Jamuna Jairaman | Leadership in Medicine: Southeast Asia
At Sunway Medical Centre in Malaysia, Jamuna Jairaman, Assistant Director of Allied Health Services, has stepped up to meet a host of challenges the organization has faced during COVID-19. This includes finding ways to stretch existing resources in order to conduct and process 1,000 RT-PCR nasal and throat swab tests per day, while continuing to maintain high quality standards for all of the lab services and prevent staff burnout. Throughout the world, health care leaders are being pressed in similar ways to meet the increased demands caused by the pandemic.
To build up her leadership skills and maximize her effectiveness, Jairaman is currently participating in Harvard Medical School’s Postgraduate Medical Education’s Leadership in Medicine: Southeast Asia. This one-year certificate program supports new and emerging health care leaders in Malaysia, Southeast Asia, Australia, and the Pacific region. She recently shared her insights as to how the pandemic has impacted her organization and as an emerging leader, why she decided to partake of the Harvard opportunity. She also shared some of the strategies her organization has adopted to help them move forward.
What does your position involve?
I’m responsible for overseeing and managing the Laboratory Services for Sunway Medical Centre. This is comprised of Core Pathology Laboratory, Molecular Diagnostic Laboratory, and Special Haematology Transplant Laboratory. I’m also charged with operating the services in the most effective and efficient manner in order to yield excellent operational results, customer service delivery, and stakeholders’ return. In addition, I manage new business development and implementation of services related to these departments, which are in line with Sunway Medical Centre’s expansion business plan and strategic direction, as well as in conformance to regulatory requirements. Finally, I lead the Quality and Risk Management Initiatives within the Allied Health division. This involves working closely with the head of departments to review, design, and implement quality framework to conform to accreditation standards and statutory requirements.
Since COVID-19 became such a serious concern in Malaysia in March of 2020, I continue to handle all of these responsibilities—but the pandemic has also resulted in many changes to how we deliver our services. As a result, the pressures I face on the job are now magnified.
Can you give some examples of how the pandemic has impacted your organization?
At the beginning of the pandemic, we were facing service disruptions even for non-communicable diseases such as cardiovascular, diabetes, and hypertension. Common reasons for reducing services were due to cancellations of planned treatments and postponing wellness screenings, since people were hesitant to go to hospital to seek for treatment.
I was urged to expand COVID-19 testing at Molecular Diagnostic Laboratory; initially, we had a capacity of 160 tests/day, but this ramped up to 500 tests/day and subsequently 1000 tests/day. I had to look at the resources available at that point of time, in terms of man power, equipment for both extraction and PCR, supply, and space, and determine how best to scale them up to meet the need that exists.
How have you responded to these and other challenges?
Since the start of the pandemic, we have implemented a number of new approaches to respond to these challenges, including:
- Reassigning staff to meet changing needs.
- Creating a business continuity plan (BCP), which consisted of two different teams scheduled at different shifts in order to practice social distancing among co-workers and continuity of service.
- Building telemedicine capacity for direct-to-consumer care, including patient-friendly options with mobile platforms and branding our own app that enables patients to communicate with us right from their phones.
- Providing drug delivery direct to the patient; in many cases, the medication is now delivered right to the patient’s home.
- Offering home services for phlebotomy.
- Continuously educating our team on the new norms, which include adhering to the 3Cs (avoid Crowded places, avoid Confined places, and avoid Close conversation) and 3Ws (practice Washing hands, Wear masks, and Watch your distance).
- Redesigning protocols and pathway to suit the pandemic situation.
I was also required to be part of the COVID-19 taskforce team. My responsibilities include providing updates on the new platforms that we are evaluating for rapid PCR services, staying on top of the stock level of COVID-19 test kits, tracking the census being tested per day, and handling an array of challenges at the operational level.
What other pressures are you facing — and are these long-term pressures or new ones because of COVID-19?
We are currently facing many long term tensions, including those that existed before COVID-19 and also new pressures that have arisen as a result of the pandemic.
Being in a profit driven organization, some of the ongoing pressures we have long been dealing with include a strong focus on meeting revenue and cost savings goals on a consistent basis. Furthermore, the health care industry in Malaysia has proliferated over the last decade. This is clearly manifested in the private health care sector; however, private hospitals in Malaysia are predominantly located in the adjoining cities of Kuala Lumpur and Selangor in Klang Valley where customers are educated, more discerning, and demanding with regard to service quality. It is clear that informed customers of health care centers are able to read and understand alternatives to the services offered, thus allowing them to evaluate quality more critically.
In addition to these pressures, we now have many new ones that have resulted from the current state of the world. This includes: the fact that implementation of a business continuity plan (BCP) during movement control order (MCO) has led to half strength of staffing. Further, the skill mix is really crucial in designing a proper BCP plan. Proper scheduling with zero overtime is also a huge challenge. Deployment of staff to COVID-19 services requires me to fast track the training process while ensuring we are still meeting high standards of quality and that we have tested safety measures in place.
Are you finding it harder now than ever before to lead?
I would not say it’s harder, but I would say it’s more challenging to lead now. I am working with people of all ages, and I find that the management skills vary by generation, so we are not always speaking the same language. Furthermore, in this current pandemic situation, I need to constantly motivate the team members who are overwhelmed with performing COVID-19 testing. I also must find ways to prevent burnout, try to automate some of the manual processes and think both within and also outside of the box, to find new ways to align people with different roles to work as a unified team, and cultivating a culture that emphasizes how together we can achieve more. The significant increase in workload as a result of COVID-19 also means I need to find ways to ensure sustainability of all of the changes we make.
What strengths are you drawing on to help you lead right now?
Based on my personality trait, my leadership type is a DOVE, which has characteristics such as: people orientated, deeply loyal, friendly, hardworking, and a great team player. I do feel these are essential qualities required for effective leadership. Basically, I am the subject matter expert in terms of laboratory services; therefore, in my current organization, I am always challenged with expansion of new services and technologies such as laboratory automation, streamlining the workflow, and expansion of new services. Besides my technical specialty, I would say my greater strength is attention to detail. I’ve always been detail-oriented in my work, and it’s something I enjoy with so much dedication and enthusiasm.
Why did you decide to participate in the Harvard Leadership Program?
I am part of a career development program called Excel in My Career and Leadership (ExCeL) @ Sunway. This led me to enroll in the Harvard program, which builds on some of the areas covered in the ExCeL program. The Harvard program will definitely be a good grooming ground and will provide me with more in-depth health care leadership skills, financial analysis tips, quality improvement tools, and an array of knowledge via the case studies obtained in the modules and workshops.
What do you hope to get out of the Harvard programs?
My hope is that by attending this program, I will be able to work on my personal development. Specifically, I want to improve my communication skills, teamwork, and ability to think critically. It is also an opportunity for me to network with health care leaders from other countries, including those in India, Thailand, Vietnam, Australia, and Singapore. I am very impressed by the other participants of this program and with the fact that they share their experiences and ideas so openly. Through this forum, I feel like we will all learn a lot from each other.
Information regarding COVID-19 has rapidly evolved. The content in this article provides a historical snapshot of events surrounding the date of posting.
Learn more about Harvard’s Leadership in Medicine: Southeast Asia.
Written by Lisa D. Ellis