AHA magazine Nov-Dec 2019: Going beyond medicine

aha

Issue 6: November-December 2019

GOING BEYOND MEDICINE

MCI (P) 065/04/2019

Yishun Health’s holistic approach to health is literally built into its green and healing environment, which supports the well-being of patients and the wider community

13 ENABLING PEOPLE WITH INDEPENDENCE AND FUNCTION

SHARING STORIES of courage and HOPE

26

WATCH OUT FOR AMD 30

PUBLISHER

ontents

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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

30 DAILY DOSE

Watch out for AMD

Age-related macular degeneration is the third-leading cause of blindness in Singapore.

Go for screenings regularly to spot the signs early

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COVER STORY

Going Beyond Medicine Yishun Health supports healthy people and communities though its green and healing environment

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HEALTH HIGHLIGHTS Healthcare news and updates

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

13 SPOTLIGHT

Enabling people with independence and function

Yishun Health’s ABLE Studio is a one-stop centre for educating, encouraging and empowering patients and caregivers 16 EVERYDAY HEROES

Running in step towards health and fitness

Two colleagues and running mates share how they motivate each other towards health and fitness goals

DESIGNED FOR HEALTH 2 |

24 5 THINGS ABOUT… Stroke

One in four people will have a stroke in their lifetime, so learn how to spot the signs of this debilitating condition 26 LIVE WELL

Sharing stories of courage and hope

Cancer survivors Brenda and Josephine are sharing their story to inspire, encourage and give hope 28 MAKAN TIME

Chocolate Beetroot Mousse

Not all desserts are sinful.

This one contains an unusual ingredient: beetroot, a good source of folic acid and fibre

Part 1 of 3 A green healing environment supports and drives healthy people and communities.

In the first issue of this new three-part series, we highlight this guiding principle, which played a big part in the design of KTPH, and has come to be part of the foundational ethos of the Yishun Health campus and its culture of sustainability.

31 MIND & HEALTH

Soul-search your values

See if you can find 20 words that reflect core values that can shape one’s approach to life

DESIGNED FOR HEALTH

The universal guiding principle in medicine, ‘do no harm’, applies not only to the delivery of healthcare, but in every aspect of what we do as an organisation.

It is the foundation on which we have built our healing environment. In this three-part series, we explore the ways in which Yishun Health was located, designed and greened — and how we have sought to minimise the environmental impact of our daily operations wherever possible, without compromising patient care and safety.

This issue’s cover story (page 18) traces the history of our green beginnings, and how we built a hospital that would not only serve patients but also the community at large. From taking a holistic view of how to support health and recovery holistically to purposeful passive design, the feature describes the ways in which KTPH set the precedent as Singapore’s first ‘green hospital’.

The Everyday Heroes (page 16) and Live Well (page 26) sections respectively feature a pair of running enthusiasts spurring each other to meet fitness goals, and a pair of cancer survivors eager to share their story to give hope to people facing the big C.

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

ktph.com.sg/aha 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

Gina Ang 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

Taking a Stand for Sustainability at the 5th Green Hospitals Asian Conference

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TPH, in partnership with Health Care Without Harm and Global Green and Healthy Hospitals Network (GGHH), organised and hosted the 5th Green Hospitals Asian Conference (GHAC) from 8–10 October 2019.

The conference, held for the first time in Singapore, was themed “Towards a Sustainable, Climateresilient Asian Healthcare”. It was attended by more than 200 healthcare and sustainability professionals and experts from 25 countries, and graced by Er Dr Lee Bee Wah, Chairman of the Government Parliamentary Committee for the Environment and Water Resources, and Member of

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Representatives from KTPH, Health Care Without Harm, and Global Green and Healthy Hospitals Network posing for a photo together

Parliament for Nee Soon GRC. In her opening speech, CEO Mrs Chew Kwee Tiang shared Yishun Health’s long-standing commitment to sustainability as an integral part of our health-promoting mission.

Presenting some aspects of how we as an organisation have lived up to this were several speakers.

Gladys Wong, Senior Principal Dietitian, Nutrition & Dietetics, took to the stage during one of the parallel sessions to talk about food and waste — and how our Meatless Mondays initiative was started and how it has grown.

In a separate session, Mr Jerry Ong, Senior Vice President, CPG Consultants, shared various guiding principles that make up a green building. Mr Ong was deeply involved in designing and building KTPH, the first ‘green’ hospital in Singapore. COO Ms Yen Tan also took the time to share how the culture of sustainability has been nurtured over the last nine years.

Guest-of-Honour Er Dr Lee closed the plenary session that afternoon and reminded everyone that “being a good steward is a shared responsibility”. She was then invited to launch Seeking Sustainability — The Khoo Teck Puat Hospital Experience book, published to commemorate the efforts of those who have helped to build and run an environmentally friendly hospital, and to share our experiences with our healthcare guests.

Walking the talk and marking our stance on sustainability, KTPH, together with international representatives and members of GGHH, declared targets for the coming years. KTPH pledged to further reduce the use of plastics and non-biodegradables by looking at more environmentally friendly medical consumables. In addition, we committed to reducing energy consumption by 5% by increasing solar power generation capacity and upgrading facilities to be more energy efficient.

Led by the Green Committee, a hospital tour was organised to give participants a better idea of some of our green initiatives

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hat’s Up

Gaining Recognition

Our Winning Kampung Mindset O

n 26 September 2019, Yishun Health’s Population Health & Community Transformation (PHCT)’s Wellness Kampung won a Human City Design Award. This initiative was picked out of a total of 75 entries across 25 countries, and was the only one chosen out of 10 entries submitted from Singapore. Held in Seoul, South Korea, the Human City Design Award acknowledges designers or groups that have contributed to building a more harmonious and sustainable relationship between Man and his environment.

More specifically, it rewards them for their efforts in tackling urban environmental issues with innovative solutions and creative designs.

A Career of Empathy & Empowerment Y

ishun Health won two awards at the Asian Hospital Management Awards (AHMA), held on 12 September 2019. AHMA is a prestigious award that recognises and honours hospitals in the Asia Pacific that take innovative and progressive approaches to improve healthcare in the region.

Admiralty Medical Centre (AdMC) received a Gold Award under the Facility Management and Financial Improvement Project category, while the Community & Home Eye Screening Service (CHESS) won an Excellence Award under the Community Involvement Project category. They were picked from a pool of more than 500 entries from 17 countries.

Yishun Health brought home the Singapore HEALTH Award (Merit) on

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4 October 2019 in acknowledgement of our stewardship in championing healthy living practices and programmes for employees, partners and the community.

This biennial award recognises organisations that monitor and evaluate their health promotion programmes, ensuring effectiveness for their employees.

Yishun Health was also conferred the Charity Gold Award at the annual Community Chest Awards Ceremony at the Istana on 9 October 2019. This award recognises organisations with employees on SHARE for their high donation rate to Community Chest.

Yishun Health attained an 80–89% staff participation rate, underscoring the caring and generous heart of the all Yishun Health staff.

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ishun Health’s Deputy Head, Medical Social Services (MSS), Jenny Goh, received the Ann Wee NUS Social Work Alumni Award on 13 September 2019.

The award recognises NUS Social Work alumnus who have made major contributions to social work education and practice. It is named after Mrs Ann Wee, a pioneer social work educator and the longest-serving Head of the NUS Department of Social Work.

Jenny, who is also Principal Medical Social Worker and Manager at KTPH, has worked for 20 years as a social worker. In her acceptance speech, she paid tribute to pioneering social workers such as Mrs Wee for their inspiring values and faith.

She also shared stories about her favourite interactions with patients and caregivers, adding that it was a privilege to be part of their journey.

From left: Dr Alicia Pon (Senior Lecturer, NUS Dept of Social Work), Ms Goh Chiang Choo (Master MSW, CGH & past recipient), Ms Jenny Goh, Dr Rosaleen Ow (Senior Lecturer, NUS Dept of Social Work), A/Prof Esther Goh (Head, NUS Dept of Social Work), Dr Goh Soon Noi (Head of Medical Social Services, CGH) and Ms Mavis Teo (Head of MSW, Master MSW, KKH)

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hat’s Up

Supporting Seniors in their Golden ‘Eye-light’ Years

Keep Fit, Yishun Health!

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he annual Fitness Challenge was held on 3 September 2019, with the participation of more than 4,000 staff across a period of two weeks. Started during our Alexandra Hospital days, the Fitness Challenge encourages staff to exercise regularly as part of our Five Pillars of Health. It cements our culture as a health-promoting hospital that motivates the community to lead a healthy lifestyle.

Not to be left out, our partners joined us as well: almost 30 management and staff from FoodFare, Cheers, UEMS, ISS and Food Canopy took part in a day of friendly fitness competitions.

You are Not Alone: Caring for Caregivers T

he Ophthalmology & Visual Sciences and Geriatric Medicine departments collaborated to launch Awareness of Macular Diseases (AMD) Week and a Geriatric Health Carnival at AdMC. Held on 5 October 2019, the launch was graced by Dr Lam Pin Min, Senior Minister of State, Ministry of Transport & Ministry of Health.

The Geriatric Carnival aimed to engage, educate and empower senior residents to adopt and lead a healthy lifestyle. There were fitness and cooking demonstrations, as well as exhibition booths. With the same vision of encouraging these seniors to age healthily and gracefully, OVS provided eye screenings to detect macular diseases.

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M

ore than 100 caregivers attended a Caregivers Seminar on 5 October 2019.

Organised by Yishun Health’s Patient Experience Office, the seminar aimed to educate participants on practical ways of self-care and finding joy in their role. It also reassured them that they are not alone in their caregiving journey.

The programme covered lighthearted tips on eating joyfully as well as deeper conversations on Advance Care Planning. The event provided the caregivers with a safe and comfortable space to learn, share and find support.

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potlight

hat’s Up

Appreciating O our Medical Educators

n 20 September 2019, Yishun Health held its annual Teachers’ Appreciation Day to commend and honour teachers and clinical education leads in medical, nursing, pharmacy, and allied health, as well as the heads of departments for their commitment and support in delivering high-quality medical education to develop future medical leaders.

Organised by the Education Development Office (EDO), the event was opened by Education Director, Adjunct Associate Professor Yip Chee Chew. He also announced the integration of the Residency Program Office into EDO, and the re-organisation of EDO into three units: Pre-Professional Education (PPE), Graduate Medical Education, and Education Development. These will optimise resources and manpower utilisation, and better align EDO with the working structure and philosophy of the National Healthcare Group Education Office.

Some of the new initiatives rolled out by EDO include: • A bi-monthly Clinician Educator Meeting to build up a community of practice • The pilot E-TIME Project to capture the teaching activities and hours in the Ophthalmology & Visual Sciences department • A wellness programme on mindfulness conducted by our psychologists for the nursing educators and students

EnABLing people with independence and function More than just a retail pharmacy, Yishun Health’s ABLE Studio is a one-stop centre for educating, encouraging and empowering patients and caregivers.

Together, We can Beat Breast Cancer S

ome 300 participants attended the Breast Cancer Awareness Public Forum on 28 September 2019. Organised by the General Surgery department,

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the Forum was a collaborative effort by Rehabilitation Services, Psychology Service, Nutrition & Dietetics, and Food Services.

It covered a wide range of

topics, educating members of the public on the prevention and management of breast cancer, and was held in both English and Mandarin.

Edmund Lee (fifth from right) runs the ABLE Studio with his team of dedicated staff

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potlight ‘Pack and Pay’ cards ensure that patients receive all the items they need

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here is more to ABLE Studio than wheelchairs, nutritional feeds and adult diapers.

The two outlets at KTPH and YCH are part of Yishun Health’s broader mission to drive hassle-free healthcare and seamless transitions from hospital to home, as well as empower people to maximise their quality of life.

Edmund Lee, Executive, Pharmacy, has worked at Yishun Health since 2006, and has been running ABLE Studio since 2013. He shares that, in its early incarnation at Alexandra Hospital, ABLE Studio was called the HIP (Home for Independent Persons) Studio. Located at the Geriatric Centre, it was the first rehabilitation studio to include mock-ups of HDB living areas. There, it served as a teaching and demonstration site, showcasing how products and practical solutions could be integrated into the home and help the elderly live more safely and independently.

A second, bigger version — called the Home Care Solutions Centre — was opened at Jurong Medical Centre in 2007. It featured a full five-room flat mock-up and — being located in a more visible area and close to the pharmacy, outpatient rehabilitation and geriatric clinics — was more accessible to the public.

However, Edmund shares that it

was not well integrated with the pharmacy at that time.

The opportunity to truly synergise came with the move to KTPH. “Here, we have merged the retail and educational arms into one centre,” explains Edmund. Added to this is the strong clinical support and collaboration from Yishun’s Geriatric Medicine department, Pharmacy department and Rehabilitation Services. Today, ABLE Studio is a one-stop centre for educating, encouraging and empowering patients and caregivers. Its role, says Edmund, is to be “part of the patient journey and facilitate discharge and the seamless transition back home.”

ABLE TO HELP Every rehabilitation item sold here goes through a rigorous evaluation beforehand, and is tested by physiotherapists and occupational therapists to meet safety, quality and functionality criteria. These items are chosen based on five concepts for home care solutions for the elderly.

Developed by Dr Wong Sweet Fun, Deputy Chairman, Medical Board (Population Health), these concepts are aimed at helping the ABLE Studio team assess the suitability of items for sale [see sidebar].

Apart from this, all staff working at ABLE Studio are trained to

THE JESIE CONCEPT

An ABLE Studio staff demonstrating how a geriatric chair can be set up and used

E = Easy Reach At an appropriate height to perform daily tasks

JESIE is an acronym for how ABLE Studio selects appropriate home care solutions for the elderly.

S = Safety Keeps you away from danger

understand the unique geriatric and rehabilitation needs of its clients, and the administration of funds and subsidies. “When our Medical Social Worker colleagues bring eligible patients down to buy items, we work with them to do the paperwork for financial support, such as the Endowment Fund, Get Well Fund, Senior Mobility and Enabling Fund, or funding from SG Enable,” Edmund describes.

ABLE Studio also plays an important role in facilitating the easy purchase of items for wound dressing, podiatry needs or tube feeding. They have collaborated with the Geriatric Medicine Specialist Outpatient Clinic to develop ‘Pack and Pay’ cards, an initiative by Jessie Tan, Nurse Manager. After appointments, patients only need to bring down this ‘menu’, which has the essential items clearly listed. “We can then pack and ensure that patients receive all the items they need. It is hassle-free, easy to read, and cuts down on miscommunication.”

At the same time, trained staff help customers make informed choices about the products they are purchasing.

To reach out to patients and caregivers beyond the hospital, the team has even created an

interactive online functional home educational tour to showcase home care solutions, tips and safety for the home.

I = Independent It is possible to do it yourself

E = Energy Saver A less-tiring way to perform tasks

SUPPORTING PATIENTS AND COMMUNITIES Some of the items stocked at ABLE Studio include nursing-led innovations, such as the range of Angie products, which are designed

by Senior Nurse Clinician Toh Hai Moy, Yishun Health’s own inventor.

These products, including devices and everyday improvements, were created in response to patient needs and are aimed at raising patient comfort and convenience.

Beyond stocking rehabilitation products and home care solutions for the public, ABLE Studio also supports the day-to-day operations of Yishun Health’s inpatient wards, outpatient clinics, and community nursing teams. During in-house roadshows and exhibitions, the team is often involved, be it to supply items or conduct talks and demonstrations. Some of these are also held in the community. “It is part of our efforts to educate people about home care, fall prevention, and mobility aids,” says Edmund.

These efforts all add up to achieve ABLE Studio’s simple but impactful mission: making life better.

J = Joint Protection Reduces joint pain and prevents further joint damage

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veryday Heroes

Running in step towards

out of shape he was. “It was hard, and it was not a good feeling to see how unfit I had gotten.”

With a sheepish laugh, he recalls that TK chatted the whole time that he was panting, sore and desperately trying to hold up his end of the conversation.

However, that first run was the ‘hook’ Benjamin needed to make it a regular routine. This was also aided

by TK popping by his cubicle after work with an enthusiastic, “Change

health and fitness

The journey towards a healthier you starts with the first step.

Sometimes, that takes a little encouragement. Colleagues and running mates Benjamin Lim and Lee Tuan Khong show that it doesn’t take much to be each other’s motivator towards health and fitness goals.

your shoes, let’s run!”

I

t is a familiar tale.

Benjamin had always been fairly fit as a student: he ran, canoed and led an active lifestyle.

But once he started work, other priorities started getting in the way.

Soon, he found himself piling on the kilos; at his heaviest, he weighed more than 90kg. This weighed on him in more ways than one. Working in operations at Yishun Health’s A&E Care Centre, he saw the consequences that could potentially occur. “What really got to me was seeing the number of heart attack cases coming in,” he shares. That, he says, was the push he needed to start taking steps to get back on the road to wellness.

THE FIRST STEP IS THE HARDEST He knew it would not be easy to restart a running regime; fortunately for him, there is a long-standing — albeit informal — running group in his department. “My wanting to run was bolstered by the environment I was in,” he affirms. It also helped that his supervisor, Tuan Khong (better known as TK), is an avid runner.

Ben remembers that first run, which took place about a year ago, with a laugh. It was a relatively short one, just two laps around the Yishun Pond, but it revealed to him just how

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“I enjoy running because it is a sport where I am in full control of everything; from how fast and far I want to run to my pacing and stride length.

And when you see yourself improve, you are motivated to do more.”

MOTIVATIONS, MILESTONES AND MARATHONS The resolve to continue running was not only for health: Benjamin wanted to run again with his father. “We used to run half marathons together,” he says. That became a goal; the more he ran, the more it became a viable one.

All it took was patience and consistency, he reflects. “Running is a sport where, the more you do it, the less discomfort there is. And the better you get at it, the more enjoyable it becomes.

Though it never really gets easy, your increasing fitness allows you to enjoy it.”

TK chimes in with a wry chuckle, “And now you can talk while you run.”

Having a supportive environment and regular encouragement has been a huge factor for success — both in Ben’s exercise regime and eating habits, he adds. “TK would ask me, ‘Ben, do you really want to eat that fried chicken?’” he recalls. TK even gave him a book on sports nutrition to educate himself on how to fuel adequately for his runs.

This shared interest in running has seen the two colleagues and running enthusiasts signing up for several races.

Benjamin has since completed six runs in the last year, scaling up from runs around the pond and 5km and 10km races to half marathons. As TK notes, “Having a race to train for is like a performance objective; when you don’t have one, you lose focus.” They are now ramping up their weekly running distance as they train for the Standard Chartered full marathon at the end of November. It will be Benjamin’s first 42.2km run.

This road towards wellness is something that has brought more than physical benefits. Benjamin finds it therapeutic, too. “I enjoy running because it is a sport where I am in full control of everything; from how fast and far I want to run to my pacing and stride length,” he reflects. “And when you see yourself improve, you are motivated to do more.”

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Cover Story

DESIGNED FOR HEALTH PART 1 OF 3

GOING BEYOND MEDICINE Envisioned as a health-promoting hospital, KTPH has striven to go beyond the traditional idea of what a hospital is. More than a facility to treat the sick, the pioneer management team envisioned a cocreated, patient-centred and community-integrated organisation where healing is a combination of medicine, design, environment and sustainability.

The architects used scientific methods, including wind tunnel testing, to orientate the hospital’s three towers to strategically capture prevailing winds and maximise wind flow

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Cover Story

DESIGNED FOR HEALTH PART 1 OF 3

A

s with most critical care wards, the KTPH intensive care unit (ICU) is a sombre place. But adding to the constant beeps of machines and hiss of equipment is a key difference: every ICU room has a view of greenery and sky, bringing the outside into the otherwise sterile area.

Rising up just beyond the promenade of the Yishun Pond, Tower Blocks B and C enjoy waterfront views. This location was purposefully selected. Unlike private wards, which are air-conditioned, the hospital’s subsidised wards are naturally ventilated, and this placement would ensure these wards receive the greatest amount of natural wind flow.

It is not only patients and visitors who enjoy the lush and tranquil environs of KTPH and YCH. Volunteers and Yishun residents regularly make their way to the hospital’s food court, gardens and resting places. The intended absence of physical barriers welcomes the community into the hospital grounds

and affords many opportunities to nudge people towards healthy and sustainable living.

These are just a handful of design elements that underscore the approach that Yishun Health has taken in the creation of a truly healthpromoting hospital that believes in going beyond medicine to drive

THE BRIEF

The original design brief was an inches-thick compendium that challenged participating architects to create a hospital that: • • • • •

Is intuitive for wayfinding Is energy efficient and sustainable Blends in with the neighbourhood and complements the community Integrates with Yishun Pond Creates a green belt to join the Yishun Town Garden to Yishun Park, using the hospital and the Pond as links

Mr Chin Yew Leong, Deputy Director, Operations (left), and Mr Donald Wai, Director, Hospital Planning & Infrastructure

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health through design, environment and sustainability.

It all stems from a simple fact: environmental health is a strong determinant of wellness. Dirty air, litter-strewn streets and polluted water bodies all have an impact on public health. Added to this, research predicts that accelerating climate change will lead to rising temperatures, more aggressive flu seasons, and speedier spreading of vector-borne diseases.

Cognisant of this connection, Yishun Health has long made sustainability and environmental consciousness an integral part of our culture. Even in our nascent days at Alexandra Hospital, the pioneer management team was convinced that the hospital could be more than just a building for medical treatments. This ethos has formed the very foundations of who we are and has been, quite literally, built into our physical spaces, operations, as well as patient and community engagement.

Former Alexandra Health Group CEO Mr Liak Teng Lit led the charge. He believed that an environment with greenery, natural light, fresh air and fragrant plants could facilitate recovery and recuperation. This healing environment would bring peace of mind to patients and family members during what is often an anxiety-ridden experience. For staff, a beautiful environment to work in and take ownership of would reduce work stress, raise morale and improve overall performance. This vision resonated with the whole organisation.

Management and staff were responsible for the largely staffdriven transformation of the

“Our vision was to create ‘a garden in a hospital, a hospital in a garden’, with a living ecosystem that would be inseparable from the experience of the hospital.”

MR DONALD WAI DIRECTOR HOSPITAL PLANNING & INFRASTRUCTURE YISHUN HEALTH sprawling 13-hectare hospital compound at Alexandra into a lushly landscaped swathe of flowering plants, fruit plantations and butterfly gardens.

Mr Liak’s vision, explains Mr Donald Wai, Director, Hospital Planning & Infrastructure, was to create a “a garden in a hospital, a hospital in a garden”, with a living ecosystem that would be inseparable from the experience of the hospital. When the move to Yishun was announced, he says Mr Liak saw it as a “golden opportunity” to work with a fresh slate — and, at the same time, still transplant as much of their green heritage into this new location. This, insists Donald, was completely out of the norm at the time. However, Mr Liak’s vision of a garden hospital that was focused on preventive health aligned well with the ‘hasslefree hospital’ challenge set by

then-Minister for Health Mr Khaw Boon Wan. It was a leap of faith by the hospital management, Ministry of Health and stakeholders.

This concept was comprehensively set out on a design brief for invitations to provide consultancy services for the new hospital. Apart from requirements that came from the hospital, the hefty tome included input from the community. Suggestions ranged from having peaceful spaces and gardens to shuttle buses and a food court with a view.

RISING TO THE CHALLENGE In May 2006, CPG Consultants was selected to achieve the ambitious goal. Heading the architecture team was Mr Jerry Ong, who, by his own admission, was just as ‘green’ as the hospital’s aspirations. “As a young architect who had never done hospitals before, my bosses decided I was to be given a go at it as they wanted someone to take a fresh look at the brief and do something different,” he recalls.

And the brief, he shares, was unprecedented. “There was more to it than the planning and organising of spaces for patient, clinical and operational flows, although this was part of it. The hospital team also called for a different approach to other aspects, such as community, environment and landscaping.”

CPG’s winning design was chosen for its “best response to the site” in the form of several unique aspects. Passive design considerations were worked into the very blueprint of the development as a whole to ensure it met sustainability as well as community integration goals.

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Cover Story

DESIGNED FOR HEALTH PART 1 OF 3

For one, the whole development was thoughtfully designed to relate to the scale of the surrounding neighbourhood of 30-year-old HDB blocks. “We built three free-standing towers and intentionally separated the clinic tower into yet another three blocks so that it would scale better against the residential houses,” describes Mr Ong. This prevented the building from being a monolithic “wall of grey” and “better integrated it into the neighbourhood”, he explains.

Within this V-shaped configuration, each block is angled to reduce heat gain from solar radiation, while also capturing the prevailing winds. The development also maximises the view to the pond and ‘draws’ it into the hospital grounds in the form of a waterfront promenade and continuing water features that make it an integral feature of the hospital rather than an add-on.

This orientation and other passive elements enable some 35% of the hospital to be naturally ventilated.

Apart from wide corridors, open spaces and high ceilings, the architects also planned for shading and glazing to minimise solar heat

“Green design and technology are well and good, but it is only the first step; you have to sustain it.”

MR CHIN YEW LEONG DEPUTY DIRECTOR OPERATIONS YISHUN HEALTH penetration, wing walls to channel wind into the building, and jalousies angled at 45˚ for optimum air flow and least rain penetration.

Plenty of practical architectural elements also allows the intensification of greenery. “We make use of every available space, from walls and connecting corridors to roofs, to integrate greenery,” explains Mr Ong. This greening was undertaken with patients, caregivers and residents in mind, so that the hospital can be an everyday part of

the community, not just a facility that caters to those with poor health.

KTPH has a green plot ratio of 3.92, meaning that every unit of ground is matched with nearly four new units of green area. The vibrant and thoughtfully landscaped grounds, together with the development’s green and sustainable design, won it the Building and Construction Authority’s Green Mark Platinum Award in 2009. In 2017, KTPH was winner of the first-ever international Stephen R. Kellert Biophilic Design Award, organised by the International Living Future Institute, in recognition of its innovative and extensive use of biophilic design to promote healing and well-being. Biophilic design is an emerging field that promotes improved health and well-being by creating connections between people and nature in the built environment.

Beyond awards, the true test has been how the development has been received by the community it is in. Some 15% of visitors visit simply for leisure. And for patients, the hospital’s greenery has been a source of comfort and healing.

Dr Nirmal Kishnani, an Associate

15%

of people visit the hospital simply for leisure. This gives us the opportunity to influence them towards healthier lifestyle habits.

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“LIKE A RESORT”

When Mr Janssen Cheah, 54, was scheduled for a heart stent surgery in August 2019, the father of two was naturally concerned. Although it was a straightforward procedure, he was still slightly anxious about it. On the day of the day surgery, he remembers laying on a gurney to be transferred to the operating suite. As he was wheeled through the open-air corridors, his thoughts took another turn. The sight of greenery, sound of birds, and smell of fresh air calmed his nerves. “It was like a tropical rainforest, not at all cold and sterile,” he remembers. He entered his surgery in a much calmer frame of mind. His wife, Joan, agrees. “For the family, the environment helped to ease our worries. KTPH looks like a resort with areas to rest, eat, gather. It may be intangible but it makes a world of difference.”

Professor of Architecture at the National University of Singapore, wrote a paper on biophilic design and urban environments using KTPH as one of its examples. The paper found that it did better in several areas such as self-reported wellness. The open and integrated nature of the hospital also attracted visitors who are not patients, but who visit for leisure. Survey respondents strongly agreed (responses ranged from 4.0 to 4.2 out of a maximum of 5) to the statements “I feel calm and relaxed here”, “I feel less stressed here” and “I feel close to nature here”.

AN ONGOING COMMITMENT Nine years on, Donald walks the hospital grounds each day as he goes about his work, and is often filled with a deep sense of achievement. It has been a very challenging and satisfying experience to see how the original concept of “a garden in a hospital, a hospital in a garden” has come to fruition. “The building has become more timeless and lusher,” he says.

Intentional choices, such as not using

painted surfaces and selecting a neutral grey façade, have also meant that the development has aged well and is easier to maintain.

This long-term perspective is something that Mr Ong points out as one of the most difficult but ultimately rewarding aspects of the work. “Designing a space to be truly green takes commitment,” he states.

“As architects, we are fortunate that a client such as KTPH has this great alignment between what they said they wanted and what they were willing to do. They really walk the talk, believe in it, and push for it.” This shared conviction has led to a decadelong partnership and even friendship, he reveals. Mr Ong is still asked to consult and give feedback on future plans. He was even a guest speaker at the recent Green Hospital Conference in October 2019, hosted by KTPH. And as formidable as the task of building KTPH was, Mr Ong stressed it was the “easy part” — the truly difficult part comes after. As Operations Deputy Director for Facilities Management Mr Chin Yew Leong points out, “Green design and technology are well and good, but it is only the first step; you have to sustain it.”

Yew Leong, who also chairs Yishun Health’s Green Committee, emphasises that true sustainability is both a top-down as well as ground-up effort. It takes strong will from the leadership, he says, one that leads by example and sets down structured policies and strategies. Coming from the private sector, which focused mostly on cost savings, this was a bit of a culture shock to him when he joined the organisation in 2013. He found that the KTPH leadership took a comprehensive approach that factored in environmental impact, mindset change and community engagement, noting that “the management is sincere about nurturing a sustainable culture”.

Apart from taking steps to minimise the inevitable impact of dayto-day operations on the environment through policies, building design and facilities management, a significant part of the organisation’s focus is on mindset change. Yew Leong says it is a balancing act, where they strive to deliver safe and high-quality care, ensuring the hospital functions well operationally, while also being a good steward for the environment.

This, says CEO Mrs Chew Kwee Tiang, is all part of the early vision since 2000: to build a hospital that would perform its duty not only to patients, but to the environment as well. It goes towards the larger vision of driving health not just through medicine, but through a holistic understanding of the many components of health, taking into consideration the bigger picture that underpins sustainable healthcare operations. “We are committed to performing our primary role as a healthcare provider while proactively minimising our impact on the environment.”

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Things About...

1

STROKE IS CAUSED WHEN BLOOD SUPPLY TO A PART OF THE BRAIN IS CUT OFF

This can be due to: • A leaking or burst blood vessel that bleeds into or around the brain (haemorrhagic stroke) • A blockage of a vessel supplying blood to the brain (ischaemic stroke) Either of these causes will deprive the brain of oxygen, during which up to two million brain cells die every minute.

If stroke is not treated quickly, further damage to the brain may lead to death.

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1in4: Don’t be the one Did you know that one in four of us will have a stroke in our lifetime?

Stroke can not only lead to permanent disability, but is also a leading cause of poor quality of life and early death.

EVERY SECOND COUNTS

A stroke is a medical emergency. Early detection and prompt medical action is of paramount importance, and can make all the difference between death, disability and strong recovery.

Remember the F.A.S.T. way to spot the early signs of stroke: Face: Is there drooping on one side of the person’s face?

Arms: Ask the person to raise both arms. Does one arm appear weak and slumped downwards?

Speech: Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?

Time: If the answer is “yes” to any of these, call 995 immediately.

3

STROKE: AN UPHILL RECOVERY

Stroke causes long-term effects that can range from the physical and cognitive to psychological and social. Stroke survivors often face a challenging and long road ahead. They may suffer from weakness, poor coordination, as well as speech and swallowing difficulties.

Memory and focus can also be affected. In addition, they face common problems such as depression, anxiety and anger.

Sadly, one in four stroke survivors experiences some form of stigma.

It is important to understand and support stroke survivors in their journey towards health and recovery.

5

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THERE IS AN ESSENTIAL NEED FOR REHABILITATION AND SUPPORT Rehabilitation plays a crucial part in recovery. It helps survivors relearn how to perform daily tasks, movements and even speech. Rehabilitation can last for months or years, depending on the severity of the stroke. As such, stroke patients need all the support they can get. Lifestyle changes are also important to prevent another stroke, as statistics have shown that 3–4% of patients who have had stroke will experience a second stroke.

PREVENTION COMES FIRST

Adopting and maintaining a healthy lifestyle — such as a healthy diet, exercise and not smoking — is helpful in preventing strokes.

Managing risk factors — such as hypertension, diabetes mellitus and high cholesterol — is crucial in preventing stroke recurrence.

Be sure to go for regular health screenings

Prevention comes first Eat a balanced diet high in fruits and vegetables and low in sugar and salt

Exercise at least 150 minutes a week

In consultation with Dr Jasmyn De Leon, Resident Physician, Acute Stroke Unit, KTPH Avoid smoking and excessive alcohol

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| 25

ive Well was something she had done regularly for years. During one of her routine annual health checks in March last year, her doctors discovered a white patch in her lung and diagnosed her with Stage 1 lung cancer. Though it was a blow to hear it, Brenda was reassured that the cancer was in its early stages and had not spread. In fact, it was operable. Since removing the cancerous node in July 2018, she has not needed any further treatment, only a yearly scan for the next five years. “I was diagnosed early and took action fast,” she shares.

While she acknowledges that some people are put off by screening because of fear, she notes that it is more important to know than to remain ignorant of illness. “Once you know, you can do something about it,” she explains.

Screenings are an investment for your health, she adds. “After all, health is wealth.”

Whether by chance or by design, Josephine and Brenda’s experience with their respective cancer diagnoses underscores the importance and truth in this oft-repeated truism: screening saves lives. This is especially if it is done regularly so as to pick up diseases in their earlier and more treatable stages.

Sharing stories of courage and hope

Awareness and screening saves lives: this is the important message that cancer survivors, Brenda Yeow, 73, and Josephine Koh, 60, hope to spread.

Stepping forward to share their stories of diagnosis, treatment and recovery, they inspire, encourage and give hope to people to take charge of their health.

B

efore 2004, Josephine, had never heard of a mammogram. In fact, when her sister-in-law brought up the topic at a Chinese New Year gathering, she had to ask how the word was spelt. At the time, she was in her 40s — and in the recommended age group for screening — so she decided to book an appointment.

It was fortunate that Josephine took that step, as the screening revealed that she had Stage 1 breast cancer that was progressing to

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STEPPING INTO THE LIMELIGHT Stage 2. The mother of two was deeply shaken by the diagnosis. “My hands were trembling,” she recalls.

She was worried how her daughters — who were only about 10 and 14 at the time — would process the news.

However, she garnered strength from the support of her husband, and the confidence of her doctors.

Josephine underwent surgery to remove the growth and several lymph nodes, followed by a month of radiotherapy treatment. She has been cancer-free since then, and has diligently followed up with her

oncologist and surgeon each year for review and monitoring. “Every year that I pay for my consultations and scans, just to hear that I am still clear [of cancer], is worth it!” she exclaims.

The cancer scare led Josephine to take more steps to live a healthier life. She picked up tai chi and continues to include brown rice, lots of vegetables, and healthy soy foods into her diet. Her diligence has even rubbed off on her now adult daughters, who — like mum — make annual health screenings a habit.

As for Brenda, health screening

To spread this important message to others, and encourage them to make screenings a part of their yearly routine, Josephine and Brenda took to the stage on 24 August 2019 during Yishun Health’s Mini Medical School (MMS). There, they talked about their diagnosis, treatment and recovery.

Their honest and inspiring stories touched many audience members, so much so that several people asked them for practical tips and even a comforting hug after the session.

Already a regular participant in MMS, Brenda was even quicker to

register for this year’s MMS session as she was naturally drawn to the topic, ‘When Cells Don’t Die’. One of the assignments for the MMS was to ask if people were open to sharing their experiences with cancer. She wrote a detailed account of her story and indicated that she was willing to share it with the ‘class’. Josephine was compelled to do the same.

“Something made me want to tell people about my journey and give them hope,” she admits. She also wanted to highlight the importance of family support, as her husband

and daughters had been instrumental in giving her the strength she needed to push through her treatment.

As the MMS ‘valedictorians’, the two ladies hoped to dispel fear about treatment and recovery. In stepping forward to talk publicly, they also wanted to change mindsets and make talking about cancer and illness less taboo. As Brenda notes, it is very easy to take things for granted, but “no symptoms does not mean everything is okay”. She encourages everyone to go for regular health screenings, as they lead to early detection and save lives.

HAVE YOU DONE YOUR HEALTH CHECKS?* Apart from monitoring health metrics — such as weight, blood sugar, blood pressure, and cholesterol levels — regular cancer screening is part and parcel of a comprehensive ‘report card’ for your health. Here are the recommended screening ages for the two most common cancers in Singapore.

BREAST SCREENING Age

Breast self-examination

30–39

Monthly (a week after your period)

40–49 50 and above

Mammogram frequency Yearly Every two years

Women with a family history of breast cancer should seek advice from their doctor on the appropriate age and frequency of screening.

COLORECTAL SCREENING Risk level

Age

Screening frequency

Average No family history

50 and above

Colonoscopy every 5–10 years

High History of colon cancer in family members aged 60 and below

10 years prior to the youngest case in the family, or 40 years old, whichever is earlier

Every 5 years

High–Very High Personal or family history of: • Colorectal polyps • Colon, ovarian or endometrial cancer • Inflammatory bowel disease

Consult your doctor as soon as possible on the recommended age and frequency of screenings

Screening for colon cancer should begin at 50. However, for those with an increased risk, screening should begin earlier. *Information from Health Hub

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akan Time

cut & keep

Chocolate Beetroot Mousse Not all desserts are sinful. This one contains an unusual ingredient: beetroot, a good source of folic acid and fibre.

Recipe contributed by Chef Ng Cheng Lean, Food Services, KTPH, in consultation with Nutrition and Dietetics, KTPH

INGREDIENTS SERVES 20 • • • • • •

300g beetroot, cooked 350ml low-fat milk 4tbsp honey 40g dark chocolate flakes 14g gelatin powder 250g whipping cream

Top jelly layer • 100g beetroot, cooked • 150ml water • 10g sugar • 1½tsp instant jelly powder

NUTRITIONAL INFORMATION (PER SERVING) Energy

88kcal

Carbohydrate

8g

Protein

2g

Fat

5g

Saturated Fat Polyunsaturated Fat

4.2g 0g

Monounsaturated Fat

0.3g

Cholesterol

1mg

Dietary Fibre Sodium

1g 30mg

METHOD 1. In a saucepan, boil the beetroot with milk, honey and gelatin powder.

2. Remove the saucepan from heat, and add the chocolate flakes.

3. Slowly mix in the whipped cream with the beetroot mixture.

4. To make the mousse, pour the mixture into a mould and place it in the chiller to set for 30 minutes.

5. Heat another saucepan, mix in all the topping ingredients, and bring it to a boil.

6. Pour the mixture onto the mousse and let it set in the fridge.

7. Serve cold with fruits.

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aily Dose

ind & Health

Watch out for AMD

Macula

SOUL-SEARCH YOUR VALUES

Core values — the fundamental beliefs and principles that guide and motivate our attitudes and actions — are an intrinsic part of who we are, and influence how we behave and relate to others and ourselves. Can you spot the 20 words that reflect such values hidden in the jumble of letters in the box below?

Age-related macular degeneration is the third-leading cause of blindness in Singapore.

Go for screenings regularly to spot the signs early.

Everyone has different values. Reflecting on what our own values are helps us to clarify what matters to us on an individual level, where we want to be, and how we need to change.

In consultation with Dr Lekha Gopal, Senior Consultant, Ophthalmology & Visual Sciences

Have a little fun looking for these 20 values that can go towards building the ‘optimal’ you. The words can be hidden horizontally, vertically or diagonally in both directions.

P

oor sight is not necessarily an inevitable aspect of ageing. If you are over the age of 50 and find that your vision is not as clear as it once was, seek help early, as it might be a sign of eye disease. One of the most common age-related eye conditions is age-related macular degeneration (AMD).

AMD occurs when the macula breaks down. The macula is located at the back of the eye and is responsible for central, colour and detailed vision, such as reading and driving. When it degenerates, it can lead to severe vision problems.

There are two forms of AMD: • Dry AMD: This is a less severe and more common form of AMD. It causes the formation of yellow deposits, called drusen, in the macula. Vision could be normal in this form.

• Wet AMD: Dry AMD can progress to wet AMD, which is more aggressive. In wet AMD, abnormal blood vessels grow underneath the macula.

These can leak fluid and blood, causing permanent damage to the retina. This can lead to rapid and severe vision loss.

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Symptoms to look out for include loss or distortion of central vision. In particular, there may be a shadowy or grey spot in your vision. Straight lines may also appear bent or wavy.

Normal

Wet Macular Degeneration

Dry Macular Degeneration

An Amsler Grid is used to screen for AMD. While a person with normal sight sees straight lines, someone with AMD may notice distortion of the grid and see bent lines or a darkened area.

AMD usually affects people 50 years and above; those with a family history of this condition are also at greater risk. Other risk factors include smoking; in fact, smokers are four times as likely to get AMD. If you have a family history of AMD, start eye screening early. Early screening is a good way to prevent vision loss. Early intervention for early-stage wet AMD can maintain vision or even reverse some of the damage.

YOUR FRIENDLY NEIGHBOURHOOD MATA Screen for AMD easily and in the convenience of your own home with the MATA app, developed by Yishun Health’s Department of Ophthalmology & Visual Sciences. This should be complemented with an annual eye screening. To download the app, scan either of the QR codes here.

A R Y T H V K S S E N D N I K

O S G T E O Y K Z Y M Q O E E

P U S E I C N R V U P U E D C

T X N E C L N E C U Z Q F U N

I W L M N N I A S I S A K T E

M I F G R N E B T T Z Y B I I

I S F R I S E D A P Y O X T L

S D N X M L T P N D E A M A I

Three questions are helpful in identifying our own values: • What is important to me deep down inside?

• What sort of qualities do I want to cultivate as a person?

• How do I want to be in my relationship with others?

M O F C B M E J O E N C I R S

J M D G R U O M U H P E C G E

E C N E U L F N I B A E P A R

E C N E T S I S R E P N D E C

N Z G N I V O L N U F S Z N D

B M H C R E A T I V I T Y W I

A S S E R T I V E N E S S L U

The hidden values are:

Apple

Android

• KINDNESS • WISDOM • ASSERTIVENESS • PERSISTENCE

• RESILIENCE • GRATITUDE • DEPENDABILITY • HUMOUR

• INDEPENDENCE • FUN-LOVING • OPTIMISM • OPENNESS

• HONESTY • CREATIVITY • INFLUENCE • ACCEPTANCE | 31