This document outlines the key considerations for planning and implementing a new healthcare service, including: 1) Identifying the need for the service based on evidence of clinical need, case burden, or policy requirements. 2) Determining the necessary resources, personnel, equipment, medications, policies, and collaborations required to establish and run the service. 3) Developing standard operating procedures that detail patient flow, roles and responsibilities, quality indicators, and standards to ensure the service is delivered safely and effectively.

2. Why is this
service needed?
What is needed
for this service?
How will the
service run?
How do I ensure
quality of the
service?
How do I ensure
continuity of
the service?

3. Personal
interest?
Policy
requirement?
Clinical
needs?

4. Buy-in and support
To apply and obtain resources for
the running / operation of the
service
To keep the service running
• Hospital Pengarah? District Health Officer?
• State Health Dept? Ministry of Health Malaysia?
• Community stakeholders
• Dasar Baru
• Posts for human resources
• Operational budget
• Legacy
• To inspire others to start similar
services

5. Evidence of benefit from similar
interventions/service
Case burden, unmet needs
Anecdotal needs,
expert opinion
• Clinical benefit
• Cost effectiveness
• Impact to patient,
family and
community• Annual or monthly census
• Morbidity and mortality
reports
• Clinical audit

6. Human resource Equipment &
infrastructure
Medications Collaboration Policy / administrative
support
• Medical officers,
medical assistants,
nurses,
rehabilitation and
therapists etc
• Training needs,
skill sets
• Home visit bag,
dressing sets
• Vehicle
• Space –
daycare,
counselling
room
• Essential
medications
• System to
support
access to
medications
• Tertiary
hospital
support
• Community
NGO linkage
• Pharmacy and
nursing
administration
• Referral criteria,
terms of service
• Operational budget
• Standard operational
procedures

7. Plan a service flow that will fit in to current services
Consider the different phases
Patient identification
Referral process
Service details
Termination of service / transition to adult services / transition to
community
Who is in charge of each step of the service flow? E.g. patient assessment by nurse / MA / MO?
Which steps / processes where the service will interact with others / collaboration? E.g.
Community NGO / leaders, procurement of equipment via MSW
A detailed SOP is required for the proposal for service to request for budget

8. Quality assurance
Ensuring patient safety and standard of care
Process
Steps in the SOP, work process
Indicators
e.g. Referrals received
are seen by specialist
within 72 working
hours.
Standards
e.g. 80% of referrals
received are seen by
specialist within 72
working hours.
Clinical
Clinical outcomes, patient satisfaction
Indicators
e.g. Patients receiving
pain management
should have pain score
of 0-3.
Standards
e.g. 90% of patients
receiving pain
management should
have pain score of 0-3.

9. Ensure that safeguards for
patient safety is in place
Ensure that you are trying to
achieve an acceptable standard
in providing service/care
Scrutiny by hospital or district
health office administration –
justify that the budget provided
is used properly
Benchmarking and
accreditation – for
policymakers, stakeholders

11. Have I managed to convince everyone that this
service is essential?
Is this service a good fit for my setting (hospital,
community)?
Have I managed to secure and sustain the minimum
resources required for the service to run?
How do I pass on the knowledge and skills?
• Clear SOP documents
• Two-by-two staff
• Regular training sessions and
deep learning