letter of support to allow the exception which KKM will approve).

Here we go!! :

SAMPEL Senarai Semak Pemeriksaan Pasca Pendaftaran Klinik Perubatan, Akta Kemudahan dan
Perkhidmatan Jagaan Kesihatan Swasta 1998 dan Peraturan-Peraturan Kemudahan dan Perkhidmatan
Jagaan Kesihatan Swasta (Klinik Perubatan Swasta atau Klinik Pergigian Swasta) 2006
1
MEDICAL CLINIC ID NO. : ………………….........
REGISTRATION NO. : ………………………… DATE OF REGISTRATION : …………………...
NAME OF PREMISES : ………………………………………………………………………………..……
ADDRESS OF PREMISES : ………………………………………………………………………………..……
: ………………………………………………………………………………..……
TYPE OF SERVICES : General Outpatient
Specialist Services Specify ……………………………………….
OPERATING HOURS :……………………………………………………………………………………..
TYPE OF PRACTICE : Solo Group
NATURE OF BUSINESS VENTURE : Solo Corporate Body Society Partnership
NAME OF HOLDER OF COR : ……………………………………………………………………………….
NAME OF PERSON IN CHARGE : ……………………………………………………………………………….
DATE AND TIME OF INSPECTION : ….………………………………………………………………………..
NAME OF INSPECTOR(S) : ……………………………………………………………………………………..
………………………………………………………………………………………
Please ( 􀀹 ) in the appropriate boxes
PART I – DOCUMENTS INSPECTION
REG. ITEMS COMPLY Yes No COMMENTS
ORGANISATION & MANAGEMENT
R.8. Person in Charge
Current APC
Qualification
R.9. Other Healthcare Professional Staff
Current APC
Qualification
R.20. Minimum Information Captured in Attendance,
Referral and Death Register – name, full IC number, age,
gender
R.22. Staff Register with Qualification, Full Registration No., Address and Tel. No.
RMP – Permanent/Temporary (including Locum)
Other Staff -
R.30. Appropriate Patient Medical Record System with
Minimum Information – with legible writing – to include
date & time of consultation & examination, diagnosis,
Treatment, doctor’s chop (name & MMC No.) Assistants
first name
POLICY AND PROCEDURE
R.14. Written Policy
(1) Provision of written policies on–
(b)
Procedure of patients registration, attendance and
referrals
Incident reporting
SAMPEL Senarai Semak Pemeriksaan Pasca Pendaftaran Klinik Perubatan, Akta Kemudahan dan
Perkhidmatan Jagaan Kesihatan Swasta 1998 dan Peraturan-Peraturan Kemudahan dan Perkhidmatan
Jagaan Kesihatan Swasta (Klinik Perubatan Swasta atau Klinik Pergigian Swasta) 2006
2
(c)
(d)
Infection control including notification
(h)
Transportation of laboratory specimens
R.27. Patient Grievance Procedure
R.71. Organised Maintenance Programme
R.108. Fee Schedule
OTHERS
R.35. Arrangement for Vector Control
R.54. Arrangement or Agreement for the Management of
Hazardous Waste
PART II – FACILITIES AND SERVICES INSPECTION
SECT/R
EG. ITEMS COMPLY Yes No COMMENTS
ORGANISATION AND MANAGEMENT – TO BE EXHIBITED
S.28. Certificate of Registration (COR)
R.7. Organisation Chart
R.15. Policy Statement
(a)-
(c)
Staff Identification/Billing Procedures/
Patient’s Rights
R.24. Duty Rosters of HC Professional Staff
R.74. Emergency Call Information
SPECIAL REQUIREMENTS FOR PHARMACEUTICAL SERVICES
R.82. Storage and Maintenance of Poison and Dangerous Drugs
In accordance to the Dangerous Drugs Act 1952
R.83. Stored and Dispensed Medications Appropriately
Labelled
R.84. No Expired Drugs in Premises
R.86. Maintenance of Cold Chain for Vaccines as instructed in
the WHO’s Booklet “Safe Vaccine Handling, Cold Chain and
Immunization.”
SPECIAL REQUIREMENTS FOR RADIOLOGICAL OR DIAGNOSTIC IMAGING SERVICES
R.93. Valid Atomic Energy Licence for Radiological or
Diagnostic Imaging Services
GENERAL PROVISIONS FOR STANDARDS OF PRIVATE MEDICAL CLINICS
R.34. Location of Private Medical Clinics
R.41. Appropriate Signage and Labeling
R.36. Adequate ramps for patients in wheelchairs / on
stretchers.
R.37. Doors
(1) Main Entrance, Consultation and treatment room doors ≥
1.2m clear opening
(2) Toilet doors ≥ clear 0.9m and not swing inwards
(6) No doors (except closet doors) swing into the corridors
SAMPEL Senarai Semak Pemeriksaan Pasca Pendaftaran Klinik Perubatan, Akta Kemudahan dan
Perkhidmatan Jagaan Kesihatan Swasta 1998 dan Peraturan-Peraturan Kemudahan dan Perkhidmatan
Jagaan Kesihatan Swasta (Klinik Perubatan Swasta atau Klinik Pergigian Swasta) 2006
3
R.38. No carpets in surgical/clinical room, stairs, toilets,
bathrooms.
R39. Ceiling
(1) a Aircond. room –2.4m floor to ceiling high
b Non aircond. room –3.0m floor to ceiling high
STANDARDS FOR OUTPATIENT FACILITIES AND SERVICES
R.90. General requirements
(1) Not a thoroughfare
(2) Type of facilities commensurate with type of services
(3) Minimum basic facilities provided–
(a) Adequate waiting area
(b) Administrative/Financial facility/area
(c) Toilet
(e) Dirty/Clean utility room/area
R.91. Medical Outpatient Services
(1) No. of consultation room(s)
(a) Minimum dimension of 3.0m and minimum area of
11.1m2
(b) Facilities available
(i) Clinical Handwashing facilities – backsplash, wall
mounted tissue/paper towel holder, wall-mounted
soap dispenser, no or closed overflow holes,
(ii) Examination light
(iii) Storage of supplies and equipment
(iv) Dressing cubicle or area
(v) Screen
(vi) Film illuminator
(2) Treatment room
(a) Minimum dimension of 2.4m and minimum area of 8.0 m2
(b) Facilities available
(i) Clinical Handwashing facilities – backsplash, wall
mounted tissue/paper towel holder, wall-mounted
soap dispenser, no or closed overflow holes,
(ii) Examination light
(iii) Storage of supplies and equipment
(iv) Dressing cubicle or area
(v) Screen
(vi) Film illuminator
(3) Minor surgery room
(a) Minimum dimension of 2.4 m and minimum area of 8.0
m2
(b) Facilities available
(i) Scrub sink
(ii) Liquid detergent dispenser
(iii) Operating light
(iv) Storage room or area
(v) Screen
(vi) Film illuminator
(5) Adequate and sufficient sterilising facility – location
above waist level, away from patient couch or high
activity area, not cramped among other equipments, not
too far/close from/to equipment washing sink
SAMPEL Senarai Semak Pemeriksaan Pasca Pendaftaran Klinik Perubatan, Akta Kemudahan dan
Perkhidmatan Jagaan Kesihatan Swasta 1998 dan Peraturan-Peraturan Kemudahan dan Perkhidmatan
Jagaan Kesihatan Swasta (Klinik Perubatan Swasta atau Klinik Pergigian Swasta) 2006
4
(6) Adequate linen and equipment storage room or area
R.75. Basic Emergency Care Services (Referring to 5th Schedule)
(9) Provision of basic emergency equipment, apparatus, materials–
(a) An emergency call system
(b) Oxygen
(c) Airways and manual breathing bag
(d) IV supplies
(e) Electrocardiogram
(g) Suction equipment
(h) In-dwelling urinary catheters
(i) Drugs and other emergency medical equipment/supplies
deemed necessary
R.45. Plumbing
(2) Dedicated Sink for cleaning utensils and equipment with
exhaust fan for the area
‘J’/’S’ shape outlet piping for sinks in clinical rooms
R.51. Adequate Ventilation
R.52. No Exposed Sewer Line at Work/Clinical Area
R.54. Appropriate Management of Hazardous Waste – no selfdispose
method, ‘yellow plastic lined’ pedal operated bins in
clinical rooms, regular pick-ups of disposed item.
R.55. Organised Housekeeping – all materials properly
arranged, clean floor and furnitures, pedal operated bins for
non-hazardous waste in clinical rooms,
R.65. Proper Linen Processing – in house/
outsource
R.43. Janitor’s Closet or Area – with mop washing sink, hooks
to hang mop/cleaning items, rack for storing detergents,
adequate ventilation.
OTHERS
o Infrastructures as per Submitted Floor Plan
If No, please comment below
COMMENT(S):
..............................................................................................................................................................
..............................................................................................................................................................
..............................................................................................................................................................
..............................................................................................................................................................
..........................................................................................................................................................
Visit Done By, Received by,
1. ................................
2. ................................
.................................................
Name: Name: Name:
Designation: Designation: Designation:
Date: Date: Date:

Progress pictures

Plaster ceiling is up, sink tiles assembled.

How to open a clinic in Malaysia , part 1

Ok... As concise as I can, in point form, how to open a general practitioner private clinic in Malaysia.

1. Location location location

- make sure you scout all the potential areas for a suitable place to set up a clinic. Population, commercial and industrial areas, financial status, growth and development, costs, convenience, image. Many factors influence the future prospect of your clinic. Although if there are other clinics around, a healthy competition is welcomed. Usually a shop lot is required. Ensure ample parking and a populated area.

2. Obtain the premises.

- if you own the lot, then it's a breeze. If you rent, prepare 3 months rental payment plus 1 month for utilities. Then the tenureship agreement will be signed. 

3. Approach MOH for borang A

- approach the state MOH jabatan kesihatan to obtain borang A (application for opening GP clinic). Instructions are included in the form on what documents to prepare and how to submit. An online version must also be submitted on medpcs.com and printed out for submission. Prepare money order or bankers cheque of RM 500 for processing fee. Once forms are completed , submit with all the required documents and a floorplan of 1:100.

4. Floorplan layout

- this is crucial as many criterias are needed to get this approved, such as corridors 1.2m wide, janitor closet...etc..work closely with your contractor to draw out the plan (I'll include a few samples later). The layout is not standard so feel free to be creative as long as it falls within the kkm plan criteria. Layout mostly includes consultation room, treatment room, pantry, counter, pharmacy and dispensary. You can add a Surau or play area for kids if space permits.

5. Approach your Majlis perbandaran (once approval of clinic renovation is obtained from kkm)

- go to majlis perbandaran to get approval for partition... Prepare payment of RM 100 per room.. Get their form

- once partition forms filled up and submitted, head for approval of sign board. To fill up another form there with the concept art for the sign.

- license for business will be given there . Prepare RM 200.00 

- charges for box light signboard RM 120 and without light RM180. 

- once partition form n signboard forms filled, submit and within an hour, license is approved.

To be continued....

Behind the Scenes.

Although we've been posting pictures of the renovation and groundwork progress, there's actually more procedures taking place behind all this. The Ministry of Health protocols, paperwork, blueprints, pharmaceuticals, medical equipment, manpower and the lot.

Within the next few posts, I'll highlight the step by step guide on how to startup and establish a new clinic from scratch. From an empty shoplot to a full functioning clinic. 

Let me get myself organized first before I start....

Progress day 4

Further progress on our clinic. Piping, sink and ceiling. 

3 Matra Klinik Novamedik

What the title means is 3D images of the clinic. Our contractor's team was able to produce a 3D rendering of our future clinic. It's partially complete for now but later, we could literally insert the selected tiles, color and furniture. Will update further on the images.

Day 2 renovation

The janitors closet and deep sink is taking place. Piping going through the walls. 

Renovations Begin.

As of 1st October 2013, renovations of Klinik Novamedik begins. A total sum of close to RM 40k will be used to set up the clinic. Our intentions for the design would be a contemporary modern minimalist. Let's hope it turns our the way we planned it. Construction should take 20 days.    

Welcome to the Birth of Klinik Novamedik

In the following moments, we will embark on a journey together, to the birth of Klinik Novamedik, Subang Bestari, the brainchild of Dr M.Shazli and Dr Murnilina. From humble beginnings of an empty shop lot to a new functioning general practice clinic. We will highlight the procedures and protocols for opening a GP and the fundamental works that go behind erecting a medical facility, from renovation, to pharmaceutical purchases, to hiring/training staff and equipments. We will learn along the way and may make mistakes in the process, but all for a good cause.

Later, once the the clinic is completed and functioning, patients later can visit this blog for further information or inquiry about the clinic.

Let the journey begin.....

(Key hand over was on 26/9/2013)