Healthcare sector has emerged as one of the fastest growing segments over the last few years despite the global economic downturn. Healthcare sector in Malaysia has been nominated as one of the National Key Economics Areas which targeted to generate massive income for the country while maintaining the level of excellence services offered. The determination shown by the government in healthcare has been supported by both public and private healthcare institution of the country. Although, healthcare service excellence is upmost important issue being debated, hospitals in Malaysia are still facing with many issues especially neglected medical cases and patient waiting time. This issue is closely related to continuous improvement practices in the hospital. Therefore, this study focuses on the development of appropriate 5S-Kaizen measurement scales and service excellence in hospital. There are four identified antecedents of service excellence to be evaluated based on the implementation of 5S-Kaizen practices.  The four antecedents are staff performance, service environment, service process level, and customer emotion. All scales were gathered from previous literature and have been adapted to the context of Malaysia. In future, the scale can be validated at public hospitals and private hospitals; hence, the goal under the 10^th Malaysia Heath Plan to maintain healthcare sector current growth rate can be succeed.