Head of Department YBrs. Dr. Yau Weng Keong
Phone 03-26155690/6996    
Fax 03-26923021
Email This email address is being protected from spambots. You need JavaScript enabled to view it.

BACKGROUND

The Department of General Medicine was first established in 1870, making it one of the largest and the earliest department in Hospital Kuala Lumpur.  Initially, the department started functioning through one outpatient clinic and two wards, namely Ward P1 and P2.  Since then, it has grown and now consists of specialist clinics, 22 medical wards with 495 operational hospital beds and approximately 1000 staff of various categories.

 

VISION

To be leaders in Internal Medicine providing best effective appropriate care, collaborative, holistic and innovative patient’s care in sustainable manner.

 

MISSION

Compassionate highly trained professionals to improve health through clinical care, research and education to our community.

To become the centre of excellence, use evidence-based medicine to provide the highest quality and comprehensive patient-centred care through partnership with the patients and their caregivers by;

  1. Treating their disease and educating them to achieve the best possible outcomes.
  2. Creating awareness on their disease and health, which is a priceless asset.
  3. Promoting ways to maintain better and healthy good quality lifestyle to prevent future disease and complications.

Educate our residents in best practice of evidence-based medicine and professionalism.

 

CORE OBJECTIVES

 1) Provision of Holistic Patient Care as a team in the Specialty of Medicine and Medical Subspecialties, including curative, rehabilitative, preventive, promotive aspects using appropriate technology.

 2) Training of doctors and all medical staff in the various grades such as house-officers, medical officers, postgraduate student in the Master of Medicine programme, specialist as well as assistant medical officers and nurses especially with regards of subspecialty training to provide prompt, safe and efficient services.

 3) To promote researches and audits to ensure and improve service quality.

 4) To create safe and conducive working atmosphere and environment for the members of The Medical Department to work as a team to achieve their fullest potential in excellent performance.

 

CLIENT CHARTER 

1

Percentage of hypertensive patients with blood pressure ≤ 140/90 mmhg as measured in the General Medicine Outpatient Clinic

≥ 40%

2

Percentage of patients with waiting time of ≤ 90 minutes to see the doctor at General Medicine Outpatient Clinic

≥ 90%

3

Non ST elevation myocardial infarction (NSTEMI)/ Unstable angina case fatality rate

≤ 40%

 

ORGANISATION CHART

 

 

 

 

CLINIC SCHEDULE 

 

8.00 am - 1.00 pm

2.00 pm - 5.00 pm

MONDAY

-General Medicine Clinic (Level 2)

-Endocrinology Clinic  (Level 2)

-Rheumatology Clinic (Level 2)

-Warfarin Clinic (Level 2)

-Haematology Clinic (Level 2)

-Infectious Disease Clinic (Level 2)

-Gastroenterology Clinic(Old block)

-Geriatric Cognitive Clinic (Level 8)

-General Medicine  (Level 2)

- Endocrinology Clinic  (Level 2)

-Geriatric Clinic (Level 2)

-Obesity Clinic (Level 2)

TUESDAY

-General Medicine Clinic (Level 2)

-Endocrinology Clinic (Level 2)

-Rheumatology Clinic (Level 2)

-Gastroenterology Clinic(Old block)

-Geriatric Cognitive Clinic (Level 8)

-General Medicine Clinic (Level 2)

-Heart Failure Clinic (Level 2)

-Incontinence Clinic (Level 8)

WEDNESDAY

-General Medicine Clinic (Level 2)

-Endocrinology Clinic (Level 2)

-Rheumatology Clinic (Level 2)

-Warfarin  Clinic (Level 2)

-Geriatric Cognitive Clinic (Level 8)

-General Medicine Clinic (Level 2)

-Obesity Clinic (Level 2)

-Valvular (Level 8)

- Geriatric Falls And Movement Disorder Clinic (Level 8)

THURSDAY

-General Medicine Clinic (Level 2)

-Endocrinology Clinic (Level 2)

-Rheumatology Clinic (Level 2)

-Cardiac Rehabilitation Programme

-Gastroenterology Clinic(Old block)

-Geriatric Cognitive Clinic (Level 8)

-Cardiac Clinic (Level 2)

-Endocrinology Clinic( TYPE 1 DM) (Level 2)

-Geriatric Memory Clinic  (Level 2)

 

8.00 am – 12.15 pm

2.45 pm - 5.00 pm

FRIDAY

-General Medicine Clinic (Level 2)

-Rheumatology Clinic  (Level 2)

-Endocrinology Clinic (Level 2)

-Infectious Disease Clinic (Level 2)

-Warfarin  Clinic  (Level 2)

-Gastroenterology Clinic(Old block

-Mild Cognitive Impairment Clinic (Level 8)

-General Medicine Clinic (Level 2)

 

SERVICES

The department will continue to provide secondary and tertiary care of patients in the specialty of Internal Medicine and medically related subspecialties Endocrinology, Geriatrics, Coronary and Critical Care Medicine, Gastroenterology, Infectious Disease, Haematology, Rheumatology, Palliative and Wound care Medicine.

Current services of the established subspecialties within the department are listed below:

 

General Internal Medicine

a) Outpatient services

i. General Internal Medicine clinic

ii. Combined physicians & obstetrics outpatient clinic in the WCH, Kuala Lumpur

iii. Cardiology related Clinic : Heart Failure Clinic, Cardiac Rehabilitation Clinic, Valvular Clinic, Heart failure Clinic, warfarin Clinic and Novel anticoagulant Clinic.

iv. Non Invasive laboratory/ testing : Cardiac exercise stress test, Echocardiograpy, Spirometry, 24 Hour ambulatory BP

v. Medical Pre-operative assessment Clinic

vi. Visiting Physician Clinic to KKKL

 b) Inpatient services

i. Coronary Care Unit (CCU)

ii. Cardio Rehabilitation Ward (CRW) Unit

iii. Echocardiography service

 

Advance / Acute Internal Medicine

Outpatient service :

- General Medicine Clinic

- Physician Visiting Klinik Kesihatan Kuala Lumpur (Every 3rd week of Tuesday 8am to 2pm)

- Combine physician & obstetrics outpatient clinic in the Maternity Hospital, Kuala Lumpur

 

In patient Service:

General Medical Wards

High Dependency ward

Dengue wards

Tuberculosis Wards/Isolations wards

Medical Admission Unit (MAU):-

 

Aim:

- To improve quality of care / fasten up diagnosis and management for Short Stay patients.

- To improve / expedite admission to medical wards and decongest Emergency Department so than patients receive early commencement of medical treatment and nursing care.

 

     25 bedded ward – short stay mixed ward.

     Mobile MAU team – managing patients awaiting medical beds in Emergency Department

     Fast Clinic – early, short term review clinic for patient’s needing early review from    

     discharge from Emergency Department and MAU.

 

Gastroenterology

a) Gastroenterology and hepatology outpatient services

b) Inpatient services

c) Endoscopic services: upper endoscopy (OGDS-diagnostic and therapeutic), colonoscopy (diagnostic and therapeutic), ERCP (diagnostic and therapeutic), endoscopic ultrasound, oesophageal manometry (including management of achalasia cardia) and 24 hour ambulatory pH studies and placement of percutaneous endoscopic gastrostomy

d) 24 hour emergency endoscopy services (haemetemesis and malena)

 

Infectious Diseases

- Providing daily inpatient services to medical and non-medical wards with regards to general infectious diseases and HIV care

- Managing patients in TB ward and isolation

- ID rounds in Institut Jantung Negara (IJN) every Tuesday afternoon

- Genitourinary Medicine (GUM) clinic every Tuesday morning at Dermatology clinic

- Antimicrobial Stewardship (AMS) rounds every Thursday morning in medical wards

- Combine clinic with Department of Oncology every Thursday morning, in managing patients with HIV and Kaposi Sarcoma (when required)

- ID clinic every Friday morning

 

Rheumatology

Diseases which are managed by the unit include

  1. inflammatory arthritides (eg rheumatoid arthritis, psoriatic arthritis)
  2. crystal arthropathies (eg gout)
  3. spondyloarthropathies (eg ankylosing spondylitis)
  4. metabolic arthropathies
  5. degenerative conditions (osteoarthritis)
  6. systemic lupus erythematosus
  7. scleroderma
  8. Sjӧgren’s syndrome
  9. antiphospholipid syndrome
  10. systemic vasculitides (eg eosinophilic granulomatous polyangiitis, polyarteritis nodosa)
  11. osteoporosis
  12. inflammatory myopathies (eg dermatomyositis, polymyositis)
  13. fibromyalgia
  14. soft tissue rheumatism (eg trigger fingers, rotator cuff tendinitis)

 

Services offered by the unit are:

a) Outpatient services, including daycare service

    - Daycare services include intravenous infusions (cyclophosphamide, biologics, zoledronic acid, methylprednisolone) and intramuscular methotrexate injections

b) Inpatient services

c) Specialised procedures: joint aspirations and injections, musculoskeletal ultrasound, polarised light microscopy for crystal identification, nailfold capillaroscopy

 

We work closely with colleagues in respiratory medicine, nephrology, dermatology, neurology and obstetrics in order to provide the best care possible to our patients.

The unit also provides postgraduate subspecialty training for candidates of the Master of Medicine, Rehabilitation Medicine and Family Medicine programmes, and the Geriatrics and Acute Internal Medicine fellowships.

 

Haematology

  1. Outpatient Hemato clinic - level 8 SCACC, 0800-1400 monday 2x/month. New cases and follow up cases 
  1. Consultative hematology - inpatient referrals (diagnostic & therapeutic except treatment of Hemato malignancies) 
  1. Radiosynovectomy (RS) for hemophilia arthropathy in collaboration with Radionuclear & Paediatrics/paed surgery)

 

Wound Care Unit

The Wound Care Unit was started in 2014 at Level 8, SCACC.

a) Outpatient services

b) Inpatient services include all wards in Hospital Kuala Lumpur except the surgical wards.

 

Palliative Care Service

Consultative

- referrals from all disciplines within HKL including gynae WCH

- referrals from IPR

 

Outpatient

 - Every Thursday 2pm-5pm in Radiotherapy Oncology clinic

 - Visiting clinic to IPR every Tuesday 8am-1pm

- Adolescent Palliative Transition Clinic in WCH first Wednesday every month

 

Service

- malignant cases requiring Symptom Management, patient and family support, Complex End of Life care

- non-malignant cases life limiting illnesses requiring Palliative Care

 

Endocrinology Service

1) outpatient

2) inpatient

Outpatient Clinic :

Monday

Endocrine Clinic

800 am -12 noon

 

Insulin Clinic with General Medical ( Type 2 DM )

200 pm - 5 pm

Tuesday

Endocrine Clinic

800 am -1 pm

Wednesday

Endocrine Clinic

800 am -1 pm

 

Endocrine Clinic

800 am -1 pm

 

Combined Neuroendocrine

1st Wednesday every month 200 pm - 5 pm

 

Combined O&G Clinic

2nd & 4th Wednesday every month 200 pm - 5 pm

Thursday

Endocrine  and thyroid Clinic

800 am -1 pm

 

Type 1 DM   Clinic

200 pm – 5 pm

Monday, Tuesday , Thursday

Dynamic test/Study

Short Synacthen Test

OGTT – for GH suppression or prolonged OGTT

Insulin Tolerance Test

Glucagon stimulation test

Prolonged fasting test ( 72 hours ) – may begin as inpatient and continue as inpatient

Saline Suppression test

Water deprivation test

 

 

Inpatient Service  ( via referral ):

Diabetic emergencies

Diabetes in pregnancy

Type 1 DM

Young DM ( less than 40 years old )

Difficult DM ( prior management by other physicians )

Thyroid emergencies

Perioperative care for pituitary, thyroid, parathyroid and adrenal cases

Perioperative care for functioning neuroendocrine tumours like insulinoma , carcinoid syndrome

Severe hypercalcemia > 3 mmol/L  or severe hypocalcemia < 1.8 mm0l/L

Severe hypernatremia > 150 mmol/L  or severe hyponatremia < 120 mmol/L

Severe hypophosphatemia < 0.4 mmol/L

Non – diabetic hypoglycaemia

Adrenal insufficiency

 

Geriatrics

The geriatrics unit HKL received its first patient on 17th July 2003 with initial bed strength of 10 beds, it is now accommodating up to 20 patients.   It is managed by four geriatricians, two medical officers, a Matron, a Sister and a team of nurses and attendants.  Geriatric Unit of HKL is essentially a multidisciplinary team comprises of pharmacist, dentist, old age psychiatrist, physiotherapist, occupational therapist, speech therapist, dietitian, medical social worker.

Services include:

a)  Outpatient and daycare services

b)  Comprehensive Inpatient services that include Acute, Subacute and Rehabilitative Wards

c)  Domiciliary services

 

08.00-1300

14.00-17.00

MONDAY

GERIATRIC ASSESSMENT CLNIC

GERIATRIC COGNITIVE CLINIC

(ACC 8TH FLOOR)

GENERAL GERIATRIC CLINIC

(ACC 2ND FLOOR)

TUESDAY

GERIATRIC ASSESSMENT CLNIC

GERIATRIC COGNITIVE CLINIC

(ACC 8TH FLOOR)

GERIATRIC CONTINENCE CLINIC

(ACC 8TH FLOOR)

WEDNESDAY

GERIATRIC ASSESSMENT CLNIC

GERIATRIC COGNITIVE CLINIC

(ACC 8TH FLOOR)

GERIATRIC FALLS AND MOVEMENT DISORDER CLINIC

(ACC 8TH FLOOR)

THURSDAY

GERIATRIC ASSESSMENT CLNIC

GERIATRIC COGNITIVE CLINIC

(ACC 8TH FLOOR)

GERIATRIC MEMORY CLINIC

(ACC 2ND FLOOR)

 

08.00-1215

14.25-17.00

FRIDAY

GERIATRIC MILD COGNITIVE IMPAIRMENT CLINIC

(ACC 8TH FLOOR)

 

Research 

The Department is actively involved in researches  in various areas of internal medicine. A focus in dengue research has been developed and it has expanded its collaborative programmes with Institute of Medical Research and local universities. The Department continues to engage with new and potential research partners.

Training

Training of House Officers and Medical Officers are held within the medical ward rounds and the CME programmes held within the department.

Interactive post graduates classes and lectures for House Officers and Medical Officers are also held every week, concentrating on Acute Medicine and case managements with regards of the Internal Medicine and other subspecialties under Department of Medicine.  There classes are supervised by Specialist and Consultants.

The department is actively proactive in research, training and striving to maintain Total Quality Care through its continuous quality improvement pursuits.

This department is also the location of training placements for the Advanced Diploma in Nursing and also the Post-Basics for Wound Care for Assistant Medical Officers

 

CONTINUING MEDICAL EDUCATION (CME)

Our Department has regular CME program on every Wednesday afternoon.  It is normally presented by house officers, medical officers, medical specialist and chaired by the senior Consultant.  Topics presented are mainly about the latest updated on the management of the diseases or morbidity or mortality case discussions. Occasionally, other subspecialties/departments are also invited to share their expert opinion and latest update on certain topics.

The morbidity and mortality meetings are also held every week at each ward level to review all the cases.  The meeting serves not only as the part of the internal auditing but also as part of the learning process for the doctors.

Journal Club Meetings are also held within the department.  This is mainly to update or highlight the latest treatment within the subspecialty.

Radiology/Medical meetings are also held on every Thursday afternoons at the Radiology Department to discuss the cases with regards of diagnostic imaging such as X Rays, CT scans, MRI, etc with Radiologists.  This is also a learning session for presenting Medical Officers and Interns.

 

 

Head Of  Sub-specialty Unit

 

Ketua Jabatan

DR. YAU WENG KEONG

Pakar Perunding Perubatan Kanan (Geriatrik)

GRED KHAS B

 

Ketua Unit Critical Care

DATUK DR. NOEL THOMAS ROSS

Pakar Perunding Perubatan(GIM)

Timb. Ketua Jabatan

GRED KHAS C

Ketua Unit Reumatologi

DR. ONG SWEE GAIK

Pakar Perunding Perubatan (Reumatologi)

GRED KHAS C

Ketua Unit Endokrinologi

DATUK DR. MOHAMED BADRULNIZAM BIN LONG BIDIN

Pakar Perunding Perubatan (Endokrin)

GRED KHAS C

 

Ketua Unit Penyakit Berjangkit

DR. LEONG CHEE LOON

Pakar Perunding Penyakit Berjangkit

GRED KHAS C

Ketua Unit Geriatrik

DR. RIZAH MAZZUIN BINTI RAZALI

Pakar Perubatan (Geriatrik)

GRED UD56

Ketua Unit Perubatan Dalaman

DR. SAIFUL SAFUAN B.MOHD SANI

Pakar Perubatan (GIM)

UD56

Ketua Unit Palliative Care 

 DR AARON HIEW WI HAN

Pakar Perubatan (Palliative Care)

GRED UD56

Ketua Unit Haematologi

 DR. SHARIFAH SURYANI BT SYED RAHIM SHAH

Pakar Perubatan

GRED UD56

 

Ketua Unit Penjagaan Luka

DR. HARIKRISHNA A/L K. RAGAVAN NAIR

Pegawai \perubatan

Gred UD54

Ketua Unit Gastroenterologi

DR. NOOR ALIZA BINTI ABD MUTALIB

Pakar Hepatologi dan Gastroentrologi

GRED UD56

 

 

 

 

GENERAL MEDICINE CLINIC

 

 

THE DRESSING PROCEDURE IN WOUND CARE UNIT

 

THE ECHOCARDIOGRAPHY IN NON-INVASIVE CARDIO LAB 

 

 

 

 

 

 

 

 

 

 

 

 

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