AHA magazine May-Jun 2018: Truly unified care

aha

Issue 3: May-June 2018

our next lap: truly unified Care

MCI (P) 101/04/2018

Chairman of the Medical Board A/Prof Pek Wee Yang on Yishun Health’s care plans for our patients and the community

Paying it forward

AHA May-June18 cover.indd 1

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Beyond Beauty

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Make Time for Mindfulness

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16/5/18 4:50 PM

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ontents

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COVER STORY Coordinating Care Around You Yishun Health’s Chairman of the Medical Board, A/Prof Pek Wee Yang, shares his thoughts on what care integration truly means

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HEALTH HIGHLIGHTS Healthcare initiatives in this year’s Budget

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

12 EVERYDAY HEROES

Paying it Forward

Healthcare Humanity Award winner, Mr Rosli bin Hadi, on giving back 20 SPOTLIGHT

Beyond Beauty

There’s more to plastic surgery than aesthetics

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22 PUBLISHER 22 5 THINGS ABOUT…

Kidney Health

Keeping kidney disease at bay 24 DAILY DOSE

Make Time for Mindfulness

Practical tips to being in the present 26 LIVE WELL

Meet Your Friendly Mr Fix-Its

Wellness Kampung’s Repair Kaki initiative 28 MAKAN TIME

Three Treasures Brown Rice

A delicious one-pot dish for the family 30 MIND & HEALTH

Colour Me Mindful

Colour in this infographic to practise mindfulness

Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group in the north of Singapore. It comprises Admiralty Medical Centre, Khoo Teck Puat Hospital and Yishun Community Hospital.

It includes community extensions such as Wellness Kampung.

EDITORIAL TEAM Albert Foo Sharon Ng Sabrina Ng Hannah Wong

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

E D I TO R I A L D I R E C TO R

Chua Kim Beng

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

Sheralyn Tay

aha

E D I TO R

Issue 3: May-June 2018

our next lap: truly unified Care Chairman of the Medical Board A/Prof Pek Wee Yang on Yishun Health’s care plans for our patients and the community

INTEGRATED CARE SERIES PART 1 OF 3

Dang Hui Ling A R T D I R E C TO R

Regina Wong DESIGNER

Melissa Poon S E N I O R M A N AG E R , C L I E N T R E L AT I O N S H I P MCI (P) 101/04/2018

Jessie Kek

W Paying it forward

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Beyond Beauty

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Make Time for Mindfulness

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hy aha?

The name aha holds much significance for us at Yishun Health.

In part, it is a nod to our beginnings at Alexandra Hospital; it also stands for ‘Advocates for Health in Action’. Through these pages, we hope to empower you to take charge of your own health and discover those ‘aha!’ moments that lead to a healthier, happier you.

C O N T R I B U TO R S

Geraldine Lee, Justin Loh

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) 101/04/2018

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ealth Highlights

BUDGET 2018:

HEALTHCARE ROUNDUP The Ministry of Health (MOH) announced a wide range of initiatives at this year’s Budget. Here’s what it means for you.

More polyclinics near you

The polyclinic network to be enlarged; it will increase to 30–32 by 2030.

TO BE COMPLETED BY 2023

RE-OPENING BY MID-2018

• Nee Soon Central • Tampines North

• Yishun

2020

2017 2018 COMPLETED IN 2017 • Pioneer • Punggol

2030 2023

TO BE COMPLETED BY 2020 • Bukit Panjang • Eunos • Kallang • Sembawang

TO BE COMPLETED BY 2030

4–6 more new polyclinics (locations to be finalised)

MORE ILLNESSES COVERED UNDER CDMP & CHAS CDMP

Chronic Disease Management Programme

CHAS

Community Health Assist Scheme

New items that will be covered from June 2018 Pre-diabetes* Diabetes-related consumables such as insulin injections, lancets and test strips Ischaemic heart disease (this takes the number of conditions covered under this programme to 20) New items that will be covered from June 2018 Pre-diabetes*

*To encourage those with the condition to seek early intervention.

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STRENGTHENED COLLABORATION WITH GPs Primary Care Networks (PCN) support private GP clinics to organise themselves into groups offering teambased care in the community.

Under this scheme, patients will receive better care by a multidisciplinary medical team.

$45 million

have been committed to PCN over the next 5 years

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PCN have been formed since the launch in 2017

>300

GP clinics are involved in PCN

New IP riders to incorporate co-payment MediShield Life integrated shield plan (IP) (then)

Policyholders typically need to copay 10% of the hospital bill, but some buy a full rider option to cover 100% of their bill. Current holders will not be affected by the change in policy.

MediShield Life integrated shield plan (IP) (now)

Any new full riders issued from now onwards will have to transition to the co-payment model from 1 April 2021.

From that day onwards, insurers must include a co-payment component of at least 5% for all new rider plans; however, the total amount that a policyholder has to pay can be capped at S$3,000 a year.

MediShield Life covers treatment costs in Class B2 and C wards in public hospital, while integrated shield plans are an add-on to increase the coverage for medical fees at higher-class wards in public hospitals or private hospitals.

STREAMLINED SERVICES FOR SENIOR CITIZENS Pioneer Generation Office will be renamed Silver Generation Office (SGO) with effect from 1 April 2018.

Housed within the Agency for Integrated Care, SGO will reach out to citizens aged 65 and above to link them with active ageing, befriending and aged care services in the community.

BROADENED USE OF MEDISAVE CDMP Medisave withdrawal will be limited to $500*/year (formerly $400/year) from June 2018 *For treatments, vaccinations and health screenings Flexi-Medisave Age limit will be lowered to 60 years* from June 2018 *Singaporeans aged 60 and above will be able to use up to $200 of their Medisave a year for outpatient medical treatments at public sector specialist outpatient clinics (SOC), polyclinics and CHAS GPs.

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hat’s Up

Visual Road Nudges to quit smoking

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espite many ‘no smoking’ signs prominently displayed around the grounds, evidence of smoking was still observed in several areas surrounding KTPH. To address this issue, KTPH partnered local construction company Samwoh for a joint community health project to implement visual health nudges.

This collaboration saw graphic health warnings painted onto the pavement at three smoking hotspots.

These eye-catching messages, the first of their kind in Yishun, raise awareness of the ills of smoking.

Passers-by can also scan the QR codes, which are linked to smoking cessation videos produced by the Health Promotion Board (HPB).

Since its implementation, the results have been encouraging, showing a reduction in the total smoking violations at the three hotspots.

- KTPH and Samwoh team members posing with one of the road nudges

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Making a splash!

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n celebration of World Water Day, Yishun Health and PUB co-hosted a community event on 11 March 2018 to pledge and share the value of water conservation. Participants promised to take shorter showers, half-flush toilets, wash vegetables and dishes in a container, brush teeth with a mug of water, and use washing machines only on full loads when possible.

Guest-of-honour Er Dr Lee Bee Wah, Adviser to Nee Soon GRC Grassroots Organisations and MP of Nee Soon GRC, acknowledged partner schools and Nee Soon residents for their water conservation efforts.

- Er Dr Lee Bee Wah (second from right) is joined on the right by Mrs Chew Kwee Tiang (CEO, KTPH and Yishun Health) and Mrs Cindy Keng (Director, 3P Network, PUB) in giving the ‘thumbs up’ to water conservation

Kaizen Festival 2018 Y

ishun Health held its third annual Kaizen Festival on 18 April 2018 to continue driving the spirit of continuous improvement (Kaizen).

The festival is an evolution of The Good Ideas Forum that was held when Yishun Health was known as Alexandra Hospital.

In her opening address, CEO of KTPH and Yishun Health, Mrs Chew Kwee Tiang, highlighted the history of the organisation’s Kaizen culture and the enduring relevance of ‘Think Think Do, Think Do, Think Do’, which has inculcated a thinking

and doing mindset among staff. She also encouraged staff to keep up the Kaizen spirit that continuously seeks to improve patient care.

Apart from recognising the good work done by staff across the Yishun Health Campus, this year’s Festival included three educational and funfilled fringe workshops. As part of the Kaizen Poster Competition, 72 shortlisted posters — out of the 141 entries received — were also displayed at the KTPH Learning Centre. Of these, the winners of each category were announced at the close of the festival.

- A/Prof Tai Hwei Yee (Chief Quality Officer, NHG Group) with one of the winning Kaizen teams

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hat’s Up

Dietitian’s Day: promoting Meatless Monday

Turn to page 28 for a recipe that’s perfect for your next Meatless Monday!

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n an effort to promote a plant-based diet, KTPH’s Nutrition and Dietetics team set up an information booth to raise awareness of the subject for Dietitian’s Day 2018. Using informative posters, they shared advice on the benefits of a once-weekly meat-free day movement known as Meatless Monday.

In addition to the information booth, KTPH dietitians also held a series of Meatless Monday nutrition talks in collaboration with four Community Centres and Residents’ Committees in Yishun. Held on 17, 18 and 25 March 2018, these talks saw the dietetics team highlight the benefits of going meatless and share practical tips in planning healthy plant-based meals.

From top: - Mok Wang Yen (KTPH dietitian) answering questions on plant-based diets from a member of the public - KTPH dietitians welcoming visitors to the booth

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Talks on bone health

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ishun Health welcomed some 230 senior citizens to the KTPH auditorium when it hosted the Orthopaedic Public Forum in Mandarin on Saturday, 24 March 2018. The Forum was aimed at raising awareness of bone conditions and remedies.

Yishun Health’s orthopaedic specialists gave presentations on numerous topics, including arthritis, osteoporosis, and acupuncture for back pain. Nurses also set up a booth to share advice on ageing well, staying active, and joint health.

Left: - Nurses setting up a health screening booth to check blood pressure, weight, and osteoporosis risk Right: - Dr Alvin Tan chatting with one of his patients, who shared her experience of total knee replacement and being able to walk just one day after surgery

6th Workplace Health Forum T

he sixth instalment of the Workplace Health Forum (WHF) was hosted by Yishun Health on 2 March 2018. It was an occasion for partners to network and share best practices in workplace health promotion. This year, the forum was broadened to become a National Healthcare Group (NHG) cluster event.

Dr Michael Wong, Senior Consultant & Director, Health for Life

Centre, KTPH, spoke on Living Well @ Workplaces. He noted how ‘living well’ is one of NHG’s five strategic care thrusts, and encompasses areas such as workplaces, schools and the community. To build a culture of living well, it must go beyond ad hoc activities and become integrated into everyday living.

Drawing examples from Yishun Health’s own five pillars of health, he highlighted that such

initiatives must be ground-up, have multiple touchpoints, and focus on engagement and education so as to empower people to act.

Three other healthcare professionals from NHG also shared about the different aspects of keeping healthy at work. Their talks were on Workplace Weight Management, Vaccination for Employees, and Mental Well-being at Work.

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hat’s Up

Trainees’ Engagement Day

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ore than 100 junior doctors and Year 5 medical students gathered for KTPH’s second Trainee’s Engagement Day (TED) on 2 February 2018.

The annual orientation-style event, organised by Yishun Health’s Residency Program Office, gave participants a glimpse of Yishun Health’s healthcare philosophy. They were introduced to the different aspects of the Yishun Health Regional Health System, and were given opportunities to chat with faculty and staff. The team from the Woodlands Health Campus also shared their community outreach efforts ahead of the completion of the campus.

The event included a Human Library, which showcased three ‘human books’ from the Wellness Kampung. These were inspiring patient stories that illustrate the journeys patients go through, reminding doctors of the person behind every ‘disease’ or ‘case’. This timely reminder was underscored with a walk-through of Project Orange, an exhibition profiling the community in the north.

From top: - ‘Human books’ sharing personal stories on sickness, recovery and living well - Junior doctors having a discussion with Dr Ong Chin Fung (Associate Designated Institutional Official (ADIO), NHG-YH Residency Program Office) - Participants viewing Project Orange, an exhibition that profiles the health journeys of residents in Chong Pang

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RHS Forum: Disrupting Tradition T

he annual Yishun Health Regional Health System (RHS) forum — themed ‘Disrupting Tradition’ — was held on 23 February 2018.

Dr Wong Sweet Fun, Clinical Director, Population Health & Community Transformation, opened the event with an update of the various innovative community programmes that have challenged the traditional trajectory of care.

One of these was the Share a Pot initiative, which was recognised for its approach to addressing frailty in modern Singapore. This weekly soupfor-seniors community effort was one of six winners of the iF World Design Guide Social Impact Prize. It now has 1,200 registered participants and 164 volunteers across 18 active sites, with six more coming up this year.

The forum also featured guest speakers from non-healthcare

backgrounds: Mr Tong Yee from The Thought Collective, and Ms Ngiam Su-Lin and Mr Kok Heng Leun from Both Sides, Now (BSN).

Mr Tong spoke of his experience in conducting experiential trails around Singapore, and stressed the importance of conversation. When people see themselves as part of the narrative, they feel invested in it, he said; this builds a sense of shared responsibility. Ms Ngiam and Mr Kok shared their experience in approaching the traditionally taboo topic of death through art. This allows a more open approach in broaching end-of-life issues, including advance care planning, a topic that KTPH and BSN have been co-promoting since 2013.

The forum culminated in a fun and raucous lohei to ring in the Lunar New Year.

Above: - Mr Tong Yee, Dr Wong Sweet Fun, Ms Ngiam Su-Lin and Mr Kok Heng Leun taking questions from the audience Below: - Participants digging into a lohei lunch after the thoughtprovoking discussions

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veryday Heroes

Paying it FORward Inspirational stroke survivor Mr Rosli bin Hadi volunteers at Yishun Community Hospital.

Besides lending a helping hand, he also offers hope, a listening ear, and advice to other patients. It is no wonder he won the Healthcare Humanity Award in April.

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T

he days following his stroke were some of the darkest for Mr Rosli.

That is understandable — the sudden onset of weakness, immobility and anxiety would worry even the most extreme optimist.

Somehow, he found the motivation to get better.

“I am naturally quite positive; despite my stroke, my personality helped me to recover,” shares the 54-year-old. Telling himself that he would and could walk again, he dedicated himself to his stroke recovery therapy programme.

Within a month, he was well enough to be discharged.

Today, he is back at Yishun Community Hospital (YCH) — not as a patient, but as a volunteer.

While most would prefer to leave their illness in the past and not visit a place steeped in those memories, Mr Rosli looks at it differently.

After all, YCH was the place where he recovered, and a place where others were going through the same experience as he had.

“I wanted to volunteer because I wanted to help other stroke survivors,” he explains.

It is also a way for him to stay active post-stroke. His physician, Dr Djoni Huang, Principal Staff Physician at YCH, is impressed

by Mr Rosli’s selflessness and compassion. “During his own illness, Mr Rosli witnessed many others suffering from the same condition and had a strong calling to volunteer,” he recalls.

INSPIRING OTHERS Mr Rosli has been volunteering for about a year now. These days, he goes to YCH about twice a month.

He wheels patients from YCH to the Specialist Outpatient Clinics or takes on a befriender role.

He admits that he did not think that such simple acts would be

significant for patients. However, when patients learn that he is a stroke survivor, their eyes would light up with curiosity. “They often ask, ‘How did you get better?’”

Sharing his own experiences has become a form of encouragement for many of the patients he encounters in his volunteer work.

Mr Rosli even helps out at the gym during therapy sessions, sometimes explaining the role of certain basic exercises and reinforcing the techniques taught by physiotherapists. “I tell patients this is not a place to sleep! It is a place to recover. The ‘community’ in community hospital is because the goal is for us to go back into the community,” he enthuses.

I am encouraged to come back to volunteer because I want to help people and I want to see stroke survivors like myself smile.

MR ROSLI BIN HADI

LIVING WELL AFTER STROKE Looking back on his illness, Mr Rosli sees it as a lesson for living well.

“I don’t think about my stroke as a bad thing. It encourages me to take care of myself more,” he affirms.

He credits his volunteer work for not only adding meaning to his life, but also for helping him in his recovery from stroke — it keeps him active and reinforces a positive mindset as he helps other people.

“I am encouraged to come back to volunteer because I want to help people and I want to see stroke survivors like myself smile.”

“Volunteerism is a form of occupation that holds much therapeutic value. One can gain a sense of value and belonging in the community through volunteering,” explains YCH occupational therapist Beryl Lim. “Despite the challenges in his journey, Mr Rosli is recognised for his consistent efforts in motivating and inspiring other stroke survivors with his valuable experiences. We are greatly blessed and thankful for his dedication.”

can help You

INSPIRED TO BE A VOLUNTEER? The links below have information on how to sign up and a list of areas where you can chip in.

KTPH: www.ktph.com.sg/volunteer YCH: www.yishuncommunityhospital. com.sg/join-us/volunteers

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Cover Story

COORDINATING CARE

around YOU

With healthcare demands, costs and expectations rising, there is an urgent need to transform the way care is delivered. This entails a hard look at what it means to be a public hospital, a medical professional, and a healer, says Associate Professor Pek Wee Yang, Chairman of the Medical Board at Khoo Teck Puat Hospital and Yishun Health.

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LEFT TO RIGHT: Ms Cara Lee (Senior Occupational Therapist, YCH), Ms Ng Huoy Ling (Nurse Manager, Population Health), A/Prof Pek Wee Yang (CMB, KTPH and Yishun Health), Mr Teoh Gin Wah (Centre Coordinator, Wellness Kampung), Dr Valliammai D/O Nallakaruppan (Consultant, KTPH), Ms Nur Jannah Begum Binte Arsat (Senior Radiographer, KTPH)

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Cover Story

S

ingapore, like many modern societies, is facing a confluence of socio-demographic changes that has led to increasing demands on the healthcare system.

While Singaporeans are enjoying healthier and longer lives in general, a growing yet rapidly ageing population means that the burden of chronic diseases — especially multiple co-existing conditions that result in medically complex issues — will inevitably rise.

“Many of these conditions [such as diabetes, stroke and heart disease] have a fairly long tail and get progressively worse, eventually leading to end-stage problems such as organ failure,” says Associate Professor Pek Wee Yang, Chairman of the Medical Board for Khoo Teck Puat Hospital (KTPH) and Yishun Health.

He notes that, although the current healthcare model is well suited to managing these end-stage issues, it uses a lot of time and resources. “This acute care model is predicated on treating disease instead of preventing it; we simply will not have a sustainable system if we continue this way.”

A/Prof Pek stresses the need to shift the paradigm to build a truly holistic and sustainable healthcare

The idea of care integration may seem very process-driven, but it is a mindset issue.

We simply need to think of delivering care to patients as if we were doing so for a beloved family member.

DR LEE KOK KENG, MEDICAL DIRECTOR, YCH

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system. Apart from building more infrastructure to cater to increasing demand, this also means going further upstream to prevent people from coming to the hospital in the first place.

We want to build community health by helping people to see their own potential in helping themselves stay healthy. The community — its GPs, community nurses, families and social networks — is a rich resource in and of itself.

DR WONG SWEET FUN, DEPUTY CMB (POPULATION HEALTH), KTPH AND YISHUN HEALTH

HEALERS VS DISEASE SPECIALISTS Doctors today have become very good at treating specific organs and conditions. However, this means patients with more than one condition need to seek multiple specialists. A/Prof Pek points out that care for such cases can become complicated and fragmented, resulting in frustration for the patient. Apart from poor patient compliance, there is added social and opportunity cost when family members need to take time off work to accompany loved ones to medical appointments.

“We cannot use old methods to solve new problems,” A/Prof Pek insists, pointing to the need for a realignment of care. “We have to go back to being holistic physicians and not just disease specialists.”

Whether one is a specialist or a general practitioner, medical personnel should remember that

patients are people first, and their conditions must be addressed holistically, he stresses. “If you talk about health, you are not just referring to physical health, but many other dimensions of health, where a person is more than one organ or disease.”

A MODEL FOR MINDSET CHANGE To this end, Yishun Health has developed a vision for a unified clinical care model that focuses on the person as a whole. “We will organise care around him or her, integrating care so that the process is less cumbersome,” reveals A/Prof Pek. “Instead of viewing ourselves as just a hospital, we should deliver a model of care that straddles the spectrum from the acute hospital and the community hospital to empowering the community to stay healthy.”

While the roadmap has been laid out, he emphasises that this improvement entails more than the re-organisation of hospital processes and operations. “It takes a mindset change,” he states. “We need to ensure that our doctors have the right capabilities and aptitude

Care integration is building a culture where, regardless of where the patient is sited within the campus, our doctors readily cross boundaries to provide consult so that patients receive timely medical care.

A/PROF PHOA LEE LAN, DEPUTY CMB (CARE INTEGRATION & CLINICAL STANDARDS), KTPH AND YISHUN HEALTH

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Cover Story What we are looking for is a cultural reset in the healthcare landscape. How can we reorganise our care and move away from episodic, siloed care so that we can create a more meaningful relationship with patients?

A/PROF TERENCE TANG, DEPUTY CMB (CLINICAL INFORMATICS, INNOVATION & PATIENT ENGAGEMENT), KTPH AND YISHUN HEALTH

to cross the boundaries of the traditional siloed care.” He believes that doctors must take a more holistic approach, and there needs to be a stronger sense of ownership where medical professionals “walk the entire journey” with patients and build care plans around his or her emotional, psychological, social and functional needs, beyond just the medical.

One of the ways Yishun Health is moving away from conventional segregation is integrating the acute care team in KTPH and the community care team in Yishun Community Hospital (YCH). Work is also underway to build a culture that empowers doctors across different specialist teams to improve collaboration and further enhance the development of holistic patient care plans.

ENGAGING COMMUNITY PARTNERS Beyond the hospital care setting, A/Prof Pek says there is room for

MEDICAL TEAMS IN KTPH & YCH

YISHUN HEALTH’S MODEL OF CARE INTEGRATION Steps are being taken to set the foundations for a truly integrated model of care that will improve workflows, enhance community capabilities, and create a seamless patient experience.

Whether they are from the acute care setting of KTPH or intermediate care of YCH — all are part of a single ‘campus flow’. This will translate to easier referrals, more seamless movement of patients, and collaborative, multidisciplinary care.

This will be driven by a strong culture of ownership and collaboration.

GPs & PRIMARY CARE PROVIDERS Community health partnerships will be enhanced so that people with chronic diseases can be managed by their GPs, and supported by nurses and allied health services.

Stronger partnerships and resources will be rolled out to support GPs in this effort.

PATIENTS & THEIR FAMILIES Patients will receive more coordinated care that suits their needs, whether at Yishun Health hospitals or their neighbourhood.

This means more convenient care and fewer hospital appointments — but specialist care is still at hand should the need arise. Patients will be empowered to raise levels of self-care.

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general practitioners to play a bigger and more strategic role on the community front. “They play a key role at the centre of a team of community nurses and allied healthcare professionals, which form small ‘honeycombs’ of care that cover a particular geography,” he describes.

This way, people can receive care where they live, be supported by a doctor and a team of healthcare workers, and be assured that serious episodes can be referred back to the acute hospital. This seamless flow from the community to the hospital and back to the community should be one of the key characteristics of this new care model. “Our healthcare resources should follow the patient so that, no matter where they go in the healthcare system, they will receive the support that is right for them.”

Multidisciplinary care must evolve towards transdisciplinary care. This approach moves away from episodic ad hoc care, enhances the communication and collaboration between every medical professional, and builds a greater sense of ownership of every patient.

A/PROF TAN KOK YANG, DEPUTY CMB (SERVICE DEVELOPMENT), KTPH AND YISHUN HEALTH | 19

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potlight

BEYOND BEAUTY Plastic surgery goes beyond beautification. It also repairs the body to restore function and return quality of life to those affected by disease, trauma or congenital defects.

From left: Dr Jerry Goo (Consultant, General Surgery) and Dr Pek Chong Han (Associate Consultant, General Surgery)

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W

hile plastic surgery is popularly associated with aesthetics, there is more to this surgical discipline than breast augmentations and face lifts.

According to plastic surgeon Dr Pek Chong Han, Associate Consultant, General Surgery, cosmetic or aesthetic surgery is only a subset of the medical specialty known as plastic surgery. “Plastic surgery consists of two broad categories: cosmetic surgery and reconstructive surgery, which includes facial surgery, hand surgery, microsurgery and the treatment of burns,” he explains.

While cosmetic surgery aims to improve one’s normal appearance, “reconstructive surgery aims to reconstruct a defective part of the body or improve its function”. If an injury or burn has affected the way the body looks or functions, or if severe infection or cancer has resulted in ‘holes’, scars or other physical changes, reconstructive surgery techniques are used to restore both form and function to the affected body part(s).

Flap reconstruction, for example, involves transferring living tissues — such as skin or muscle as well as its accompanying blood vessels that keep these alive — from one part of the body to another. Flap surgery can restore form and function to areas of the body that may have lost skin, fat, muscle movement, and/or skeletal

support. According to Dr Pek, every defect that is presented is unique in its own way, and its consequent reconstruction is as much an art as it is science.

GROWING THE SERVICE In Singapore, reconstructive surgery represents much of the workload in public hospitals, while the reverse is true for the private sector. Within KTPH, the plastic surgery department handles a wide range of conditions and conducts 20 to 30 surgical procedures a month.

The most common procedures are skin grafts or reconstruction of lower limb defects. Other procedures include managing complex wounds of the body, as well as breast reconstruction.

In the outpatient setting, Dr Pek notes that many patients request for a plastic surgery consult to improve the appearance of scars or to remove lumps over cosmetically sensitive areas such as the face.

The Plastic Surgery and Breast Surgery teams also work closely to bring breast reconstruction to breast cancer patients. Dr Jerry Goo, Consultant, General Surgery, shares, “The oncoplastic breast reconstruction service is a natural extension of our current KTPH breast unit. It is aimed at providing optimal coordinated patient care for the treatment of breast cancer and benign breast diseases.”

Dr Goo adds that the guiding principle of the oncoplastic breast unit — and the overall goal of

Every defect that is presented is unique in its own way, and its consequent reconstruction is as much an art as it is science.

DR PEK CHONG HAN (SEATED)

LIFE AFTER BREAST CANCER Mdm Phua Ai Ling may have had a close brush with breast cancer, but her cheerful, chatty and positive demeanour belies that fact. Discovering a lump in her breast in late 2017, she quickly sought medical advice and was able to catch the growth in its early stages.

After seeking advice from others who had gone through the same journey, Mdm Phua decided on a mastectomy and breast reconstruction in addition to chemotherapy.

The mother of two felt that the surgery would offer her the most natural outcome as the procedure uses fat from her own abdominal area to reconstruct the breast.

“Dr Pek and his team are very attentive and reassuring,” she shares, adding that she is thankful for the team and their care.

reconstructive surgery — is to offer surgical options to help people return to normality, and enhance emotional and physical well-being, selfesteem, quality of life, and cosmetic satisfaction. Says Dr Pek, “Patients often underestimate the positive effect of breast reconstruction on their overall healing process.”

The department also works closely with all other specialty surgeons in KTPH, adds Dr Pek, and there are plans to expand the service to other areas. “Plastic surgery deals with reconstructive problems of the entire body, literally from head to toe. We endeavour to resolve any reconstructive problem from any referring specialty, allowing the patient to have a better quality of life.”

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Things About...

5 Things About Kidney Health As the body’s primary filtration system, the kidneys play a major role in keeping the body in balance.

In consultation with Dr Lim Eng Kuang Consultant, Renal Medicine, KTPH

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GET TO KNOW YOUR KIDNEYS

The kidneys are two beanshaped organs situated on each side of the lower back. Each kidney is the size of a clenched fist. The kidneys play an important role in preventing the buildup of waste and extra fluid in the body, maintaining stable levels of electrolytes (such as sodium, potassium and phosphate), producing hormones that help regulate blood pressure, maintain bone health and prevent anaemia.

In doing so, they keep the body in balance on all fronts.

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HOW YOUR KIDNEYS WORK

Every day, about 110 to 140 litres of blood passes through our kidneys. Millions of small filtering units called nephrons within the kidneys filter the blood, letting out excess fluid and waste products while preventing blood cells and large molecules such as proteins from passing through. The filtered blood — with the right balance of water and minerals — is sent back to the bloodstream, while the waste is transported out of the kidneys into the bladder as urine.

4.7

people are diagnosed daily

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KIDNEY DISEASE IS ON THE RISE

Singapore has a high rate of kidney failure (see below).

KIDNEY DISEASE IS PREVENTABLE

Like most organs in the body, the health of your kidneys can be affected by poor diet, lifestyle choices, and inherited genes. Apart from uncontrollable factors such as family history, controllable risk factors include smoking, obesity, excessive intake of painkillers and poorly controlled blood pressure and/or diabetes. If you have any of these risk factors, it is important to speak with your doctor to learn

new dialysis patient is identified every five hours

2 in 3

cases of kidney failure is caused by poorly controlled diabetes

how you can better manage your kidney health.

• Control sugar levels • Monitor blood pressure • Stop smoking

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FOR HEALTHIER KIDNEYS, WATCH THE SALT AND FAT

Too much dietary salt reduces the kidneys’ ability to regulate fluids.

This results in higher blood pressure, which can damage the blood vessels in the kidneys. The recommended salt intake is 5g (one teaspoon) a day — but many of us eat way more than this! To reduce salt consumption, always choose fresh food over processed or preserved food, and replace salt and sauces with fresh herbs, spices or lemon zest. Limit your intake of soups, gravies and condiments such as ketchup. Eating too much fat can also impact kidney health as obesity is a major risk factor for kidney disease. Limit fried food, reduce the amount of oil in everyday cooking, and leave the skin and fat behind when eating chicken and other meats.

• Fresh food • Herbs and spices • Lean, skinless chicken

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MAKE TIME FOR MINDFULNESS Practising mindfulness can improve memory, concentration and decision making. It is also helpful in managing stress, enhancing emotional health and nurturing self-esteem.

In consultation with Clinical Psychologists, Psychology Services, KTPH

WHAT IS MINDFULNESS? Mindfulness is the practice of taking a little time to be aware of the moment, yourself or the world around you, even during the hustle and bustle of the work day.

HOW CAN I BE MORE MINDFUL? The first step is taking notice of your thoughts, feelings, physical sensations or even the activity you are engaged in. This act of being in the present is immediately calming to the mind. It also gives you the chance to take a step back and notice where your thoughts are leading you. This practice is useful in learning to handle anxiety and stress. The discipline of being mindful helps — whenever your thoughts are taking over — to impart the presence of mind to assess if these thoughts are helpful to the situation.

MINDFULNESS IS NOT

MINDFULNESS CAN BE ACHIEVED BY

• Emptying your mind of all thoughts • Forgetting the past • Living without any plans • Ignoring struggles or uncomfortable feelings • Becoming passive and non-assertive • Positive thinking • Something you need to do all the time

• Being more aware of our stream of thoughts and feelings • Thinking how various experiences make us feel — and how we can respond wisely rather than react impulsively • Living more in the present and less in the past or future • Cultivating small pockets of time to notice the world around you Turn to Mind & Health on page 30 to put some mindfulness into practice.

Mindfulness means paying attention in a particular way, on purpose, in the present moment non-judgementally.

JON KABAT-ZINN, FOUNDER, MINDFULNESS-BASED STRESS REDUCTION 24 |

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Northern Region Community Nurse Post

Khoo Teck Puat Hospital runs Community Nurse Posts in various areas across Northern Singapore. Our nurses are here in your neighbourhood! 邱德拔医院已在新加坡北部多处设立社 区护士健康检查站。我们的社区护士就 在您的邻里！

Our Services (fully subsidised)

• Chronic disease monitoring (BMI, blood pressure, blood sugar)

• Functional screening

(Vision, hearing, oral health)

• Health counselling & coaching • Medication monitoring • Memory test

• Fall risk assessment

我们提供的服务(全数资助) • 慢性病检测 (身体质量指数，血压，血糖)

• 身体功能检测

(视力，听力，口腔健康)

• 健康辅导 • 药物检测 • 记忆测试 • 跌倒风险评估

For enquiries, please call our hotline at 9236 6573 (Mondays – Fridays, 9am - 5pm) 如有疑问，请拨打我们的热线 9236 6573 (星期一至五，早上九点至下午五点) | 25 35 Poster.indd 25

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ive Well

Meet your friendly Mr Fix-Its Started as a way to engage senior gentlemen in the community, the Wellness Kampung’s Repair Kaki initiative has become a convivial gathering of tinkerers and handymen.

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A

round a table scattered with a random collection of small household appliances sits a group of elderly gentlemen wielding screwdrivers, soldering pens and magnifiers. Amid the clatter and concentration, there is also friendly chatter and frequent bursts of good-natured laughter.

GATHER, REPAIR, LIVE BETTER This is a typical scene of an initiative called Repair Kaki, launched by the Wellness Kampung. It is modelled after Repair Cafés, a global community movement to reduce waste, maintain repair skills, and strengthen social cohesion. Here, volunteers with electrical, electronic and other DIY skills assemble to fix appliances brought in by residents.

It was started last year as a way to engage a wider range of senior residents, like these men. Since then, they have worked on 80 items and enjoyed a success rate of roughly 80%.

The main goal of the programme is not actually repairing things, but rather to increase the level of social participation and overall wellness.

Research shows that better social networks and greater participation in social activities are associated with lower risks of cognitive decline and higher levels of psychological and physical health.

“It keeps my mind active because I learn a lot from those who are more experienced,” he shares. “Also, it is very satisfying when you manage to fix something.”

These repair sessions are also a way to make more friends.

Mr William Goh, 59, was introduced to the initiative by his daughter, who wanted him to participate in more social activities. “She was afraid I’d be lonely,” he reveals.

One of the chattier people in the group, Mr Goh not only acts as repairman, but also as a handphone tutor.

“I teach them to use their handphones, apps and watch movies so that they can live a more colourful life,” the affable gentleman enthuses.

REPAIR KAKI Fridays, 1pm–5pm Wellness Kampung @ 765 Nee Soon Central Blk 765, #01-366 Yishun Street 72 Singapore 760765

Mr Chu Siew Wah (above); Mr William Goh (opposite page)

A GATHERING OF MR FIX-ITS The Friday Repair Kaki sessions sees eight to 10 regulars. Many of them, like Mr Chu Siew Wah, 74, worked as electricians or were in the electronics or engineering fields.

“Repairing things is my hobby,” he says. “I decided to join because this is my interest.” Mr Gary Ong, 68, a retired electrician, finds the activity challenging and meaningful.

It keeps my mind active because I learn a lot from those who are more experienced.

Also, it is very satisfying when you manage to fix something.

MR GARY ONG | 27

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akan Time

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cut & keep

THREE TREASURES BROWN RICE

This savoury dish is hearty, wholesome and full of flavour. This delicious and quick-to-make one-pot meatless meal for the family can be easily made in a rice cooker.

In consultation with Nutrition and Dietetics department, KTPH

INGREDIENTS

METHOD

Go nuts, peas!

Serves 4

1. Soak the shiitake mushrooms in warm water till softened. Slice into strips.

2. Rinse the brown rice and set aside.

3. Add oil and minced garlic into the rice cooker bowl, close the lid and start the rice cooking function to heat up the unit.

4. When the rice cooker unit is warm enough to sauté the garlic, open the lid and add the blackeyed peas, cashew nuts, sliced mushrooms and long beans. Stir well and close the lid for 5 minutes, or until the mixture is fragrant.

5. Add soaked brown rice and give the mixture a stir. Close the lid for 10 minutes.

6. Mix the vegetarian oyster sauce with the water and pour this into the pot. Stir the ingredients and close the lid to allow the rice cooking function to finish its cycle.

7. Serve hot!

Cashew nuts and black-eyed peas are great sources of protein and fibre. A handful of nuts (about 30g) a day is also heart-healthy!

• • • • • • • • •

8 dried shiitake mushrooms 200g brown rice 1tbsp cooking oil 4 garlic cloves, minced 100g black-eyed peas 100g unroasted cashew nuts 200g long beans, diced 3tbsp vegetarian oyster sauce 600ml water

NUTRITIONAL INFORMATION (1 SERVING)

Energy

508kcal

Carbohydrates

72g

Protein

17g

Fat

17g

Saturated fat

3g

Cholesterol

0mg

Fibre

11g

Sodium

399mg

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ind & Health

Colour me mindful Paying more attention to the present can vastly improve mental and physical well-being. One good way to be mindful is through regular practice — focusing on simple everyday activities and tasks.

B S

avour, experience and enjoy your food Pay attention to the taste and texture of your food. What is the sound of biting into an apple?

How does a freshly peeled orange smell? Can you feel the crumbs of a biscuit on your tongue and lips?

rush your teeth mindfully Observe how the toothpaste oozes out of the tube, the cool sensation on your teeth, and the way the toothbrush bristles feel in your mouth.

Run your tongue over your teeth and smile — you’ve just completed two minutes of mindful practice!

P

ractise mindfulness while doing the chores Purposefully focus your attention as you perform household chores. Notice the way the sheets feel under your hands, the way the foam lathers on the sponge, and be fully aware of the way your hands move.

Try it yourself!

Colour in this illustration for a simple and fun way to be fully engaged in the present.

My mindful moment is…

Snap a photo of your masterpiece and send it to us at aha@ktph.com.sg for a chance to be featured on our Facebook wall!

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Registration Now Open!

Continuing Medical Education Series May–July 2018

Khoo Teck Puat Hospital is committed to providing quality, affordable and hasslefree healthcare with science, love and wisdom. Aligned with this mission is our effort to engage and support medical professionals in the community.

We do this through regular Continuing Medical Education (CME) sessions for General Practitioners and family physicians. These sessions provide the latest clinical updates to improve patient care.

Dates

Presenting Departments

12 May 2018, Saturday, 1pm-5pm

Geriatrics

19 May 2018, Saturday, 1pm-5pm

General Surgery

26 May 2018, Saturday, 1pm-5pm

ENT

7 July 2018, Saturday, 1pm-5pm

Orthopaedics

14 July 2018, Saturday, 1pm-5pm

Psychological Medicine

21 July 2018, Saturday, 1pm-5pm

Urology

28 July 2018, Saturday, 1pm-5pm

Endocrinology

Information correct at press time

The CME series is organised jointly by the GP Engagement Office. For enquiries and to register, contact: GP Engagement Office Mobile: 9114 2819 Email: ktph.icare@ktph.com.sg

For a full schedule of CME sessions, visit www.ktph.com.sg/gpcme

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YHC-Directory-190mmx260mm-hw.pdf

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Yishun Health

is a network of medical institutions and health facilities of the National Healthcare Group in the north of Singapore. It comprises Admiralty Medical Centre, Khoo Teck Puat Hospital and Yishun Community Hospital.

It also includes extensions such as Wellness Kampung.

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.

676 Woodlands Drive 71, #03-01 Kampung Admiralty, Singapore 730676 6807 8000 www.admiraltymedicalcentre.com.sg www.fb.com/admiraltymedicalcentre

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.

90 Yishun Central, Singapore 768828

2 Yishun Central 2, Singapore 768024

6555 8000

6807 8800

www.ktph.com.sg

www.yishuncommunityhospital.com.sg

www.fb.com/khooteckpuathospital

www.fb.com/yishuncommunityhospital