Life @SGH Campus Jul/Aug 2013 by Singapore General Hospital

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Joining the ranks

A Research force to be reckoned with

Learning in his bones

May Day Award winner shares his lifelong passion

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FĂŞte de la Musique comes to campus The day music lived everywhere

LIFE at SGH Campus | Jul/Aug 2013

bench press

Tink Tank on campus

class act Engineering in Medicine

music fest

The day SGH campus transformed into a soundscape

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integrated care

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Caring for "Esther"

Caring for “Esther”

passion for learning in his bones

May Day Award winner Chittoo Suppiah shares his lifelong joy of learning

“Esther” is not a real person. She was invented by a team of healthcare professionals in Sweden. Her persona as an ailing but competent woman with a chronic condition and occasional acute needs has inspired improvements in how patients flow through a complex network of care providers and settings in Sweden.

joining the ranks

Outstanding researchers among our Allied Health Professionals

SingHealth, under the leadership of Prof Fong Kok Yong, our Group Director (Medical), is similarly reviewing our strategies to improve coordination of care for patients across the different settings. Advisor Tan-Huang Shuo Mei

in every issue 16 18 20 22 23 24

quality pulse spree in action campus buzz time out your take the last page

contents

Contributors Office of Integrated Care, Estee Chan, Geoffrey Gui, Chia Kuok Wei, Ratna Abdul Rahman, Vanessa Peters, Jennifer Wee, Claudia Yeo, Mumtaj Ibrahim, Carol Ang, Michelle Scully, Goh Sai Luan Distribution General Services Dept, Helen Yang On the Cover Dr Andrea Kwa, Dept of Pharmacy and Dr Pua Yong Hao, Dept of Physiotherapy share their research stories. ----------Life@SGH Campus is published every two months in print and online by the SGH Communications Department

He gave the example of the Esther Project at the Care Integration Retreat in May, organised by the SGH Office of Integrated Care. The event brought together more than 80 healthcare professionals and social service experts from SingHealth, government agencies and partners in the Intermediate and Long-Term Care sector. We are also developing new models of care with partners in the primary care sector. As part of the government initiative to tap on capacity and expertise in the private sector, we will be setting up a Family Medical Centre in partnership with General Practitioners. Located in Chinatown, it will serve to provide team-based outpatient care for patients in the community.

“Care integration is more than integrating clinical pathways or protocols between clinical specialties. It also involves integrating with social care, or care in the community, in order for us to be effective in caring for the population’s health.” — PROF FONG KOK YONG,

Group Director (Medical)

LIFE at SGH Campus | Jul/Aug 2013

up close

focus

Passion for learning in his bones

Brought to you by Office of Integrated Care

979. Straight out of National Service, with only a PSLE education, 20-year-old Chittoo Suppiah had no idea what to do but knew he wanted to work. An army officer suggested joining SGH.

Integrated care 101

Mum’s special remedy

What is integrated care?

It is an approach to bring together different healthcare professionals involved in the care of a patient so that the services are coordinated and seamless. The desired outcomes are improved patient/client experience and satisfaction and enhanced quality of care, quality of life and other health-related outcomes.

Why do we need to do this?

As our population ages, many of them have complex chronic diseases which require them to be cared for by different clinical specialties. This has invariably resulted in the fragmentation of healthcare delivery. Fragmented care is costly, suboptimal and potentially harmful to the patient. All the hard work put in to help the patient often gets unravelled when the patient is discharged from the hospital. Integrating care brings better outcome by addressing the issues caused by fragmentation and the lack of social support. Effective care integration increases the job satisfaction of healthcare workers and frees up more time for other areas of work such as teaching and research.

Why us?

We are the largest Academic Healthcare Cluster, with expertise spanning the entire continuum of care – from primary care in our SingHealth polyclinics to longterm community care at Bright Vision Hospital. Our colleagues are dedicated and innovative. We are well placed to take the lead in creating a new paradigm of care through integration.

What are we doing to integrate care?

Within SGH, various departments have come together to develop new models of care which are centred on the needs of our patients and seek to close the loop of care with our partners in the community. We are also continually establishing linkages with the primary care and step-down care sectors to ensure that patients transit safely back to their community and their homes after discharge. By providing information and resources, we can also empower patients to take better care of themselves.

Suppiah’s first job at SGH was as a health attendant in the Operation Theatres which were then situated at the old mortuary in Norris Block (near present-day Health Promotion Board). He was required to clean the patient trolleys, equipment and floors of the theatres between operations. The early days were especially challenging because of his fear of being near the mortuary and aversion to blood. “After work, I would go home, still with frayed nerves and unable to eat anything – except for my mother’s special spicy Indian porridge!” he shared.

Appetite for learning

Eventually, the young man became used to blood and thrived in the surgical environment. There was so much to know and learn. Suppiah’s thirst for knowledge and support from colleagues led him to go for in-service training to upgrade himself. In time, he trained as a member of the ancillary staff team in various surgeries. Starting with Ear, Nose and Throat operations, he went on to General Surgery, Plastics, Neurosurgical and Colorectal surgeries. Finally, Suppiah spent two years acquiring the necessary know-how specifically in Orthopaedics. His secret to successful learning? “Asking. I am always asking questions, even till today. “

No bones about it

Suppiah’s favourite department is Orthopaedic Surgery and this is truly where his heart lies. No

bones about it, he lights up when asked why. “Oh, I love everyone here - all the nursing staff and all the doctors. Everyone helps and supports each other and they have always been willing to share their knowledge.” When pressed, he reveals, “it’s my favourite because it has the most instruments, the most equipment, even different types of surgery tables because of the variety of operations.”

Teacher Suppiah

34 years later, Suppiah now works as an Operating Theatre Technician, taking charge of equipment and surgery positioning aids in orthopaedics surgeries. “Now, when the doctor names any surgery, in a few minutes, I can prepare the instruments, and I know what equipment will be used,” he beams confidently. No mean feat when he starts explaining the complexity of the set-up. Today Mr Suppiah has also become a teacher – he has been training junior staff for the last 10 to 15 years. His dedication to continuous learning has earned him the NTUC May Day Model Partnership Award this year. He credits all his teammates for their belief and support. Yet at the end of the day, “The best part of the job is helping patients. It is very touching when they come back and say thanks. Some will come with cakes and flowers!” When asked if he sees himself working another 34 years here, he responds: “I love SGH very much. So yes, yes – so long as my mind and hands can work, I will work here.”

LIFE at SGH Campus | Jul/Aug 2013

feature Pharmacy Clinician Scientist Dr Andrea Kwa has won national and international recognition for her work in antibiotic resistance.

Joining the ranks Outstanding researchers among our Allied Health Professionals are becoming a force to be reckoned with. Their success in securing grants and gaining international recognition puts them among the ranks of Clinician Scientists in SGH and SingHealth. More than pushing boundaries in science, they are changing mindsets and helping to break down barriers between medical professions.

Timeline of change The early years

“Research in Physiotherapy is not new. We have always had to do a Research project in our final year of studies. But in the past, these were usually not sustained. Those who pursued research further were motivated purely by personal interest and did them in their own time, such as over the weekends,” said Ms Tan Bee Yee, Head of Physiotherapy. That was the typical state of research among Allied Health Professionals then.

From 2000

With exposure, especially during overseas training, more became aware of the importance of research. This was the experience of Pharmacy Clinician Scientist Dr Andrea Kwa and Principal Physiotherapist Dr Pua Yong Hao, both research mentors in the division. “My Health Manpower Development Plan (HMDP) training in the US in 2000 made me aware that practice must be backed by evidence. If we do not do our own research,

we are doomed to follow guidelines set by others which may not be applicable here,” said Andrea, who was then a Clinical Pharmacist working in critical care and infectious disease. The need to question came to Yong Hao even before he began work as a physiotherapist. “During my undergraduate studies in Manchester, I didn’t like that there were no definitive answers in physiotherapy. It wasn’t the truly scientific discipline that I would have preferred. I came to be considered a troublemaker in school, always asking “Are you sure this is working?” I just couldn’t see the evidence,” recalled Yong Hao. “After working a few years as a physiotherapist in a public hospital in Singapore, I decided to put myself through the rigors of a PhD programme, to put some intellectual backbone into my field,” said the scientist who studies strength and balance assessment and seeks high-tech low-cost solutions to predicting falls.

Strategist for Allied Health research Division Director Ang Hui Gek.

Turning point Frustrated with the lack of protected time to pursue research, Andrea quit SGH for a pharmaceutical company in late 2006. By then she has completed her Doctor of Pharmacy programme. Ang Hui Gek, Director of Allied Health Division, recalled the situation then. “The climate at the time was not conducive. Even the Heads of Departments were reluctant to release staff for research. So I had to be the one to be brave,” said Ms Ang, the visionary and strategist. “I decided that we would give identified passionate staff dedicated time for research. As a leader, you can’t wait for things to fall in place. You have to make things happen.” “Another strategy is to have trailblazers who can inspire and mentor aspiring researchers,” said Ms Ang. Through her personal persuasion, Andrea returned to SGH after just eight months.

Till present day

“The timing was right – the leadership was supportive; our joint proposal with microbiologists had secured a National Medical Research Council grant, and we had the expertise of my colleague Lim Tze Peng who had just completed his overseas training in research,” said Andrea.

To be right for an academic research path, Andrea embarked on a post-doctoral Research Fellowship with the University of Pittsburgh from 2010 to 2012 to hone her research skills in experimental methodologies. She also took on a new area in fungal diseases and antifungal resistance, which is an emerging problem. This was in addition to the in-vitro bacterial work that she has been familiar with since 2007. Being in a comfort zone is not “comfortable” to her at all, as a researcher. “I like to pre-empt emerging clinical problems by seeking out solutions via research before these problems come headlong in torrents.” A/Prof Celia Tan, who heads the training and research unit, courted physiotherapist Yong Hao to join SGH. He was with University of Melbourne, and already making a name with his many publications. “I decided to return. Deep in my heart, I felt that we needed to do something for Singapore Allied Health,” said Yong Hao. “I could capitalize on the strength of SGH, which is our high patient volume. Research here is more clinically relevant, and we have a good mix of patients. In a university, it is difficult to recruit enough participants for research,” said Yong Hao. “And I still get to work with my collaborators at the University of Melbourne.”

LIFE at SGH Campus | Jul/Aug 2013

feature “Mentoring also means giving

ALLIED HEALTH RESEARCHERS

(with grants and publications as Principal Investigators) Physiotherapy research trialblazer Dr Pua Yong Hao.

people the right perspective about what research is about. It can mean dampening their enthusiasm. I am dissatisfied that we have yet to translate research into clinical practice. It takes years to refine a hunch into a workable idea. That is the nature of research.”

First fruits Physiotherapy

Pharmacy

Andrea today heads a research team of three pharmacists in bench work, supported by medical technologists and use of a microbiology research laboratory. They have some 50 publications and grant of more than $2 mil to their name. She has also set up an Infectious Disease Pharmacotherapy Residency Program for Infectious Disease Clinical Pharmacists to-be, “to train logical thinking. Logical thinking makes you a better clinician and a better scientist.” “You cannot be a lone ranger in research. You have to train and “infect” others". Andrea continuously

Department

A/Prof Celia Tan

Allied Health Division

Dr Patsy Tan

Music Therapy

Dr Andrea Kwa

Pharmacy

Cai Yiying

Pharmacy

Jocelyn Teo Qi Min

Pharmacy

Liew Yixin

Pharmacy

Lim Tze Peng

Pharmacy

Winnie Lee Hui Ling

Pharmacy

Cindy Ng

Physiotherapy

Dr Dawn Tan

Physiotherapy

Dr Edwin Lim

Physiotherapy

June Quek

Physiotherapy

Ong Peck Hoon

Physiotherapy

Dr Pua Yong Hao

Physiotherapy

Dr Valerie Lim

Speech Therapy

Building partnerships

Today, Yong Hao is widely acknowledged as the ‘rainmaker’ in physiotherapy research in SGH. He has been involved in more than 20 research papers since 2009 and secured more than $500,000 in research grants. “Part of my work as a mentor is to convince my colleagues that we are doing cutting edge research. I used to be greeted by disbelief – ‘You mean we are really going to publish the data?’ They think that only academics can do it (publish their findings). And I tell them: ‘No more Mickey Mouse journals,’ ″ said Yong Hao.

Name

“We achieved a breakthrough in 2010 when the National Medical Research Council (NMRC) opened their grants to Allied Health Professionals who are Principal Investigators. Previously they were restricted to clinicians only,” said A/Prof Celia Tan who heads the Division’s research unit.

The Pharmacy research team led by Andrea has some 50 publications and grant of more than $2 mil to its name.

motivates her juniors with her poser: "Do you want to be doomed to always simply follow guidelines?” “What makes a researcher? It is down to the individual’s human traits. The kind of degree you have does not matter. A pharmacist can be a Principal Investigator (PI) just as a doctor may be a co-PI. What is important is that the different professions bring different skills to work together on a study and publish the results,” said Andrea. “If I have to do research in public healthcare, it will have to be SGH. Bosses here in Allied Health Division are not afraid of rocking the boat,” said Andrea.

“Collaboration in research is important as we need to work with clinicians, who refer patients for the studies. In addition, Allied Health Professionals now sit on various institutional research committees where policies and grant awards decisions are made. As a result, clinicians and leaders now understand our needs and challenges better. They have been helpful with advice and making changes, such as ring-fencing startup or seed funds for us, just to get some of the young researchers started.” “Another way forward is to share resources. We used to have to borrow the facilities at the Nanyang Technological University or Ngee Ann Polytechnic to measure patients’ mobility, for example. We are now working towards sharing the bio-mechanics laboratory at the Academia with the Surgical and Rehabilitation Medicine teams,” she said. “We have also started collaborations with researchers overseas, in the US, UK and Australia, as we don’t

A/Prof Celia Tan working together with Ngee Ann Polytechnic mechanical engineering students to develop a modified ankle foot orthosis device.

have many local champions for Allied Health research,” said A/Prof Tan. “The challenge for the Division today is to establish a viable career path to encourage the few who are really interested to embark on research. Having the research track in place will also help us retain talent when more Allied Health Professionals return from their PhD courses,” she said.

On the horizon

“Besides Pharmacy and Physiotherapy, the other professions are taking baby steps. I hope to see every department get involved in research to improve practice and care of our patients,” said Ang Hui Gek, Director of Allied Health Division. “Some are starting to pick up the pace, such as our Medical Social Workers. In 2016, Singapore will host the world congress for Medical Social Workers (MSW). Our MSWs have told me their goal is to contribute 20 out of the 50 papers from Singapore,” said Ms Ang, who never fails to inspire her staff. “Not all of us will become scientists. But neither is research exclusive to any profession or group. When you are curious, and you question, you are investigating or researching,” said Ms Ang.

LIFE at SGH Campus | Jul/Aug 2013

bench press

Doctor, inventor and Mr Roboto The DDO team reflects a unique multidisciplinary nature From left: Richard Lieu (Biomedics), Fiona Loke (Electrical Engineering), Dr Benjamin Chua (Vascular Surgery), Dr Henry Ho (Urology), Dr Luke Tay (Vascular Surgery), Dr Siow Weiming (Orthopaedics). (Not in picture) Dr Lim Chee Tiong (Nanomaterials)

The tinkers' tank

Imagine a place within the SGH Campus, where failure is accepted, creativity is allowed and having fun is a must; all in the name of improving patient care.

his ‘heaven’ is the Device Development Office (DDO) which works with clinicians to develop new medical devices. Formed in 2012, it was the vision of Professor London Ooi, Chairman of the Division of Surgery to include device development as a research core for Surgery ACP.

cultural and ergonomical factors which could affect a device’s adoption and use.”

A precursor to DDO projects is the Mona Lisa, a prostate biopsy robot which detects prostate cancer more accurately and safely. It was created by SGH Urologists Professor Christopher Cheng, Dr John Yuen and Dr Henry Ho, in partnership with engineers from the Nanyang Technological University.

Ms Loke, an inaugural recipient of the Singapore-Stanford Biodesign Fellowship, explained: “The clinical value, concept creation, and commercial availability of such devices involve an ecosystem of clinicians, scientists, engineers and industry partners working together during the various phases of design and development.”

The team in DDO is poised for expansion with big aspirations to train and inspire more clinician-inventors from most, if not all, departments to create innovative devices so that more patients can benefit.

Simply put, DDO is where patient care, technology, business and design meet.

DDO Manager Ms Fiona Loke who has a Masters in Electrical Engineering shares, "The DDO insists on engineers being attached to clinical environments to understand not only the clinical background of a problem but the economical, regulatory, infrastructural,

But if you think that developing medical devices involves just a few brainstorming sessions and engaging a company to create the device, think again.

So where’s the fun? Tinkering fun happens in the old school house down the slope in front of the A&E department and will eventually be within The Academia. This is where people can daydream, experiment and create prototypes. The prototypes may not work but build towards ones that do. DDO believes in “failing fast and often, for without failure, there can’t be success”.

Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission

Who are your mentors?

I am fortunate to have two mentors. Professor Christopher Cheng, Pro-temp CEO, Sengkang Hospital, taught me the analytical approach to surgical problems, while the current HOD, Dr Ng Lay Guat, imparted to me the art of being a surgeon. So whenever I am in doubt, I look to them for advice.

What inspired you to venture into medical technology / device development?

My journey started when I was just a urological trainee. We observed high infection rates and false negative results after transrectal prostate biopsy to detect cancer. To solve this, Prof Cheng, Dr John Yuen (Senior Consultant Urologist) and I obtained a series of grants to build prototypes for phantom, animal and eventually clinical studies. This led to multiple publications, awards and patents.

When Urologist Dr Henry Ho is not operating or seeing patients in the clinic, the Director of the Device Development Office (DDO) can be found brainstorming with his team or engaging industry partners to work on innovative medical devices. However, Dr Ho is motivated by only one cause: to improve clinical care and patient outcomes. Did you have to go through specialised training?

I was awarded the inaugural Singapore-Stanford Biodesign Fellowship for medical technology innovation in 2011. The training in Stanford was an eye-opener. Being in the epicentre of medical technology innovation, I was immersed in a culture and environment which encouraged open exchange of ideas and critical questioning between clinicians and engineers. As Singapore aims to achieve a similar stature, having clinicians with such exposure is a positive step forward in that direction.

Does being a urologist help you in your role as Director, DDO? Urologists embrace technological advances for our surgical practice. As a robotic urological cancer surgeon, cutting-edge

technologies such as the da Vinci Surgical System are an integral part of surgeries for prostate and kidney cancers. This complements my role as an advocate of device development and hopefully I can inspire clinicians in other specialties to do the same.

Give an analogy to describe your role as Director, DDO. I like to think of myself as a watchmaker. The master watch-maker wants to push the technical boundaries but is confined by the size of the watch. No one can wear a watch that is the size of a clock. This challenge is very similar to medical technology development. Devices have to be built with many patient considerations such as biocompatibility, long term resilience and so on. In fact, this is also where the fun is, when one is able to create a piece that solves clinical complexities.

Students trying out therapy devices that support patients who have weak lower limbs to stand.

class act

LIFE at SGH Campus | Jul/Aug 2013

Students familiarizing themselves with an Electrocardiogram (ECG) machine to record heart signals.

The nuts and bolts of Medicine

Teaching medicine to non-medical students A common grouse of healthcare professionals – devices available on the market do not meet our needs. This should come as no surprise as the curricular for engineering and medical students are independent of each other. Minding the gap

To close this gap, a multidisciplinary team from SGH and the National University of Singapore (NUS) Faculty of Engineering came together to develop and conduct Singapore’s first Engineering in Medicine module for Engineering students. Co-taught by the NUS engineering faculty and clinicians, nurses and allied health professionals in SGH, the module introduces engineering students to the realities and challenges they will face when developing practical solutions for rehabilitation medicine.

Learning realities

For three months last year, 15 second-year Engineering students from NUS interacted with patients suffering from stroke, Parkinson’s Disease, traumatic brain and spinal cord injuries, and observed first-hand how clinicians and therapists work with these patients. They also learnt the vocabulary, roles of the different specialists, the challenges and current treatment methods, and functions of state-of-the-art medical equipment with a focus on rehabilitation.

Soft skills for solid solutions

One of the students, Ms Koh Hui Lin, who is reading Bioengineering said, “Through interviewing patients and working closely with doctors and therapists, we understand patients’ needs better and hope to develop engineering solutions that can address these needs more effectively. This module has enabled me to refine my engineering ideas with clinical perspectives.” Added her classmate, Mr Teo Chong Ming, who is reading Mechanical Engineering, “To me, this module fulfills what engineering is all about – designing solutions to benefit people through the use of technology. Besides learning the ‘hard’ technical engineering skills behind product design, the module also helped to hone our ‘soft’ skills such as interviewing and understanding users̛ needs and problems.”

The students work in groups and present updates to their SGH mentors every six months. They will continue to work on their projects over three years, till the end of their degree course. Progress has been good, with one of the teams even winning the top prize for the Product Showcase category in the Startup@Singapore competition, which is the largest startup competition in Singapore. The second batch of students will begin their module in August this year. Though sustaining the programme is challenging, faculty are encouraged by the progress shown by the students, and are looking forward to furthering the collaboration so that more patients will benefit from the devices developed.

Designer engineers

These students are from a pioneer batch who are specializing in Engineering in Medicine (EIM) – one of the broad themes of the Design-Centric Programme offered by NUS’ Engineering Design and Innovation Centre. Said Dr Ng Yee Sien, Head and Senior Consultant, Department of Rehabilitation Medicine, who is the clinical course director, “The demand and importance of medical technology and engineering in medicine is exponentially rising. This is particularly so for rehabilitation, given the rapidly aging population and the rising prevalence for chronic disabling disease with advances in acute medical care.” Students learn about the challenges faced by patients. 1st Engineering in Medicine Course Cohort: Sept - Nov 2012

LIFE at SGH Campus | Jul/Aug 2013

focus

Day of laughter and music at SGH Campus

or the first time, SGH Campus came alive with the sound of music. More than 130 students, popular artists such as Asha, Jessica Irawan, Kimberly Creasman, Paris Chansons and our own in-house talents put up 30 hours of performances. These included Prof Foo Keong Tatt, Emeritus Consultant, Department of Urology, Medical Social Workers and medical students from NUS Yong Loo Lin School of Medicine who entertained at lobbies, wards, outpatient clinics, gardens and open spaces throughout campus.

Produced by Sing Theatre in collaboration with SGH, it is based on “Fête de la Musique”, a festival which originated from France in 1976 to celebrate the gift of music. Musicians from all walks of life perform for free at cafés, schools, museums and hospitals to bring joy to people.

The music galore culminated with a Concert Finale at Deck on 9 with performances by celebrities such as Sebastian Tan, Hossan Leong, Singapore Idol runner up, Jonathan Leong and George Chan. His Excellency Mr Olivier Caron, Ambassador of France to Singapore, was the Guest of Honour. Host Hossan Leong, the 43-year-old "Singapore Boy” had people in stitches with his routine about MRT incidents and of course the haze. Sebastian Tan performed his Broadway Beng persona and sang crowd favourites which had the patients and the audience swaying along. The icing on the cake was the finale dance by Maestro Antonio Vargas, who performed his well-known classical choral works in authentic Flamenco style. Volunteers from corporate sponsors Norvatis and Dragages also took part in Musicfest @ SGH as crew and ushers as part of their corporate social responsibility programme.

LIFE at SGH Campus | Jul/Aug 2013

quality pulse

Brought to you by Service Operations, a unit of Operations and Performance Management

Report it!

t the SOC Pharmacy, medication error can occur at any point during the processing of prescription. To minimise risk to patients and promote a culture of learning, Team Initiate looked at ways to improve reporting of near-miss incidents, i.e. errors which are caught in time before they reach our patients.

QI chat Senior Nurse Manager Priscilla Tan Lee Eng is the 2013 Quality Improvement (QI) Champion. Now with the Department of Emergency Medicine, she has 11 QI projects under her belt. Passionate, proactive, self-motivated, hardworking and a people person – these are words that have been used to describe her. 1. Congratulations on being QI Champion of the Year! What are your thoughts on getting this award?

The award is recognition of my team’s efforts and the QI work done so far. It is also motivation for us to continue our active involvement in QI projects and emphasises the importance of the QI culture in SGH.

2. When and how did you begin to be involved in QI?

My experience in quality management goes all the way back to 1998. I started as QIP team lead at Ward 64. The project - To reduce the time taken to prepare case notes for new cases - won the Gold Award at Team Excellence Innovation Quality Circles (TE-IQC).

3. Which project has left a deep impression on you?

That must be my most recent project - To improve the aesthetic appearance of a patient’s

The team analysed the potential root causes and found that Pharmacy staff had difficulty getting hold of the forms for near-miss reports. The forms were placed only at the end of prescription processing, which is at the point of dispensing. It was discovered from a patient safety survey that staff considered near-miss reporting to be “whistle blowing” and were therefore uncomfortable with reporting such incidents. case notes folder and to reduce frequency of replacing damaged case notes folders. The folders are now easier to prepare, saving time and costs. We have received positive feedback about the uniformity in organization of documents. Staff are also happy that they can use the time saved to provide better care for patients.

4. What qualities does a person need to make a QI project successful? Passion, leadership qualities and skills as well as effective communication. You also need to be a team player, and a customer advocate.

5. Do you have any advice for our colleagues embarking on QI projects?

Always look at the bigger picture, from an organisation's perspective. Strive to improve customer satisfaction and generate cost savings.

For the full interview, go to QI Net on the intranet at http://mysinghealth/SGH/Quality?QI-net/

Solutions

The team introduced two changes to improve reporting:  redesigning the form by reducing the size and number of fields staff are required to fill.  making the forms available and accessible at every stage of the pharmacy work process such as typing, checking, packing as well as dispensing. To nurture a culture of reducing medication error, the team also took other steps:  incorporating colour schemes to errorprone drugs as a precaution during the packing process;  introducing a medication safety notice board to share best practices and provide regular medication safety updates; and  using SMS reminders to quickly disseminate important medication safety information to pharmacy staff.

Color labels on drug bins to caution pickers about drugs with multiple strengths.

The outcome

At the end of the project, 60% more staff are reporting near misses. This is a clear indication of improvement in their level of awareness of patient safety.

Following the project, the implementation of the Outpatient Pharmacy Automation System in 2012 has significantly reduced the number of near-miss incidents.

What you missed QI Fest 2013

12th August 2013 | 12pm to 3pm | Deck on 9

FAST & CURIOUS

‘Dr Sherman Ong, Chief Development Officer from NCCS, shared on ‘Rapid improvement across Industries’.

Who is the winner of our first “Best RIE Project” award? Click here to find out: http://mysinghealth/SGH/Quality/QINet/QI+Fest+2013.htm

LIFE at SGH Campus | Jul/Aug 2013

spree in action

CEO Service Award 2013

The CEO Service Award is an annual award and the highest accolade given to the "best of the best" staff who are exceptional role models in service. This year we recognise four colleagues for their outstanding service:

AN SGH MOMENT

Roti, kaya and love “He reminded me of my father. If I were his daughter, I would not want him to go hungry. That’s why I decided to treat him to breakfast from Kaffe and Toast.” >

DR TOH SONG TAR, Consultant, Otolaryngology (ENT)

LEW LIAN CHOO, Senior Staff Nurse, Ward 63P

Enrolled Nurse Nur’ Akidah Binte Abu Bakar noticed the patient’s untouched breakfast tray when she went into the six-bedder room to retrieve a piece of equipment. She was not caring for patients in this room in General Surgery Ward (Ward 58). But it was way past breakfast time, so she was concerned.

Teams UP! Award 2013

“There were oatmeal and egg on the tray. But the patient did not want the oatmeal and was pantang (superstitious) about the egg being bad for his wounds,” said Ms Nur’ Akida.

The Teams UP! Award recognises cohesive teams working towards the best outcome and experience for our patients.

“So I offered to get him Milo and biscuits. But he said he would like bread with spread but did not have any money on him. So I told him I would help to get him some bread as I was about to go for my break.”

THE WINNERS FOR THE PERIOD FROM OCTOBER 2012 – MARCH 2013 WERE:  Ward 53A (ward category)  SOC - Clinic J (clinic/centre category)

Unsure of his preference, she bought him three flavours – strawberry jam, butter sugar and kaya. And when the daughter came by later to offer to pay for the bread, Ms Nur’ Akidah declined the money. “I was just happy to do it as though I was buying breakfast for my own father.”

THE MOST IMPROVED WARD AND CLINIC/ CENTRE TEAMS WERE:  Ward 64A (ward category)  SOC – O bstetrics & Gynaecology Centre (clinic/centre category)

BALBIR KAUR BACHITAR SINGH, Healthcare Assistant, Pre-Operative Evaluation Clinic

BELINDA LIEW YEE VUN, Physiotherapist

Ward 53A

Clinic J

Ward 64A

Obstetrics & Gynaecology Centre

LIFE at SGH Campus | Jul/Aug 2013

campus buzz

New departments take flight Department of Vascular Surgery opens

Specializing in vascular and endovascular surgery, Dr Benjamin Chua Soo Yeng, is the Head and Consultant of our new Department

of Vascular Surgery. As Director of Endovascular Surgery, he is dedicated to providing early and effective treatment for diabetic foot problems to amputations. In research, Dr Chua’s interest is in developing novel vascular surgical devices. He travels extensively in the Asia-Pacific region to teach and is also the Director of the Vascular Skills Training Programme under the Division of Surgery Surgical Skills Centre. On 1 April, the Department of Vascular Surgery started operations.

The Centre for Digestive and Liver Diseases

It is the first independent department set up for patients with vascular diseases in Singapore and the region. The department provides integrated care for patients from the initial diagnosis and cardiovascular risk management, through to surgery and rehabilitation. It includes multidisciplinary specialty clinics with endocrinologists, wound care nurses, podiatrists and a one-stop ambulatory clinic for diagnosis and surgical management of varicose veins.

Makeover for our wards Three new facilities - Wards 65, 66 and 67 - will be the prototypes as we renovate and refresh the rest of the wards in SGH. When completed, they will first serve as decanting wards as we close existing wards to install fire safety features. Construction will begin in July 2013 and is expected to be completed by mid 2015. A PREVIEW OF SOME OF THE NEW FEATURES:

CLUTTER-FREE CORRIDORS Based on the concept of “a place for everything” space will be provided for trolleys, computers-on-wheels etc.

MORE AND BIGGER WORKING AREAS There will be more work stations, located throughout the wards, to improve our access to patients. There is room for more staff at each work space, enough for the care team to huddle, away from the patients’ bedside.

FEWER PATIENTS IN A ROOM Each B2-class room will house only 5 beds, instead of 9 currently. With a patient's toilet and shower for every five beds, infection control will be improved.

Tackling a double threat

While there has been no local cases of the Avian Influenza A/H7N9 and Middle East Respiratory Syndrome Coronavirus (MERS-CoV), we are exercising greater vigilance as more people travelled during the monthlong school holidays.

However, good hand hygiene practice still remains our best protection against infection. This simple 8-step practice costs nothing and means everything!

On 1 July, we opened the new Centre for Digestive and Liver Diseases. The centre integrates former clinics C, D and E to allow more specialised care as patients can now enjoy services related to their condition. These include liver and intestinal cancer, chronic hepatitis and liver failure, chronic inflammatory disorders of the intestines and mal-absorption syndromes. The multidisciplinary centre also brings together related allied health professionals from clinics C, D and T, as well as advanced practice nurses and pharmacists. It provides clinical consultations by doctors as well as endoscopy, dietetics, drug management and patient education services.

The ward remodelling project involves colleagues from areas such as patient care, Facilities Development and Service Operations

Through a series of memos, staff received reminders to adhere to infection control practices.

June saw us stepping up precaution against emerging infectious diseases around the world.

We also put up health advisories to alert the public and patients to the symptoms to watch out for. Patients and visitors who show such symptoms, especially those returning from the Middle East, are discouraged from visiting other patients and advised to see a doctor.

I have fever, cough and/or sore throat I have been to the Middle East* in the 14 days before I became ill If so, inform your doctor or nurse. * Middle East countries include: Jordan · Qatar · Saudi Arabia · United Arab Emirates (UAE)

** MERS-CoV, or the Middle East Respiratory Syndrome Coronavirus, is a novel coronavirus in the same family as SARS. It can cause severe respiratory illness in infected patients.

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LIFE at SGH Campus | Jul/Aug 2013

e y o ur t a k

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OUR PICK!

Zulkifli, please contact us to collect your $20 prize voucher.

Cross Culture

“I call this picture "Spiraling Down". This is a shot of the famous spiral staircase found at the Vatican Museum during my visit to Rome and the Vatican City last year. Absolutely beautiful. I love the leading lines all the way to the end.”

Jollof Rice (Ghana)

Jollof Rice is common throughout West Africa, but its origin lies in Ghana. It is a very aromatic and flavourful one pot rice meal. It is great on its own or when accompanied with grilled meats. Variations include: vegetables, chicken or meat. Serves: 4 Prep Time: 15 min Cook Time: 1 hr

My name is Holly Ansah and I moved straight from leaving University, to my job as a Podiatrist in Singapore. I am a 22 year old from Gateshead in North East England. I am from the mixed parentage of an English mother and a Black father whose origins are from Ghana. I enjoy swimming, movies and socialising. I have regular contact with my friends in the UK through emails, Skype and texts (SMS). Below is a typical Ghanaian recipe which is a firm family favourite. Enjoy!

INGREDIENTS  2 cups rice  6 tablespoons olive or vegetable oil  1 medium red onion sliced  2 small red onions  2 medium Habanero chilli peppers or local chilli chopped  2 medium tomatoes  1 can tomato puree  2 cubes chicken stock  2 large carrots sliced diagonally  1 cup French beans sliced  1 pinch salt  1 pinch black pepper METHODS 1. I n a food processor, blend chillies, tomatoes and small onions. Put aside. 2. H eat oil and fry the sliced onions till translucent. Add tomato puree and fry for another 3 to 4 minutes. 3. A dd blended chilli/tomatoes/onions and stock cubes. Stir well, cover and let it cook on medium heat till oil floats on top. 4. A dd rice and 2 cups of water, stirring to make sure nothing is sticking to the bottom. Turn heat to low. 5. A dd green beans and carrots with 1 cup of water. Cook till the water has almost evaporated. 6. C over and simmer on low heat till the rice is cooked through. Serve with grilled or baked chicken, beef, shrimp or Portobello mushrooms.

— ZULKIFLI ABDULLAH, Senior Staff Nurse, Dept Of Emergency Medicine

“I love the rhythm between the Marina Bay Sands building and the sails. Processing the picture into black and white allows the viewer to focus on the shapes rather than the colours.”

“Is the figurine holding a fishing rod? No, they are just potato slices on a skewer!”

— TAN YOKE CHANG, Senior Executive, Human Resources

— TAN YEONG HORNG, Executive, Projects

NEXT: REMEMBER YOUR OLD SCHOOL DAYS?

Send us your favourite shot relating to school, teachers or learning. The most interesting photo wins a prize. Send it to mysgh@sgh. com.sg. Closing date: 30th September 2013.

Ever wanted to take better pictures with your phone, compact camera or upgrade to a DLSR? Whatever your level, join the CLICK LOR club and meet once a month for lots of fun and snapping. Find them as ‘Click Lor’ on Facebook. 23

st a l theage p

What Super Power would you choose to help you with your work? “In the blink of an eye, I can disappear and appear on SGH Campus, from my office at Surbana One or even from my house without having to take any train or bus. Teleporting is a fun and convenient superpower to have.” — NANCY LEW, Service Operations Manager, Operations & Performance Management

“Ultraman — a hero of a few words, is my favourite. I’d like his ability. He has a special timer on his chest which focuses his energy to get his world-saving job done right on time. With a power like this, no task will ever take too long or be too big to handle at work.” — JEFFREY TAN, Employee Relations Manager, Human Resources

“The super power I would like to have is teleportation. Not only would I be able to travel from one place to another in the blink of an eye, I would also be able to teleport any object and human that I hold on to. That means I can bring any equipment, patients and staff with me instantly anyway, any time!” — CONSTANCE TEO, Respiratory Therapist.

“I would like to have linguistic super power, so all patients can understand me perfectly and I can perfectly understand all of them.” — DR YANG LI YING, Registrar, Department of Obstetrics & Gynaecology

“The Super Power I would like to help me in my work ... To be able to read people’s mind!” — PATRICK KER, Senior Principal Occupational Therapist