- Introduction
- Vision, Mission & Objective
- Organisation Chart
- Services
- Clinic Schedule
- Client Charter
- Related Information
Introduction
The Department of General Medicine was first established in 1870, making it one of the largest and earliest departments in Hospital Kuala Lumpur. Initially, this department began to function through one outpatient clinic and two wards, namely Ward P1 and P2. Since then, it has grown and now consists of a specialist clinic with 10 subspecialty clinics, 26 medical wards with 543 beds and about 1000 staff from various categories.
Vision
- Treating their disease and educating them to achieve the best possible outcomes.
- Creating awareness on their disease and health, which is a priceless asset.
- Promoting ways to maintain a better and healthy good quality lifestyle to prevent future disease and complications.
- Educate our residents in best practice of evidence-based medicine and professionalism.
- 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.
- 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.
- To promote researches and audits to ensure and improve service quality.
- 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
Organisation Chart
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:
1) 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
2) Advance / Acute Internal Medicine
a) Outpatient service :
i) General Medicine Clinic
ii) Physician Visiting Klinik Kesihatan Kuala Lumpur (Every 3rd week of Tuesday 8am to 2pm)
iii) Combine physician & obstetrics outpatient clinic in the Maternity Hospital, Kuala Lumpur
b) In patient Service:
i) General Medical Wards
ii) High Dependency ward
iii) Dengue wards
iv) Tuberculosis Wards/Isolations wards
v) 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.
3) 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)
4) Infectious Diseases
a) Providing daily inpatient services to medical and non-medical wards with regards to general infectious diseases and HIV care
b) Managing patients in TB ward and isolation
c) ID rounds in Institut Jantung Negara (IJN) every Tuesday afternoon
d) Genitourinary Medicine (GUM) clinic every Tuesday morning at Dermatology clinic
e) Antimicrobial Stewardship (AMS) rounds every Thursday morning in medical wards
f) Combine clinic with Department of Oncology every Thursday morning, in managing patients with HIV and Kaposi Sarcoma (when required)
g) ID clinic every Friday morning
5) Rheumatology
a) Diseases which are managed by the unit include
- inflammatory arthritides (eg rheumatoid arthritis, psoriatic arthritis)
- crystal arthropathies (eg gout)
- spondyloarthropathies (eg ankylosing spondylitis)
- metabolic arthropathies
- degenerative conditions (osteoarthritis)
- systemic lupus erythematosus
- scleroderma
- Sjӧgren’s syndrome
- antiphospholipid syndrome
- systemic vasculitides (eg eosinophilic granulomatous polyangiitis, polyarteritis nodosa)
- osteoporosis
- inflammatory myopathies (eg dermatomyositis, polymyositis)
- fibromyalgia
- soft tissue rheumatism (eg trigger fingers, rotator cuff tendinitis)
b) Services offered by the unit are:
i) Outpatient services, including daycare service
ii) Daycare services include intravenous infusions (cyclophosphamide, biologics, zoledronic acid, methylprednisolone) and intramuscular methotrexate injections
iii) Inpatient services
iv) Specialised procedures: joint aspirations and injections, musculoskeletal ultrasound, polarised light microscopy for crystal identification, nailfold capillaroscopy
v) We work closely with colleagues in respiratory medicine, nephrology, dermatology, neurology and obstetrics in order to provide the best care possible to our patients.
vi) 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.
6) Haematology
a) Outpatient Hemato clinic - level 8 SCACC, 0800-1400 monday 2x/month. New cases and follow up cases
b) Consultative hematology - inpatient referrals (diagnostic & therapeutic except treatment of Hemato malignancies)
c)Radiosynovectomy (RS) for hemophilia arthropathy in collaboration with Radionuclear & Paediatrics/paed surgery)
7) 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.
8) Palliative Care Service
a) Consultative
i) referrals from all disciplines within HKL including gynae WCH
ii) referrals from IPR
b) Outpatient
i) Every Thursday 2pm-5pm in Radiotherapy Oncology clinic
ii) Visiting clinic to IPR every Tuesday 8am-1pm
iii) Adolescent Palliative Transition Clinic in WCH first Wednesday every month
c) Service
i) malignant cases requiring Symptom Management, patient and family support, Complex End of Life care
ii) non-malignant cases life limiting illnesses requiring Palliative Care
9) Endocrinology Service
a) outpatient
b) inpatient
a) 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 |
b) 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
10) 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) |
Clinic Schedule
Days | Morning 8.00 am - 1.00 pm | Evening 2.00 pm - 5.00 pm |
Monday | - General Medicine Clinic - Endocrinology Clinic - Rheumatology Clinic - Warfarin Clinic - Haemato Clinic - Heart Failure Clinic | - Endocrinology Clinic - Geriatric Clinic - Cardiac Clinic |
Tuesday | - General Medicine Clinic - Endocrinology Clinic - Rheumatology Clinic - Warfarin Clinic - Heart Failure Clinic | - General Medicine Clinic - Heart Failure Clinic - Geriatric Clinic |
Wednesday | - General Medicine Clinic - Endocrinology Clinic - Rheumatology Clinic - Warfarin Clinic - Valvular/Heart Failure | - Obesity Clinic - Heart Failure Clinic - Combined Clinic |
Thursday | - General Medicine Clinic - Endocrinology Clinic - Rheumatology Clinic - ID Clinic | - Cardiac Clinic - Endocrinology Clinic (TYPE 1 DM) - Geriatric Clinic - Haemato Clinic |
Friday | - General Medicine Clinic - Heart Failure Clinic - Warfarin Clinic - ID Clinic - Daycare Rheumato |
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% |
Related Information
Location Of Specialist Clinic
1) General Medicine Specialist Clinic :
Level 2 ,Specialist Complex And Ambulatory Care Centre ( SCACC ) , HKL
2) Gastroenterology Specialist Clinic:
Level 1 , Main Block , HKL
3) Infectious Disease Specialist Clinic :
Level 2 ,Specialist Complex And Ambulatory Care Centre ( SCACC ) , HKL
4) Rheumatology Specialist Clinic:
Level 2 ,Specialist Complex And Ambulatory Care Centre ( SCACC ) , HKL
5) Hematology Specialist Clinic :
Level 2 ,Specialist Complex And Ambulatory Care Centre ( SCACC ) , HKL
6) Wound Care Unit :
Level 8 ,Specialist Complex And Ambulatory Care Centre ( SCACC ) , HKL
7) Endocrinology Specialist Clinic:
Level 2 ,Specialist Complex And Ambulatory Care Centre ( SCACC ) , HKL
8) Geriatrik Specialist Clinic :
Level 2 & 8 ,Specialist Complex And Ambulatory Care Centre ( SCACC ) , HKL