Ensuring quality in healthcare calls for a coordinated, systematic, congruous, and sustained approach. Nevertheless, it demands defining what the quality of healthcare means in the local context. Presently, the Malaysian healthcare system utilizes various definitions of quality of healthcare across the different initiatives and levels of healthcare, which can lead to fragmented or ineffective quality improvement. The study aims to describe the process undertaken in developing an explicit definition of the quality of healthcare tailored to the Malaysian context, which is currently lacking. A pluralistic method was used to explore the different perspectives. Three distinct approaches were used to understand how quality is defined among the different stakeholder groups: (i) interactive policy-makers engagement sessions, (ii) a review of local quality related documents, and (iii) an online survey engaging the public. The domains depicting quality of healthcare that emerged through these three approaches were mapped against a framework and synthesized to form the local definition of quality. A national quality-related technical working group convened on several sessions to achieve consensus and finalize the definition of quality of healthcare. Quality healthcare in Malaysia is defined as providing high-quality healthcare that is safe, timely, effective, equitable, efficient, people-centred, and accessible [STEEEPA] which is innovative and responsive to the needs of the people, and is delivered as a team, in a caring and professional manner in order to improve health outcomes and client experience. The consensus-driven local definition of healthcare quality will guide policies and ensure standardization in measuring quality, thereby steering efforts to improve the quality of healthcare services delivered in Malaysia.

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has increased the demand for personal protective equipment (PPE), prompting a need to assess its usage among healthcare workers following established guidelines and ensure its rational use. This study aimed to assess the knowledge, attitude, and practice (KAP) of PPE use among healthcare workers (HCWs) in Ministry of Health (MOH) facilities during the COVID-19 pandemic and to determine the predictors associated with good KAP. Methods: This cross-sectional study was conducted from February to March 2021. The study utilized an online, anonymous, self-administered questionnaire which was pretested and content-validated. The final questionnaire consisted of 28 items and was distributed among HCWs working directly with patients/specimens/close contacts in the MOH facilities. Descriptive and inferential analyses were performed using Statistical Package for Social Sciences 26.0. Results: A total of 3132 respondents were included in the analysis after the exclusion criteria. 87.7% of HCWs possessed a good knowledge of PPE, 71.1% had a positive attitude, and 10.2% showed good practice. Formal training and having a good attitude and knowledge were significant predictors for good knowledge and positive attitude, respectively, while age, gender, state region and HCWs’ designation were the significant predictors of good practice. Conclusions: Most HCWs possessed good knowledge and positive attitude on PPE use but low magnitude on practice in terms of following guidelines, suggesting a gap between the level of knowledge and attitude and the actual practice. This necessitates additional education and training approaches to promote compliance with guidelines and ensure the rational use of PPE.