AHA magazine Jan-Feb 2021 by Yishun Health

aha

Issue 1: Jan-Feb 2021

AN INTEGRATED MODEL Of care

MCI (P) 065/04/2019

Driving better outcomes for patients through physician ownership, team-based care, and self-management

MEET OUR M.A.D. SCIENTIST!

TURNING ‘ORDINARY’ WORK 23 INTO MEANINGFUL IMPACT

SHARING STORIES OF COURAGE AND HOPE

ontents

COVER STORY An Integrated Model for Ownership & Empowerment Driving better patient outcomes through greater physician ownership and holistic teambased care

WHAT’S UP Community events, outreach efforts, and more

10 SPECIAL FEATURE A fresh new look for our NHG nursing family 18 Q&A Health and wellness questions asked and answered! 20 SPOTLIGHT Meet our M.A.D. Scientist! Champion innovator, Dr Daniel Chia, on what it takes to make a difference 23 EVERYDAY HEROES Turning the ‘ordinary’ work into meaningful impact Dr Desmond Mao expands his horizons to improve healthcare beyond the clinical realm

A MODEL FOR UNIFIED CARE 2 |

23 26 LIVE WELL Sharing stories of courage and hope From porters to healthcare chaperones, our veteran ah mas never cease to care

Part 1 of 3 To tackle the rising challenge of complex chronic illness and co-morbidities, Yishun Health has developed an integrated model that takes better care of patients, while also streamlining the provision of services to drive greater participation, doctor ownership, and oversight that leads to relationship-based care and improved outcomes.

PUBLISHER

Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group. It comprises Admiralty Medical Centre, Khoo Teck Puat Hospital and Yishun Community Hospital. It also includes community extensions such as Wellness Kampung.

EDITORIAL TEAM 28 5 THINGS ABOUT… Co-morbidities The impact of multiple chronic diseases and the importance of prevention and self-management 30 DAILY DOSE Making the most of the new normal Learning to cope with the uncertainties of the new ways of living and working 32 MAKAN TIME Chap Chye A quick and healthy take on this homestyle favourite for Chinese New Year! 34 FIT & FAB Lifting more than a finger Why strength training is an essential component of any fitness regime

MODEL FOR UNIFIED CARE

The twin challenges of an ageing society and a rise in chronic illnesses have pushed healthcare providers to revamp the way medical care is delivered. Rather than simply doing more — more specialists, more treatments, and more medications — we are looking at ways to streamline so that patients can better navigate the system, and become more active participants in (rather than recipients of) care. And on the physician’s end, we are creating processes that make it possible for doctors to take on more oversight of patients and go back to the fundamentals of broad-based, generalist medicine. In this series on unified care, we explore this pursuit of integrated care and the development of Integrated Medical Clinics (IMCs) — facilitated platforms based on the concept of physician ownership, unified care, and patient empowerment. We also cover some of the efforts that our Yishun Health staff have taken to drive good patient outcomes and experiences, be it through inventions (page 20) or research and voluntarism (page 23).

The Editorial Team

Hannah Wong Sabrina Ng Sharon Ng Albert Foo

EDITORIAL COMMITTEE

The editorial committee — made up of clinical, nursing, allied health, population health & community transformation, and administrative heads of department — advises aha’s direction. A/Prof Tan Kok Yang Bastari Irwan Chia Kwee Lee Fatimah Moideen Kutty Shirley Heng Teresa Foong

www.ktph.com.sg/ about-us/media/publications aha@ktph.com.sg

PUBLISHING AGENT THINKFARM PTE LTD www.thinkfarm.sg M A N AG I N G D I R E C T O R

Christopher Tay

H E A D, E D I TO R I A L

Chua Kim Beng

C O N T R I B U T I N G E D I TO R

Sheralyn Tay E D I TO R

Dang Hui Ling H E A D, C R E AT I V E

Sean Lee

H E A D, C L I E N T R E L AT I O N S H I P

Jessie Kek

C O N T R I B U TO R S

Justin Loh Lee Lily

aha is the official bi-monthly publication of Khoo Teck Puat Hospital (Co. Reg. No. 200717564H) and is produced by ThinkFarm Pte Ltd. All rights to this publication are reserved and no part may be reproduced without the expressed written consent of the publishers. While every effort has been made to ensure that the information in this newsletter is accurate and up to date, the editorial team will not be responsible for errors due to information received. Opinions expressed are that of the writers and do not necessarily represent the views and opinions of the publishers. Printed by Mainland Press Pte Ltd. MCI (P) 065/04/2019

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hat’s Up

KTPH Celebrates its 10-Year Anniversary!

n 2020, KTPH celebrated its 10-year history of ‘Keeping the People Healthy’ with a series of activities to celebrate this milestone. One of the more notable ones was the releasing of fish into the KTPH pond and the planting of a Tembusu tree, signifying our continued commitment to sustainability and creating a healing environment. This year’s tree planting also mirrors the events of our opening day, when Minister Mentor Lee Kuan Yew officiated and planted a Tamalan tree on our grounds. As part of the festivities, a mural called ‘Caring for You Into the Future’ was commissioned for display along the walkway into the KTPH auditorium. Mdm Kay Kuok, Chairman, NHG, and Prof Philip Choo, GCEO, NHG, officially unveiled the mural by adding the finishing brushstrokes to the piece. Mrs Chew also launched a special KTPH10 commemorative book entitled Growing Excellence, and an anniversary video showcasing Yishun Health’s care ethos made its debut. 4 |

Above, left to right: Prof Philip Choo and Mdm Kay Kuok (first and second from left) launched the mural by adding the finishing touches. From KTPH, CMB A/Prof Pek Wee Yang, KTPH10 Committee Chairman Dr Jerry Goo, and CEO Mrs Chew Kwee Tiang joined them in the mural reveal!

A commemorative book entitled Growing Excellence was launched. The book traces our aspirations and achievements over the last decade. Scan the QR code for more information on the book

Our beautiful commemorative pin signifies our commitment in ‘Keeping The People Healthy’. And while we were unable to hold large group celebrations, the whole KTPH family marked the occasion by wearing their hearts on their sleeves — in the form of a commemorative collar pin

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hat’s Up

Improving Emergency Response & Resuscitation Efficacy

Dr Desmond Mao (left) and Dr Bang Chungli

study led by Dr Desmond Mao, Consultant, A&E, has been awarded an NHG Research Impact Award at this year’s NHG Research and Innovation Award. The two-year-long study looks at the challenging area of pre-hospital Termination of Resuscitation (TOR) Protocols. In the emergency medicine landscape, paramedics must make accurate judgement calls in timeand resource-limited scenarios. TOR Protocols act as a guide to identify patients with no chance of survival, and reduce unnecessary and stressful interventions, better manage limited A&E resources, and

lower potentially hazardous highspeed transports. It also allows patients to pass away peacefully in their place of residence. Dr Mao led a team comprising Dr Bang Chungli, Resident Physician, A&E, as well as two members from SGH and TTSH in identifying gaps in TOR Protocol training and developing a

robust framework that covers standards of practice, communication skills and emotional support for paramedics. This study led to the successful launch of a pre-hospital TOR Protocols in 2019, making Singapore the first in Asia to implement such a guideline.

Recognition for Yishun Health’s Innovation Leader! D

Above: Dr Daniel Chia received the Exemplary Innovator Award, a testament to his prolific work in creating solutions for better patient care

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r Daniel Chia, Director (Innovation), Clinical Research Unit, received the Exemplary Innovator Award at the Public Sector Transformation Awards on 21 October 2020. This accolade is a testament to his problem-solving ability, and adds to the recognitions he has received over the years for his numerous contributions to Yishun Health. For instance, in 2017, he received the title of “M.A.D. (Made A Difference) Scientist” at the annual Kaizen Festival. Turn to page 20 to read more about Dr Chia and his thoughts on the practical and innovative solutions that he has come up with to fulfil unmet needs and improve the quality of staff and patient care.

An Excellent Clinician, Leader & Mentor F

or over 36 years, A/Prof Sum Chee Fang, Senior Consultant, General Medicine, KTPH, has made an impact on diabetes care. On 29 October 2020, in recognition of his dedicated service and contribution, he was conferred the prestigious National Outstanding Clinician

Award at the MOH National Medical Excellence Awards. A/Prof Sum, well regarded as a sincere and kindly doctor, is greatly respected for his vast clinical knowledge in diabetes care and research, and his pioneering and visionary work in developing and

The National Outstanding Clinician Award is a prestigious prize that recognises the dedicated service and contribution by A/Prof Sum Chee Fang

enhancing diabetes care in the public healthcare sector. In 2001, he set up the Diabetes Centre in Alexandra Hospital — unique for its time — which provided a comprehensive interdisciplinary approach to the management of patients with complex diabetes, with a strong emphasis on patient engagement and education. He also had the foresight to push for specialist training for nurses, and is credited with co-establishing the Specialist Diploma in Nursing (Diabetes Management and Education) in 2000. At KTPH, A/Prof Sum further led the improvement of diabetes care. In addition to his role as Senior Consultant at the Diabetes Centre, he has also chaired the NHG Diabetes Disease Management Committee and the MOH Diabetes Strategy Advisory Committee.

Serving with Compassion & Commitment S

enior Assistant Nurse Wee Seow Keng was among this year’s Tan Chin Tuan Nursing Awardees. The national award represents the pinnacle of distinction for Enrolled Nurses, and honours them for outstanding commitment in advancing the nursing profession. Seow Keng, who is part of the Population Health & Community Transformation (PHCT) team, has shown great compassion in her nursing duties, which she undertakes with efficiency and dedication. Many in her team praise her character and good work at the Community Nurse Post (CNP). She has consistently demonstrated a high level of

commitment, be it in tackling her daily tasks or engaging with her residents. She also works well with staff nurses and is constantly expanding her knowledge and skills.

Senior Assistant Nurse Wee Seow Keng receiving her award from Ms Shirley Heng, Chief Nurse, Yishun Health

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hat’s Up

YCH Sweeps 40 Awards at the Community Care Excellence Awards

Winners of the CCEA were recognised via an online award ceremony. Well done!

n an apt tribute to five years of safe, quality service and recuperative care, YCH received a total of 40 individual and team awards at the 2020 Community Care Excellence Awards (CCEA), organised by Agency for Integrated Care. Of the 35 individual awardees, one notable Gold Award winner was Senior Nurse Manager Pauline Tan. Pauline is known for her exemplary service and commitment, and has 8 |

even won four Service Champion Awards in 2019. Day-to-day work aside, Pauline also leads the Nursing Quality Improvement Committee and contributes to improving service, processes, and clinical quality. Among YCH’s five team awardees were two winning projects. In the first, ‘Cognitive Spark — Opportunistic Screening of Impairment of the Elderly’, the team embarked on a study that piloted improved and more appropriate

cognitive screening tests and trainings to provide early intervention for reversible factors for stable patients with an abnormal cognitive score. The team for the other project, ‘Ultrasonic Assisted Wound Debridement project’, introduced low-frequency ultrasonic vibrations to remove wound tissues to aid healing. The study took place over a year from 2018–2019, and resulted in faster recovery time for patients, and man-hour cost savings for staff.

Our Shining Stars: Healthcare Humanity Awards 2020 T

his year, Yishun Health received a total of seven awards at the 2020 Healthcare Humanity Awards (HHA). In its 17th year, the Award — which began following the SARS outbreak — recognises outstanding ‘stars’ of healthcare who go out of their way to support, comfort and care for patients. The award also lauds caregivers and volunteers for their care efforts in the community.

(Second from left onwards) Dr Wong Kuan Yee (Registrar, Dental Surgery, KTPH), Tham Juncheng (Senior Staff Nurse, Ward D58, YCH) and Dr Teoh Chin Sim (Clinical Director and Senior Consultant, Sports Medicine Centre) were recipients of the HHA this year. Some of our Yishun Health staff also received the awards on behalf of the caregivers they nominated. Not pictured: Sharon Claire Ang Chor Kiang, Nurse Manager

Reaching Out & Supporting Vulnerable Adults F

or their empathy, compassion and commitment towards supporting victims of family violence, Yishun Health’s Medical Social Service (MSS) department received the Family Violence Dialogue Group Appreciation Award (Team) during the 2020 National Family Violence Networking System Virtual Conference, organised by Ministry of Social and Family Development. Yishun Health’s MSS team deals with a wide range of cases and always handles them with sensitivity, awareness and timeliness. Besides ensuring cases are discharged to a place of safety, the MSS team also performs other roles, such as obtaining protection orders and lodging police reports. Across internal departments, the MSS team also works closely with A&E colleagues, especially its nurses. This happens whenever a crisis case is referred, with victims requiring expeditious examination and investigation processes.

Members of the winning team, led by Ms Jenny Goh (top left), Deputy Head (Yishun Health) and Principal Social Worker (KTPH)

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pecial Feature: New Uniforms

NURSING OFFICERS

• Dark blue base • Grey accents • Red piping Dark blue symbolises maturity and dynamic leadership. Red piping indicates seniority and passion.

REGISTERED NURSES

• White base • Dark blue accents • White piping White is symbolic of the nursing profession. Dark blue accents indicate growing expertise. 10 |

ENROLLED NURSES

• White base • Light blue accents • Light blue piping White is symbolic of the nursing profession. Light blue represents youth (energy and optimism)

A FRESH NEW LOOK A

FOR OUR NHG NURSING FAMILY

s of October 2020, Yishun Health nurses made the transition to a new uniform that reflects not only our commitment to our calling, but also unites us as one under the NHG family. Drawing from the design elements of the NHG logo and colours, new uniforms were introduced to all nursing staff across all NHG institutions. This coincides with the annual tradition of issuing fresh uniforms to replace sets that have become worn due to daily use. Taking the opportunity, an interinstitution Committee gathered feedback and redesigned the uniform for functionality and

professionalism — as well as a united look and feel for all NHG nurses Making good on NHG’s principle of ‘Better People, Better Care’, our uniforms were developed not

THE ANATOMY OF OUR NEW UNIFORMS The collar design was inspired by NHG’s logo and colour

Red

Dark blue

Light blue

only for a cohesive identity, but practicality and utility, so that our nurses can serve our patients with good quality care. • Made of crease-resistant material that is easy to wash and dry. • Unisex field scrubs designed for high functionality and professionalism. • The faux-wrap style has a hidden front zipper closure instead of buttons for convenience. • Discreet slits in the sleeves and skirt allow for range of movement. • Shirts come with hidden pleats and slits for greater comfort and better fit. • Four roomy pockets are integrated in each design.

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Cover Story

The Geriatric IMC is one of the five clinics that have rolled out in KTPH. It is led by Dr Ang Yan Hoon, Senior Consultant, Geriatric Medicine (second from right). She works with a transdisciplinary team, comprising colleagues such as Senior Care Coordinator Audrey Tan, and Deputy Head of Pharmacy, Low Suat Fern (on her right and left respectively)

AN INTEGRATED MODEL

OWNERSHIP & 12 |

A MODEL FOR UNIFIED CARE

PART 1 OF 3

Yishun Health’s Integrated Medical Clinics aim to create a more hassle-free and effective experience for patients by driving physician ownership, coordinating team-based care, and enabling patient self-management.

or several years now, Yishun Health has striven to better integrate care, having moved towards a transdisciplinary care approach. A new clinical care model, called the Integrated Medical Clinics (IMC), was piloted in October 2018. It offers coordinated care that is led by a Primary Physician and supported by a Care Coordinator. In doing so, IMCs seek to better manage patients with multiple and complex chronic care needs. This, in part, is a response to the changing profile of disease in Singapore. While many Singaporeans can look forward to increased longevity, there will be a group of people who will spend their later years in ill health with multiple chronic issues. In fact, some studies reveal that as many as a third of older Singaporeans have more than one chronic health condition, such as high blood pressure, high cholesterol, diabetes, heart disease, as well as agerelated diseases and frailty.

This usually means managing multiple appointments for various doctors and health services, which is typical of the traditional organ specialist, condition-centric model, points out A/Prof Terence Tang, Deputy Chairman, Medical Board (Clinical Informatics, Innovation & Patient Engagement), and Senior Consultant, Geriatric Medicine. “When it comes to having specialist care, it used to make sense to go to a particular person for a specific problem.” However, this approach cannot keep up with the changing needs of those with co-morbidities. “It is just not sustainable,” he elaborates. “Patients end up visiting lots and lots of doctors and no one has a holistic view of them.” It also leads to great inconvenience to patients as well as family members. Care also becomes confusing and fragmented, with multiple care plans, duplication, inconvenience, and added cost.

FOR

EMPOWERMENT | 13

Cover Story

ORGANISING CARE AROUND A PATIENT IMCs act as a facilitated network that consolidates, as much as possible, necessary services and expertise under a single platform. “The IMC is headed by a Primary Physician, and includes a Care Coordinator pulling together the resources and services for each patient,” A/Prof Tang explains. The first IMC was piloted on 5 October 2018 for geriatric care and, to date, Yishun Health has launched a total of five IMCs: two for geriatric care, and one each for renal disease, diabetes and heart conditions. As of today, there are more than 120 patients enrolled in these IMCs. In this first phase, the IMC teams sought out the most complex patients who, despite multiple specialist clinic attendances, still require emergency assistance with repeated hospitalisations. These cases are then assigned to key IMC physicians best suited to resolve the main issues. Together with their care coordinators, they reach out to these patients not just during clinic consultations, but more so between consultations to guide and coach them and their caregivers. They pull in inputs from other specialists, as well as support from pharmacists, psychologists, medical social workers, and rehabilitation therapists where needed. These teams also form links with Yishun Health’s Population Health & Community Transformation department, including the Community Care Teams.

GOING BEYOND INTERMITTENT CARE According to A/Prof Tang, the IMC model is specifically designed for

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“We strive to go beyond intermittent care for complex patients and move beyond the inpatientonly setting to support them in the whole journey so as to reduce complications, empower them better in selfcare, and avoid preventable admissions.” DR ANG YAN HOON HEAD, GERIATRIC MEDICINE IMC patients living with multiple chronic medical conditions with declining function, and who often face a health crisis. While a majority of those being managed at Yishun Health’s Specialist Outpatient Clinics do well on existing care flows, these patients require closer monitoring and care. A/Prof Subramaniam Tavintharan, Director and Senior Consultant of the Diabetes Centre at Admiralty Medical Centre, heads the Diabetes IMC. He shares that there is a segment of patients with more complex co-morbidities and complications. “They tend to have high medical needs, see multiple specialists, and are often

admitted to the Acute & Emergency Care Centre (A&E) for complications.” IMCs offer the extra support they need, elaborates Dr Dinna Soon, Consultant, Cardiology. She leads the Cardiac IMC with her Senior Consultant Cardiologist colleague, A/Prof Ling Lee Fong. “We enrol patients in a suitable IMC based on their most pressing primary disease,” Dr Soon explains. Once enrolled, a Unified One Care Plan is tailored to meet their needs. The goal is to bundle and integrate care so that patients can receive more seamless care. The benefit, shares Dr Soon and A/Prof Ling, is that having a primary point of care not only simplifies things for the patient, but gives doctors a greater sense of ownership as they have much more oversight on how a patient does. Dr Ang Yan Hoon, Senior Consultant, Geriatric Medicine, who heads one of the two Geriatric IMCs, says that the IMC is based on the idea of a unified care model and “sits in the intersection of community and campus flow” by integrating care and coordinating services between campus and community. “We strive to go beyond intermittent care for

A MODEL FOR UNIFIED CARE

PART 1 OF 3

A/Prof Terence Tang, who wears both hats of a Deputy CMB and Geriatric Medicine Senior Consultant, oversees the IMC and works with various teams to bring value-driven care to Yishun Health patients

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Cover Story

A Cardiac Technician performing an echocardiogram on an IMC patient to assess his heart structure and function

complex patients and move beyond the inpatient-only setting to support them in the whole journey so as to reduce complications, empower them better in self-care, and avoid preventable admissions.”

BUILDING GREATER OWNERSHIP OVER THE DELIVERY OF CARE This act of taking ownership is a crucial shift in the management of patients — and a mindset change that builds into Yishun Health’s ethos of care. It becomes truly about integrating care around a patient and building a network of support that is transdisciplinary in nature. Doctors leading these IMCs, such as Dr Lim Eng Kuang, who heads the Renal IMC, have seen a shift and 16 |

“We are moving beyond organ- or illness-specific care to care for the whole person. In many ways, we are going back to the basics and being generalists first before we put our specialist hats on.” DR LIM ENG KUANG HEAD, RENAL IMC

expansion in their role. “By acting as primary coordinating doctors, we can practise greater ownership of our patients,” the Renal department Senior Consultant says. Points out A/Prof Subramaniam, “Each disease specialist takes on a wider role beyond their own specialty to include the broader field of internal medicine to care holistically for our patients. Each doctor becomes more mindful of reducing the number of visits for patients by taking a more considered and deliberate approach to referrals, and by supporting the patient between clinic visits.” “In fact, we try to manage most stable conditions ourselves wherever possible. It allows us to grow in our own wider understanding.” This,

A MODEL FOR UNIFIED CARE

PART 1 OF 3

says A/Prof Tang, is the essence of transdisciplinary care, and it is something taking place beyond the IMCs. “We are realising a slow shift in the practice of medicine. I see my clinician peers try their best to integrate care in small ways. I hear them communicate much more with each other, notice them crossing their own boundaries of expertise to co-consult, develop strategies, and discuss the effectiveness of patients’ medications together, so patients need not make the extra trip. This, however, should not hinder referrals to other specialties when they are needed. But we take the advice, learn the necessary management, and coordinate the overall delivery of the care.” Increasingly, A/Prof Tang hears doctors sharing their concerns when their patient is admitted to the A&E. Under the IMC, lead doctors are now notified whenever this happens. “They

“I see my clinician peers try their best to integrate care in small ways. I hear them communicate much more with each other, notice them crossing their own boundaries of expertise to co-consult, develop strategies, and discuss the effectiveness of patients’ medications together.” A/PROF TERENCE TANG DEPUTY CHAIRMAN, MEDICAL BOARD (CLINICAL INFORMATICS, INNOVATION & PATIENT ENGAGEMENT); SENIOR CONSULTANT, GERIATRIC MEDICINE are more emotionally invested in the outcomes, and feel a greater sense of accountability for their patients,” he reveals. This is a heartening development that he hopes will gain greater momentum. For Dr Lim, this culture marks a

shift that embraces the original heart of medicine. “We are moving beyond organ- or illness-specific care to care for the whole person,” he says. “In many ways, we are going back to the basics and being generalists first before we put our specialist hats on.”

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ZOOMING FOR AnswerS IN A PANDEMIC “My organisation is continuing with workfrom-home measures for the foreseeable future. As much as I enjoy the convenience of not having to commute, why do I still seem to feel just as tired and stressed after a day of work and videoconferences?” You may be experiencing tiredness associated with overusing virtual platforms of communication. Sometimes known as ‘Zoom fatigue’ — after the video-calling app — this phenomenon is a new and rising

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complaint. Videoconferencing is more stressful than we may realise. In normal face-to-face interaction, we are more able to pick up subtle nonverbal cues when we communicate. A video call impairs our ingrained ability to perceive these cues naturally. The brain is overwhelmed by an unfamiliar mode of communication, and becomes hyper-focused on searching for non-verbal cues that it can’t find. Having many people on screen can also magnify this problem. Having to maintain constant eye contact on the camera — the only way we can show that we’re paying attention — is also draining.

Yishun Health experts answer your frequently asked questions about health, well-being and medical conditions. In real life, we can use our peripheral vision to glance out the window or look at others in the room for a visual break. We may also simply be mentally tired from juggling the content, the chat, and other distractions that come up during the meeting, as well as eye strain and fatigue from too many meetings. There may also be other underlying factors. Perhaps the pandemic and new ways of working from home has led to other stress factors and distractions that make your day more exhausting.

“I am short-sighted, and worry that the long hours of video calls and meetings will make my eyesight worse. Sometimes, at the end of the day, my vision gets a little blurry. What can I do?”

“How do I counteract ‘Zoom fatigue’?” Try to take mini breaks from looking at the video during longer calls. Every now and then, minimise the window, move it behind your applications, or look away from your computer completely for a few seconds. You can also turn off your camera to decrease tiring stimuli. Where possible, minimise distractions so that your brain processes fewer visual cues. You can combat mental fatigue by encouraging people in your meeting to use a plain background, or agree that anyone not talking should turn off the camera. Or why not simply switch to phone calls, email or a videocall without the video? You may not be the only one who will be relieved by the switch. As the line between work and home life blurs, it is also important to have a routine that separates your working hours from your personal one (turn to page 26 to read more about coping with burnout and anxiety during this new normal).

The pandemic has increased our amount of screen time without any of our habitual breaks. Digital eye strain — also called accommodative eye strain — comes from looking at a near target for a long period of time. The muscles inside the eyes contract to focus and, over time, will tire out. If you feel your eyes hurting, it is a sign to take steps to give your eyes a break. Tired eyes can also be caused by presbyopia, also colloquially known as lao hua yan. This is the gradual loss of our eyes’ ability to focus on nearby objects. As the muscles around the lens of the eye lose

tone, it becomes unable to focus on things close up. Try to make it a habit to practise the 20-20-20 rule: every 20 minutes, look into the distance 20 feet away (6m) for at least 20 seconds. You can also close your eyes completely for several seconds to give them a rest. To soothe tired and dry eyes, use eye drops to lubricate them. You can also try to optimise your lighting conditions: consider using a screen filter that reduces glare, and ensure your room is properly lit. Ergonomics matter: ensure your screen is at eye level by propping it up if you need to for more comfortable viewing. Wherever possible, after work, take a break from screens altogether — that means your mobile phone, too — and let your eyes rest. If you think your vision is deteriorating, it may be time to visit your optician to review the prescription for your spectacles or lenses.

In consultation with A/Prof Yip Chee Chew Head and Senior Consultant Ophthalmology and Visual Sciences

In consultation with Dr Lim Wei Shyan Consultant Psychological Medicine

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potlight

MEET OUR M.A.D. SCIENTIST!

With more than four decades of engineering and IT experience under his belt, Dr Daniel Chia is the go-to guy for all things innovative. As Yishun Health’s M.A.D. (Made A Difference) Scientist, he has worked across the organisation to initiate and roll out numerous groundbreaking systems for healthcare transformation.

sually attired in a shirt and tie, Dr Daniel Chia can often be seen scurrying across the campus. There is certainly more to him beyond his neat appearance. It is likely that his hurried pace is a manifestation of his quick mind — after all, he has six novel healthcare patents to his name that has fulfilled unmet needs and improved the quality of both staff and patient care over the years at Yishun Health. In October 2020, he was conferred the Exemplary Innovator Award at the Public Sector Transformation Awards 2020, organised by the Prime Minister’s Office. This award is a testament to Dr Chia’s ability to realise his vision of smart, digitised and innovative hospitals through frugal, practical and innovative solutions.

MrsMAN RosalindOF Tan, A Mr Simon Chan MANY TALENTS and Mr Mark

With hisYishun boundless enthusiasm, Lim lead Health’s in-house infectious energy, and landscaping team loquacious manner, Dr Chia

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can often be seen popping into offices to share one new idea after another. “Whenever I see him, my guess is, he has an idea, a project or something along the line of innovation,” shares Ms Low Beng Hoi, Director of Nursing, Population Health & Community Transformation, with a fond laugh. “Most times, I am right!” A Commonwealth Scholar in Design and Innovation, this engineer by training has a track record of leading engineering and technology firms, building and running companies, and securing 16 internationally and locally registered patents across the industrial, military and healthcare sectors. Today, as a Director (Innovation) at the Clinical Research Unit, Dr Chia applies his knowledge and experience to biotechnology solutions and other medtech innovations. Dr Chia reveals that he was approached to join Yishun Health by the organisation’s former CEO, Mr Liak Teng Lit. “Mr Liak believed we can use a lot of technology in

healthcare to improve care and make it better and more cost-effective,” Dr Chia recalls. As it was an exciting proposal that meant much meaningful work, he readily took on the role. “Why not? It is my passion!” Since then, Dr Chia has driven a wide number of inventions and innovations across the hospital (see box story).

INNOVATION IS A TEAM EFFORT Backed by his wide expertise, Dr Chia takes a very hands-on approach to his work, and truly enjoys tinkering and exploring as he develops prototypes and solutions. He works in a systematic fashion, collating feedback to tweak and improve each solution. This tightens the feedback loops, preventing any costs of rebuilding or delays in implementation. “To innovate, we must have a can-do mentality. But a can-do attitude should be complemented by the aptitude to learn constructively when things do not work out as planned,” he says.

His infectious enthusiasm is coupled with great commitment, affirms A/Prof Edwin Seet, Clinical Director, Office of Clinical Governance, and Senior Consultant, Anaesthesia. “He partners clinicians to make patient care hassle-free and cost-effective.” A/Prof Yip Chee Chew, Head & Senior Consultant, Ophthalmology and Visual Sciences (OVS), who works with Dr Chia on a wide range of ophthalmology-related innovations, also commends Dr Chia on his dedication. “He is very passionate about innovation, and often goes the extra mile — sometimes at his own expense!” A/Prof Yip shares how Dr Chia often pre-emptively designs and fabricates mock-ups for technical feasibility and financial viability, estimates budgets for deliverables, and plans for patent filing ahead of receipt of funding due to his excitement. But Dr Chia is no lone wolf. He modestly credits much of his prolific portfolio to having supportive senior management and clinical partners. “My brilliant and helpful colleagues in Yishun Health and enthusiastic friends provide a conducive environment for our endeavour in digitisation and innovation,” he shares.

TAKING HEALTHCARE INNOVATION ‘BEYOND’ Engineering prowess aside, Dr Chia also regularly puts on his business development hat, using his persuasive skill to garner support and funding so as to explore scalability, ease of implementation, and commercial viability. As he puts it, “Innovation needs to make an impact to serve people in the community.” Dr Chia sees the power of technology as an important tool to not

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potlight

just ease day-to-day hospital operations; he truly believes it can elevate care and align it to the national healthcare agenda of the Three Beyonds: Beyond Healthcare to Health, Beyond Hospital to Community and Beyond Quality to Value. “With the ageing population, we can use technology to push healthcare to people early, before it becomes a crisis that requires medical care,” advises Dr Chia. “This means empowering community efforts in preventive healthcare, promoting safe remote health monitoring and screening, and effective chronic disease management using the right tools.” This includes exploring affordable technology as well as Artificial Intelligence to raise the level of person-centred care. “We can make it easier, cost-effective, and more convenient for everyone to receive tests, get screening, and receive treatment,” he says. “We can drive early intervention and transform healthcare to health promotion and prevention.” Beyond his work at Yishun Health, Dr Chia also passionately promotes innovation among students. As the Chairman of the School Advisory Committee of Riverside Secondary School, he works with staff and students there to create a smart school. It all ties in with his own passion for lifelong learning. In fact, he says, there is nothing one cannot learn in this digital age. He likes to joke about his secret weapon and friend, one Professor ‘Google’, which he uses extensively to learn about medical conditions so that he better understand the needs of his clinician colleagues. Dr Chia muses that innovation takes patience and perspective. “We need to zoom out at a comfortable distance to see a bigger picture, and to plan the journey with effective connectors.” It takes belief, bolstered by a solid foundation of applied research and grit, to succeed. “We

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must take calculated risks and learn from others as much as we can.” This human aspect, he says, is absolutely important. “We cannot do innovation alone. We need a strong network of collaborators, good leadership, and team spirit.” With EPush, the load becomes lighter and easier for Yishun Health’s porters

EPUSH

EPUSH has been one of the most impactful projects initiated and implemented, going beyond Yishun Health to benefit two more hospitals in Singapore. The project greatly improves the manoeuvrability of the Hillrom hospital beds, making it easier for hospital porters and nurses to move beds and patients. Dr Chia designed and developed an addon motor system to the existing beds, which weigh between 260kg and 360kg. This innovation is easily adapted to different beds and is highly scalable. Dr Chia also collaborated with Ms Low Beng Hoi and her Nursing Admin team, and Chief Operating Officer Ms Yen Tan and her Operation Admin team. Since 2015, EPUSH has been implemented in phases — with improvements added at each stage and version. Today, some 530 beds at KTPH and YCH are installed with EPUSH. In 2018, Ng Teng Fong General Hospital and Changi General Hospital purchased EPUSH for installation on their own beds. EPUSH improves productivity and provides continuing work opportunities for the ageing portering workforce. It has improved operational efficiency, with 2,263 man-hours saved per year.

NOVEL TELEMEDICINE OXIMETRY SYSTEM

Although Obstructive Sleep Apnoea (OSA) poses several health risks — particularly for patients who are undergoing surgery — it is often undiagnosed. Traditional tests for OSA, done in sleep labs, is usually costly, inaccessible, labour-intensive, and uncomfortable for patients. Dr Chia worked with A/Prof Seet to develop a mobile phone app into a bedside device that can measure drops in oxygen saturation during sleep at night. The app is connected to an oximeter to calculate and record oxygen saturation levels in real time. Should oxygen readings fall below the critical area, an alarm is triggered. This easy-to-use system allows early detection of respiratory symptoms through remote monitoring at the patient’s convenience. It is also a cheaper secure alternative to other commercial home-based testing devices, and saves some S$52,000 a year in healthcare costs. This project won the ‘Best Abstract Presentation Award’ in California, USA, presented by the Society of Anaesthesia and Sleep Medicine, and is in its next phase of scaling at the institutional level.

M.O.S.E.S

Dr Chia collaborated with OVS to design and develop an eye-screening test to raise the level and reach of eye screening for patients. The Mobile Ophthalmic Slit-lamp Examination System (M.O.S.E.S) enables the screening of patients who have limited mobility, such as those who are confined to a wheelchair or who have been warded and cannot visit the SOC. This makes eye tests more hassle-free and improves the quality of eye examinations for patients.

Turning â&#x20AC;&#x2DC;ordinaryâ&#x20AC;&#x2122; work into

meaningful impact Dr Desmond Mao, an emergency physician by training, has gone beyond his day-to-day work to expand his horizon in areas such as voluntarism, community outreach, and video production. He sees it as making the most of the opportunities that come his way so as to improve healthcare beyond the clinical realm. In 2020, Dr Mao was one of the recipients of the Lee Kuan Yew Scholarship, awarded to exceptional individuals who demonstrate a strong sense of commitment to serve Singapore and her citizens, as well as the NHG Research Impact Award in the NHG Research & Innovation Awards.

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veryday Heroes

ot many people can say that they have once received the ‘protection’ of gangsters in Geylang. But when Dr Mao was volunteering at HealthServe between 2007 and 2014, he and his colleagues sometimes benefited from the help of the area’s underworld, especially to promote their services and gain the trust of the community. The non-governmental organisation was launched with the aim to deliver medical care to underserved communities. “Our original intention was to serve the streetwalkers in the area,” Dr Mao explains. “But we saw that a bigger gap was in caring for the medical needs of foreign workers.” Over time, “we slowly built rapport and created a safe place where our foreign-worker friends could see a doctor, but also maybe have some tea and a chat”. It was challenging work, but the experience was invaluable, especially in broadening the perspective and cementing the medical learning of the then junior doctor. “This work helped to make me more human. When you are still learning about medicine, you are so focused on the body of knowledge and disease processes. Having a foot in the community made me aware of the broader issues and impact of injury and illness,” Dr Mao shares.

OTHER WAYS OF GIVING BACK Today, Dr Mao no longer volunteers at the migrant worker clinic, but contributes in other ways. He is a Programme Director for National

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“I don’t really seek these projects out, but I am happy to take advantage of the opportunities as they come and make the most of them. It is very useful because you get to meet a lot of people and learn from them.” Alcohol-Related Frequent Attenders Programme funded by Ministry of Health (MOH) and Ministry of Home Affairs. The programme treats and rehabilitates patients with alcohol misuse problems and who use emergency services frequently. It aims to reduce the emergency services load by adopting a personcentred approach. The programme works with multiple partners, including the police, public hospitals, and social service organisations. It recently marked a milestone — the recruitment of its first patients. Dr Mao says this work has helped him become more empathetic about such patients. He shares, “We see a lot of these patients; seeing them comes with many challenges due to their personal experiences and backgrounds. It is human to be critical, but I have started to become more open to their backstory.” Beyond volunteering in a clinical capacity, Dr Mao has also made a foray into producing educational videos. In 2014, he created a patient education video for the A&E. The 2.5-minute clip re-enacted

different emergency scenarios, including higher acuity cases such as accidents, to showcase why waiting time for certain conditions tends to be longer. The idea came about as he was discussing the challenges of managing patient expectations with his friends, some of whom were from the media and video production industries. He pitched the idea to then CEO, Mr Liak Teng Lit, who greenlighted it. With this experience, Dr Mao went on to lead a MOH project in 2016, creating educational videos for hospital disaster preparation. This simple yet innovative solution has been an effective way for public hospitals to conduct disaster training. He shares that using videos as a training medium is a concise and scalable way to preserve and spread knowledge. This method is also more suited to the way people consume information today.

DOING SOMETHING MEANINGFUL To Dr Mao, this diverse portfolio of achievements is simply his way of doing what he can. “It’s nothing

special; I’m just an ordinary guy,” he states. “I don’t really seek these projects out, but I am happy to take advantage of the opportunities as they come and make the most of them. It is very useful because you get to meet a lot of people and learn from them. It helps me make the most of my strengths to contribute as best as I can, wherever I can.” Recently, Dr Mao received the NHG Research Impact Award under the NHG Research & Innovation Awards 2020. This was

recognition for him and his team’s study on ‘Psychological Comfort of Paramedics with Field Death Pronouncement: A National Study & the National Paramedic’. It is another affirmation of his contributions to healthcare, as well as the continuous research and innovation in NHG. Not long before this major milestone, Dr Mao was awarded the Lee Kuan Yew Scholarship 2020 to pursue an Executive MBA via a joint programme with the University of California, Los Angeles, and National

University of Singapore. “One thing I learnt doing the alcohol project is that I have some gaps, especially in finance and organisation. These are very different skills from being a doctor!” He adds that, while the course is out of his comfort zone, it will help flesh out his skill sets. “I hope this will add to what I already know from my clinical training, and equip me with the necessary skills to achieve better systems, improve patient care, and care for underserved communities.”

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ive Well

F Sharing stories of courage and hope These golden seniors of Yishun Health have journeyed with the hospital for decades, working as porters and playing a part in patient care. These days, they have been upskilled to a new role of Healthcare Chaperone to provide direct basic care, thus proving that age is no barrier to career progression, learning new skills, or contributing to the delivery of good patient care. From left to right: Shanmugam Gauri, Marthavi D/O Achuthan Nair, Sumarni Binti Saini, Absah Bte Amin, Tham Poh Chee

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or many of us, the idea of going back to school may seem daunting. But Yishun Health’s former porters gamely went on a job redesign programme, which lasted eight weeks. To them, it was a challenging but useful experience. As Mdm Shanmugam Gauri, 69, puts it, “Just try, lah, and just do.” It was this attitude of an open mind and heart that saw them through the training, and ushered them into their new role as Healthcare Chaperone. Mdm Shanmugam, who has worked at Yishun Health for 10 years, is part of the first batch of 45 Healthcare Chaperones. They graduated with a certificate from Republic Polytechnic on 21 October 2019 after a role redesign course to train in-house porters with new adaptive, technological and technical skills. The intensive training and practicum imparted to attendees the necessary skills to support nurses in basic care procedures and nutritional needs of patients in the wards.

Mdm Shanmugam’s colleague, Mdm Tham Poh Chee, 74, has clocked 26 years with Yishun Health, working first at Alexandra Hospital (AH) before moving to KTPH. She shares that the course was useful in improving her caregiving skills. Mdm Tham, who cares for a daughter with medical needs, says that learning the proper techniques for showering, sponge baths, and diaper changes has made her work — both in the ward and at home — easier. Mdm Shanmugam, who likewise is a family caregiver, has found her newly acquired skill set helpful in taking care of her bedridden husband. “I can change diapers better now, faster and more easily,” she says with pride. These new skills are of immense help in the wards as well, explains Hao Lifen, Nurse Manager, Ward B76. “Our chaperones partner the nurses to ensure the comfort and safety of our patients, making sure that patients have a pleasant experience with us. With a positive work attitude, they demonstrate perseverance in their care delivery, and carry out their duties diligently.” This is affirmed by Echo Wang, Assistant Manager, Operations Support, who supervises the Healthcare Chaperones at Yishun Health. “Even though these Healthcare Chaperones are more senior in age, their willingness to learn is truly an encouragement to all of us,” Echo shares. “In bringing positivity to their work and life, these seniors contribute beyond their role of Healthcare Chaperone to inspire others to embrace active and graceful ageing.”

A MORE JOYFUL JOB Importantly, it has also made their work more enjoyable, adds 75-year-old Mdm Absah Bte Amin, a 40-year veteran at AH and

Yishun Health. “As a porter, we used to do a lot of walking and transporting patients from place to place. Now, at the ward, we can help them more, get to know patients better, and take care of them,” she says. Sumarni Binti Saini, 72, concurs. “I’ve worked 30 years as an amah (a nursemaid, but can also refer to a female caretaker) — this new job is even better because I can learn something new.” Being able to spend more time with patients makes the work more meaningful. Mdm Marthavi D/O Achuthan Nair, 73, who has 40 years of service under her belt, shares that it reminded her of her days as an amah at AH in the Intensive Care Unit. “I enjoy working with patients and helping them,” she enthuses. “Compared to portering, we can connect with patients more, so I like this new role a lot!” It is the human connection they now have in the ward environment that makes the difference. By offering a listening ear, a friendly smile, or just an empathetic presence, Healthcare Chaperones

“These seniors contribute beyond their role of Healthcare Chaperone to inspire others to embrace active and graceful ageing.” ECHO WANG ASSISTANT MANAGER OPERATIONS SUPPORT

brighten up the day of others and contribute to a more positive patient experience. They also support nurses by being the extra pair of eyes and ears in the ward.

AN ACTIVE MIND FOR A HEALTHY BODY Apart from their professional advancement and job satisfaction as Healthcare Chaperones, these five active agers also view their work as one way to keep themselves healthy and engaged. Mdm Sumarni says with a laugh, “I need to work; it keeps me occupied. All my children are grown and working, so if I stay at home, I would be so bored and have to talk to the walls!” In fact, Mdm Marthavi could not wait to go back to work during her long break over the Circuit Breaker period. “It’s much better to work and do something useful. Our job is very manageable because we work four hours a day for five days a week.” For Mdm Shanmugam and Mdm Tham, their spare time often takes the form of caregiving but, like their peers, they practise self-care by taking walks and participating in other physical and social activities. They also maintain their emotional health by embracing a happy-go-lucky attitude towards life, a positive mindset that they all seem to subscribe to. Mdm Marthavi stresses the importance of letting go of mental burdens. “Being happy is important. Don’t hold on to your troubles,” she counsels. Mdm Absah, who often fields questions from patients on her youthful countenance, often shares this piece of advice with them: “Don’t worry so much — enjoy your life and don’t be too stressed. Smile more!”

*These photos were taken individually and merged together for this publication

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Things About...

5 Things About...

Co-morbidities More people are being diagnosed with chronic diseases such as diabetes, high cholesterol, and high blood pressure â&#x20AC;&#x201D; and at least a third have more than one co-occurring illness (co-morbidities). This trend greatly impacts overall health, underscoring the importance of better prevention, care and self-management. In consultation with Dr Benjamin Lam, Family Physician and Consultant, Family and Community Medicine, KTPH

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Having more than one chronic illness is associated with frequent hospital admission and high healthcare costs.

In Singapore, diabetes and heart failure are strongly interlinked. More than a third of heart failure patients are diabetic, while those with diabetes are four times as likely to develop heart failure.

High cholesterol often occurs with high blood pressure, and these two conditions together greatly increase the risk of heart disease and stroke.

110

Obesity is a growing problem in Singapore. About 30% of Singaporeans are overweight and 10% are obese. Obesity greatly increases the risk of developing chronic diseases.

Apart from medication, sustained lifestyle modification programmes, self-management and integrated health and social services can significantly improve the prevention of complications due to comorbidities and improve health and psycho-social outcomes. | 29

aily Dose

MAKING THE MOST OF

THE NEW NORMAL

If you are beset with a confusing mixture of anxiety and anticipation going into the new year, you’re not alone! The past year has brought about many uncertainties and new ways of living and working. Here are some tips to keep you mentally and emotionally well as we enter a new normal in these ‘COVID-19 times’. In consultation with Dr Goh Kah Hong, Head & Senior Consultant, Psychological Medicine, KTPH

UNDERSTAND ANXIETY AND KNOW WHEN IT’S A PROBLEM The COVID-19 pandemic has been a period of sustained uncertainty and heightened worry, and it has made a drastic impact on our daily lives and sense of normalcy. Feeling anxious during this time, especially as we enter a new year, is a normal response. Nevertheless, it is helpful to know how to differentiate common anxiety in response to stress from overwhelming anxiety that is bad for the soul. Whether we realise it or not, we have been facing losses — from a sense of security and freedom that we took for granted, to more tangible threat of unemployment and financial losses. People who

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have been feeling teary or heavy-hearted sometimes could well be having a normal response to the pandemic. The simplest way to tell you have normal anxiety is that you are not paralysed by it. However, this response is susceptible to dysregulation.

Sustained anxiety that interferes with the ability to cope with daily life is not healthy. If you feel paralysed by anxiety and it is causing problems such as body aches, insomnia or irritability, it may be time to learn some coping mechanisms or seek help.

TAKE THE OPPORTUNITY TO DEVELOP HEALTHY ROUTINES For many of us, the new workfrom-home routines and fewer commutes can be a chance to develop new regimens that include more self-care and healthful activities, or quality time with loved ones. It may be particularly important to ensure that you are able to separate ‘home life’ and ‘work life’ so that you achieve a good balance of both. Some ways to do this could be to ensure you have a separate working space or work ritual. One example of a work ritual would be to dress in work clothes during work hours, especially if you have to be in videoconferences. It is also helpful to remain connected with your colleagues, and perhaps set achievable and meaningful goals together. Make sure to set aside time for yourself, friends and family, so you can ‘switch off’ and achieve work-life balance.

CONTINUE TO MAKE MEANINGFUL — AND SAFE — CONNECTIONS Even as restrictions on social

Sustained anxiety that interferes with the ability to cope with daily life is not healthy. If you feel paralysed by anxiety and it is causing problems, it may be time to learn some coping mechanisms or seek help.

gatherings ease, it may be a while before we can interact as we once did before the pandemic struck. Remember to take precautions whenever socialising — you never know who is vulnerable among us. Also, being able to socialise again may not necessarily ward off loneliness, which is a perceived sense of isolation due to feeling disconnected and purposeless.

Do look out for each other and reach out to people who seem vulnerable; if you feel lonely, take a chance and initiate contact if you need to connect meaningfully. This is a good time to call up an old friend to express your care and concern — you may be pleasantly surprised by how uplifted you can feel by showing care for others. Avoid talking about COVID-19 incessantly; instead, you could choose to reminisce about the good times you had together in the past, and share your hopes for the future. More than physical connections, this helps to nurture spiritual bonding as well.

akan Time

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cut & keep

Chap Chye

Make a lower-sodium version of this Chinese New Year meatless staple for a healthier you in the coming year! Recipe provided by Demi Chef de Partie Mok Jey Lun, Food Services, KTPH, in consultation with Nutrition and Dietetics, KTPH

INGREDIENTS SERVES 4 • • • • • • • •

Dried ingredients - 30g (roughly 6 pieces) dried shitake mushroom, de-stemmed - 14g (roughly 6 pieces) dried black fungus (wood ear mushroom) - 5g black moss fungus (fat choy) - 40g (roughly 50 pieces) dried lily bulbs 300g Napa cabbage (wong bok), cut into bite-sized pieces 2 medium carrots, cut into 1 x 1” squares 2tbsp cooking oil 2tbsp sugar 4 cloves garlic, chopped 4 cubes white fermented tofu, mashed 1L water

Tip: For a spicy kick, substitute 2 cubes of white fermented tofu with the red variety

METHOD 1. Pre-soak and remove the shitake mushrooms, black fungus, black moss, and dried lily bulbs 2. In a medium pot, pre-heat the oil and sauté the garlic until fragrant 3. Add the mashed fermented tofu 4. Add 1 litre of water and bring to a boil 5. Add the shitake mushrooms, black fungus and dried lily bulbs and cook for 2 minutes, or until the water comes to a boil 6. Add the cabbage, carrots, black moss and sugar 7. Simmer for about 10 minutes, or until vegetables and mushrooms are soft 8. Serve hot

NUTRITIONAL INFORMATION (PER SERVING) Energy

172kcal

Carbohydrates

28g

Protein

Fat

• Saturated

0.4g

• Polyunsaturated

1.3g

• Monounsaturated

0.7g

Cholesterol

0mg

Dietary Fibre

11.5g

Sodium

359mg | 33

it & Fab

lifting more Than a finger In consultation with Jeremy Law, Physiotherapist, Rehabilitation Services

34 |

Strength training is an essential component of any fitness regime. It not only balances out an exercise plan, but also improves joint function, bone density, muscle, tendon and ligament strength.

hen it comes to exercise, many are familiar with the benefits of the aerobic variety, such as brisk walking, running and swimming. However, strength or resistance training is just as beneficial to overall fitness and health.

WHAT IS RESISTANCE TRAINING? Resistance training includes any movement that requires your muscles to overcome external resistances (loads) more than they are accustomed to, in a safe and gradual manner. In doing so, your muscles and other tissues, such as bones and ligaments, then undergo gradual adaptations to enable you to overcome those loads, adding to their strength.

WHAT ARE SOME BENEFITS OF RESISTANCE TRAINING? Resistance training does a lot more than build muscle size and strength. It can: • Boost your metabolism and support fat loss • Increase physical endurance and performance

• Improve balance and reduce the risk of falls and injury risk from sports and daily activities • Increase bone health and density • Enhance glucose regulation and improve insulin sensitivity • Lower the risk of obesity and cardiovascular disease • Elevate mood, sleep and energy levels

WHAT ARE SOME EXAMPLES OF STRENGTH TRAINING? The modes of strength training vary, from lifting weights to working with resistance bands; you can also simply use your body weight for resistance (in exercises such as push-ups, pull-ups, and planks). How intense the exercise is will depend on the weight, speed and number of sets and repetitions you do.

WHAT IS THE RECOMMENDED FREQUENCY? Ideally, resistance training should be done for all major muscle groups at least two days a week, with one to three sets of eight to 12 repetitions of each exercise. For beginners, the general principle to use is to ‘start low

and go slow’ to reduce risk of injury and soreness. As you gain muscle strength and endurance over time, you can increase the amount of resistance gradually to ensure the exercises stay challenging at the desired amount of repetitions, or increase the frequency of exercise per week. Just be sure to consult a doctor if you have any health concerns before starting an exercise programme.

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Community Nurse Post

Wellness Kampung

Wellness Kampung is an initiative comprising three wellness and care centres for residents in the North. They provide a suite of health and social programmes, creating a support network for residents to inspire each other to adopt healthier lifestyles in a close-knit 'kampung' setting. Opening hours: Mondays to Fridays, 8.30am to 5.30pm (closed on Saturdays, Sundays and all Public Holidays)*

115 Chong Pang

260 Nee Soon East

765 Nee Soon Central

Blk 115 Yishun Ring Road #01-495, Singapore 760115

Blk 260 Yishun Street 22 #01-87, Singapore 760260

Blk 765 Yishun Street 72 #01-366, Singapore 760765

6257 4702

6257 4802

6257 4842

*In light of COVID-19 safe management measures, please check the KTPH website for the centre schedule and call in advance to see if there are vacancies for group activities.

Admiralty Medical Centre (AdMC) AdMC is a one-stop medical centre for specialist outpatient consultation, day surgery, rehabilitation and diagnostic services, as well as community health outreach activities.

Khoo Teck Puat Hospital (KTPH)

KTPH is a 590-bed general and acute care hospital serving more than 800,000 people living in the north of Singapore. It combines medical expertise with high standards of personalised care in a healing environment, to provide care good enough for our own loved ones.

Yishun Community Hospital (YCH)

YCH provides intermediate care for recuperating patients who do not require the intensive services of an acute care hospital. Situated beside KTPH, the two hospitals provide an integrated care experience for patients.

676 Woodlands Drive 71, #03-01 Kampung Admiralty, Singapore 730676

90 Yishun Central Singapore 768828

2 Yishun Central 2 Singapore 768024

6807 8000

6555 8000

6807 8800