aha
ISSUE 4: Oct–Dec 2023
MCI (P) 020/07/2023
healing through helping others
TOUCHING LIVES THROUGH MEDICINE AND HUMANITARIANISM
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GROOVING HER WAY TO WELLNESS
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MAKE SENSE OF NUTRI-GRADE TO MAKE HEALTHIER CHOICES
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ontents
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COVER STORY Healing Through Helping Others Uncle Soon shares how good support has enabled him to overcome depression and how community connections have given him purpose and joy
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WHAT’S UP Community events, outreach efforts, and more
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12 YH IN THE NEWS A roundup of Yishun Health appearances in the media 20 Q&A Health and wellness questions asked and answered! 22 EVERYDAY HEROES Touching Lives Through Medicine and Humanitarianism Dr Ramaswamy Akhileswaran devotes his time and heart to his patients through palliative care and volunteerism
25 LIVE WELL Grooving Her Way to Wellness Nurse Clinician Fauziah Bte Saban is the picture of vitality, thanks to daily dance sessions as a Zumba instructor
Part 1 of 3
JOURNEYS IN HEALTH 2 |
Health is a journey, not a destination. It has its ups, downs, detours, U-turns and rest stops. The important thing is that we keep moving towards our health goals. As Singapore embarks on Healthier SG – the national drive to encourage Singaporeans to take steps towards better health – Yishun Health is enhancing our ongoing partnerships with primary and community care providers. In this series, our residents take centre stage as they share their personal health journeys – and how they have contributed and received care in their community.
PUBLISHER Yishun Health is a network of medical institutions and health facilities in the north of Singapore, under the National Healthcare Group. It comprises Khoo Teck Puat Hospital, Yishun Community Hospital, and community extensions such as Admiralty Medical Centre and Wellness Kampung.
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EDITORIAL TEAM 28 SPOTLIGHT Serving with Pride and Joy, Together! Learn how Yishun Health’s Allied Health Services & Pharmacy is enhancing patient care 32 5 THINGS ABOUT… Salt and Blood Pressure Learn about salt – and how it impacts your health 34 DAILY DOSE Make Sense of Nutri-Grade to Make Healthier Choices Familiarise yourself with the ABCDs of sugar in store-bought beverages 36 MAKAN TIME Seafood Curry Serve this flavourful dish over brown rice for a quick weekday meal! 38 FIT & FAB What You ‘Knee-d’ To Know About Knee Pain Learn the symptoms of knee injury and what can be done to manage it Scan here to subscribe to aha online for regular updates and stories from Yishun Health!
aha
ISSUE 4: Oct–Dec 2023
healing through helping others
Nur Amalina Hannah Wong Jack Lau 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 Caroline Tan Fatimah Moideen Kutty Shirley Heng Teresa Foong
www.ktph.com.sg/ about-us/media/publications aha@ktph.com.sg
PUBLISHING AGENT THINKFARM PTE LTD www.thinkfarm.sg M A N AG I N G D I R E C T O R
Christopher Tay E DITO R
Sunuja Naidu C O N T R I B U T I N G E D I TO R MCI (P) 020/07/2023
Sheralyn Tay
W TOUCHING LIVES THROUGH MEDICINE AND HUMANITARIANISM
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GROOVING HER WAY TO WELLNESS
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MAKE SENSE OF NUTRI-GRADE TO MAKE HEALTHIER CHOICES
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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 history; 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.
H E A D, C R E AT I V E
Lee Lily
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
Justin Loh
aha is the official quarterly 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 express 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) 020/07/2023
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hat’s Up
Recognitions at the 2023 Public Sector Transformation Awards
Both Senior Staff Nurse Zarina Bte Kamis and Jackie Phang received beautiful bouquets of flowers from Yishun Health senior management
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wo Yishun Health staff won the Exemplary SkillsFuture @ Public Service Award at the Public Sector Transformation Awards ceremony on 4 July. This award recognises public service officers who embody a spirit of continuous learning. Zarina Bte Kamis, Senior Staff Nurse, Population Health & Community Transformation, was recognised for her work in community nursing, a role she took up in 2019. Previously an orthopaedics nurse, Zarina equipped herself for this work by voluntarily pursuing a Diabetes Nurse Educator and Management course to better care for patients. She has also improved her personal skillsets and taken up SkillsFuture courses in writing and virtual learning. Her dedication to patients was underscored during the COVID-19 pandemic, when she quickly learnt how to conduct video conferencing at the Community Health Posts, 4 |
allowing her to continue monitoring her patients’ health via teleconsulting. Zarina is one of the pioneers of the Self-Managed Autonomous Regional Team, and is also involved in NHG community nursing pilots. Jackie Phang, Manager, Visitor Management Services, KTPH, was recognised for her commitment, adaptability and contribution to creating safe and enjoyable patient experiences. She moved from the private sector to join KTPH’s Patient Experience Office in 2016 and has since been instrumental in key Yishun Health programmes such as the Sunshine Buddy and Stimulating Activities for Frail Elderly, recruiting and growing the number of volunteers from zero to 140. In 2020, she rose to the challenge in her new role in visitor management, taking on added responsibilities and playing a critical part in Yishun Health’s COVID-19 response. Throughout this
challenging period, Jackie upgraded herself through internal training courses and even completed the certificate programme in Strategy Execution from Harvard Business School Online in 2022.
SMARTER INVENTORY MANAGEMENT KTPH picked up an Exemplary Innovator Award as part of a team with B.Braun and Republic Polytechnic for the Smart Inventory Monitoring Rack (SIMR). The SIMR is a weight and distance sensor that can be retrofitted on existing shelves. It provides real-time monitoring of medical consumables for easier withdrawal of consumables, more efficient stocking and greater accuracy of inventory monitoring.
Making a difference through our award-winning community care A
t the recent Community Care Excellence Awards (CCEA), Yishun Community Hospital staff won 25 silver awards and four gold awards. The CCEA recognises individuals and teams for their service and commitment to quality care in the community care sector. Read more about our gold award winners below: Dr Lin Lin Myint Kyaing, Senior Staff Physician, Medical Services won an individual gold award for being a lead in the STOP CAUTI project in Trial-Off Catheter, which uses evidence-based guidelines to
implement early removal of urinary catheters to prevent catheterassociated urinary tract infection. Beverly Lim Jun Hui, Senior Staff Nurse, Ward D67 won an individual gold award for her exemplary service and dedication to nurse education. She also led two quality improvement projects that have contributed to operational resilience and better quality and patient safety in YCH. Garde Ivory Fajardo, Senior Healthcare Assistant, Ward D98 won an individual gold award for her
service excellence and team spirit. Known for her ability to connect with others, she guides colleagues who are new to the organisation, especially those who have come from overseas. She also mentors her juniors for their nursing exams. A team gold award went to the ‘Design an Algorithm to Discontinue Unnecessary Intake/ Output Charting’ multidisciplinary team. This clinical quality improvement project has cut down on non-essential charting and led to time savings and greater staff satisfaction.
CCEA winners strike a pose with Yishun Health senior management and supporters
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hat’s Up
Welcoming the Malaysian Minister for Health
Malaysia’s Minister for Health Dr Zaliha Mustafa (first row, fourth from left) and Dr Azfar Mohamad Mustafar, Malaysia’s High Commissioner to Singapore (first row, second from left) and their delegation pose for a photo with Prof Dan Yock Young, Deputy General of Health, MOH (first row, fifth from left), and Yishun Health senior management at the Promenade
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alaysian Minister for Health Dr Zaliha Mustafa and Malaysia’s High Commissioner to Singapore Dr Azfar Mohamad Mustafar visited KTPH on 11 July. Together with their delegation, they were taken on a tour of the campus to learn more about our hospital’s services, biophilic
approach to care and the green and sustainable design of the campus. During the visit, Minister Zaliha visited our wards and rooftop gardens to see how nature, health nudges and community involvement contribute to both patient care and population health. To commemorate
During her tour of KTPH, Dr Zaliha Mustafa had a first-hand view of how Yishun Health’s green approach complements the clinical care of patients
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the visit, Yishun Health CEO Prof Chua Hong Choon presented her with a basket of fruit and vegetables harvested from our garden as well as a set of limited edition stamps that feature green projects in Singapore, including our very own Khoo Teck Puat Hospital!
A basket of fruits and vegetables harvested from Yishun Health’s garden was gifted to Dr Zaliha Mustafa
Marking 9 years of advocating for intergenerational care S
ince 2014, TriGen has been an important partnership, knowledge exchange and training programme between Yishun Health and students in the medical, nursing, social work and allied health fields. Started to activate students in health outreach and community-based care, the initiative facilitates befriending, health and psychosocial support for seniors
by teams of students, and is corun by the North West Community Development Council (NWCDC), healthcare institutions, universities and secondary schools. On 9 September 2023, the programme celebrated the end of its 13th cycle and held a TriGen Day in a gathering of some 120 participants, including students, their parents
and representatives from NWCDC and the National University Health System. Hosted by Yishun Health’s Population Health & Community Transformation (PHCT) team, it was a celebration of how a collaborative spirit and service-learning approach can build holistic care and develop the next generation to be champions within their communities.
(From left) One of the teams shared their thoughts on their experience journeying with the seniors they visited; Dr Wong Sweet Fun, Clinical Director, PHCT, received a token of appreciation from TriGen’s project directors
Certificates of participation were awarded to the TriGen teams
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hat’s Up
Celebrating the care, courage & camaraderie of our nurses! T
o cap a month of Nurses’ Day celebrations, Yishun Health held a celebration at the KTPH auditorium, complete with a concert featuring song and dance performances as well as an awards ceremony. The event was graced by special guests, Patron Ms Mavis Khoo, Ms Elizabeth Khoo and Member of Parliament for Nee Soon GRC, Mr Louis Ng.
Yishun Health CEO Prof Chua Hong Choon praised Yishun Health nurses for their care, courage and camaraderie, while Mr Ng shared his personal experiences of how the care and compassion of nurses made a difference when his children were in hospital. A rousing series of performances by staff and Clinical heads of departments also added to the excitement of the day. This
Chief Nurse Ms Shirley Heng and CEO Prof Chua Hong Choon presented a basket of fruits and vegetables to Member of Parliament for Nee Soon GRC, Mr Louis Ng
Senior management, Yishun Health leaders and the Nurses’ Day committee members distributing gifts to our nurses
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was followed by the presentation of nursing scholarships and prizes for outstanding nurses. Ms Mavis Khoo was also honoured with a token of appreciation for her contribution in developing Yishun Health nurses. To extend the joy of the day, senior management, nursing leaders and the organising committee went around the hospital distributing snacks for nurses on the night shift.
Planned over many months by the organising committee, this year’s Nurses’ Day was themed ‘Our Strength, Our Future: Against All Odds’
The energetic dancers from SICU Dance Company who emerged champions for the talent show during Nurses’ Day concert
Kaizen Festival 2023: On the quest for excellence
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onstant improvement and the pursuit of better, faster, cheaper and safer care has been a core Yishun Health principle from the beginning. This has been underscored by our Kaizen Festival, a biennial event that recognises and celebrates the dedication of staff in improving healthcare efficiency, safety and productivity.
This year, the Kaizen Festival included a range of engaging and educational events throughout the month of August. There was a Gemba Walk that saw staff follow clues around the hospitals to view Kaizen projects and solve a puzzle that revealed this year’s theme, which was ‘Spark Joy Through Improvement’.
This year saw 144 abstract submissions, of which 88 Kaizen projects were shortlisted with 23 vying for the top awards at the finals. Adding to the spirit of friendly competition, finalist teams created funny, engaging and creative minute-long video clips to share their improvement initiatives and learnings.
From left: GOH NHG Board Member Mr Tow Heng Tan (fourth from left) presented awards to Kaizen Nurturers and Champions; The Better, Faster, Cheaper, Safer winner was the team behind the ‘Dialyse Urgently from Emergency Department’ Kaizen
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hat’s Up
Celebrating National Day as one Yishun Health Y
ishun Health held our National Day Observance Ceremony on 25 August 2023 in an outpouring of national pride, camaraderie and gratitude. The day saw staff gather at the auditorium in red and white to not just mark Singapore’s birthday, but also reflect on how Yishun Health has contributed to the nation with its spirit of collaboration. Speaking at the ceremony, Yishun Health CEO Prof Chua Hong Choon paid tribute to the National Day Award recipients and Yishun Health Long Service awardees for their devotion to public healthcare. Guest-of-Honour Prof Kenneth Mak, Director-General of Health, Ministry of Health, called the event our own “kampung celebration” and one that showcases the organisation’s togetherness. To add to the National Day mood, children from the Little Skool-House danced and sang to a familiar medley of National Day songs.
Second from left: Ms Alice Leong Foong Wah, Deputy Director, Major Operating Theatre, Seetoh Wai Lin, Senior Staff Nurse, Major Operating Theatre, and Ms Velusamy Poomkothammal, Deputy Director, Nursing Administration, were recognised for their 50 years of service
A group photo to celebrate and recognise our Long Service Award recipients which includes Rosalind Tan (middle in pink), who has been with Yishun Health for 60 years!
Patient Safety Month 2023: ‘Embracing Change, Upholding Safety’ T
he month of July saw Yishun Health reinvigorating our commitment to patient safety through a series of safety-focused webinars and e-bulletins that reinforced safety concerns and best practices. Topics included pressure injuries and medication safety, explained by subject-matter experts. Yishun Health staff also contributed their Speaking Up for Safety tips and three winners were recognised. On 28 July, to close the Patient Safety Month, Chairman, Medical Board, A/Prof Pek Wee Yang highlighted three areas of focus: adapting to change; effective communication; and partnering, empowering and engaging patients, their families and care physicians. 10 |
Winners of the “Create an Impact with Your SUFS Tips” contest are (from left): James Wong, Assistant Manager, Office of Clinical Quality, Performance & Value, Dr Daniel Chia, Director, Clinical Research Unit, and Shahrul Bahri Bin Selamat, Manager, Security
Be safe, be secure! O
n 29 August, we marked the end of Yishun Health’s annual Safety & Security Week, titled ‘Go Home Safe & Healthy’. In the lead-up to this day, there were lunchtime talks and drills organised by the Safety Committee to reinforce workplace safety knowledge and emergency response. The closing ceremony capped off events and brought staff together for a showcase of safety talks, games, performances and demonstrations. There was a talk on online scams and situational awareness, a song and skit by students of Unity Primary School and Yishun Health staff, as well as educational booths on workplace safety.
Yishun Health senior management with special guests and partners from the Singapore Civil Defence Force, Singapore Police Force and Unity Primary School posing for a photo at the Safety & Security Week closing ceremony - together they pledged themselves to ‘zero harm’
Honouring our Patient Service Associates
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s one of the first faces that patients and their family members see when they step into our hospital, our Patient Service Associates (PSAs) are important members of the Yishun Health family, imparting a good first impression and
confidence in the quality of our care. To thank them, a day of celebration was held on 6 July. Themed ‘Colours of the World’, it was an occasion to celebrate the diversity of our PSA and their contribution to our mission of care. To mark the day, PSAs and their
families enjoyed activities such as games and karaoke, as well as a photobooth. Awards were presented to PSAs in the areas of innovation, customer service and personal grooming and the Yishun Health PSA logo was also launched. | 11
YH in the News …on KTPH Instagram
…in The Straits Times
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F
s the size of a healthy prostate the same as that of a walnut? Are prostate examinations painful? In conjunction with International Men’s Health Week this year, we delved into the fascinating world of the prostate gland with Dr Lau Weida, Consultant Urologist at Khoo Teck Puat Hospital. Discover the prostate’s crucial role in men’s health, demystify common misconceptions, and learn ways to maintain a healthy prostate in this episode of ‘Yes to Health’.
amilial hypercholesterolemia (FH) is an inherited condition characterised by high levels of cholesterol in the blood from birth. Speaking to The Straits Times, A/Prof Subramaniam Tavintharan, an endocrinologist at KTPH, shared how identifying individuals with FH and intervening early can result in fewer heart attacks and an improved quality of life for those affected. A/Prof Tavin also spoke about a pilot programme he started in 2015 to screen young people with heart problems for the gene mutation that causes FH.
Scan the QR code to read the full story in The Straits Times
Scan the QR code to watch the video
...on KTPH Facebook
…in Lianhe Zaobao
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hen you think of hospital food, the words that come to mind are ‘bland’, ‘tasteless’, and ‘too healthy’. However, local hospitals go to great lengths to prepare delicious and nutritious meals tailored to patients’ medical conditions. Using fresh ingredients and herbs to enhance the flavour of the food and incorporating local delicacies, hospital chefs also whip up special dishes during celebratory occasions such as birthdays and festivities. In an exclusive interview with Lianhe Zaobao, our chefs and senior dietitian share how Yishun Health’s Food Services and Nutrition & Dietetics departments work together to curate a tantalising range of enjoyable and healthy dishes.
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n celebration of Nurses’ Day this year, several of our Senior Management and Heads of Departments were invited to don scrubs and experience first-hand what it is like to be a nurse for a day. From serving medication to carrying out assisted feeding and bathing as well as tending to the wounds of some of the patients, it was a busy yet meaningful day for those who participated.
Scan the QR code to read the full story in Lianhe Zaobao
Scan the QR code to spot the special guest and to see how everyone performed
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@khooteckpuathospital
YH in the News
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Cover Story
HEALING THROUGH
HELPING OTHERS At 57, Uncle Soon is a model for active living. Juggling part-time work, volunteerism and daily exercise, the Sembawang resident is a familiar face at Blossom Seeds, a non-profit active ageing centre. But he shares that this has not always been the case – and that it took a little help and support to enable him to go from passive recipient to active contributor.
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JOURNEYS IN HEALTH PART 1 OF 3
Uncle Soon escorts a patient to his medical appointment
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Cover Story
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ith his cheerful demeanour and warm smile, Uncle Soon has a way of making you feel at ease. His amiable ways make him perfect for his role as a volunteer Medical Escort, where he accompanies seniors to their medical appointments, making sure they are looked after and have some companionship. “I go to their homes, help them into their transport to the hospital, take a queue number for them and wait with them,” he explains. “I just talk to them, listen to them, let them complain,” he adds with a laugh. This helps him understand each of his charges so he can interact better with them. And it is not just for rapport building – Uncle Soon also offers a listening ear and keeps an eye out for signs of low mood, which can be a common but overlooked problem among older adults. He makes the effort to do this because he knows what it is like to be depressed and feel alone – and is determined to do what he can to be a helping hand to those in need.
SINKING INTO A DARK PLACE Uncle Soon never thought he was ‘the type’ to fall into depression. He filled his days with arduous and physically demanding work as a storeman in a car parts warehouse and cycling and swimming during his leisure hours. However, in March 2021, he broke his arm while working and had to take three months off to heal and recover. Upon returning to his job in June, he felt he needed a change of environment. After 20 years at the same place, the work had begun to take its toll and he
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“Doing this work, I can also see what I want for myself in my own senior years, and what a meaningful retirement looks like. I know how I can take steps to continue to keep myself fit and active, mentally and physically.” Uncle Soon, Medical Escort, Blossom Seeds
decided to look for a different job. “I quit my job to rest and looked for something else to do,” he shares. However, despite a three month-long search, he could not find anything that suited him. With no work and not much else to occupy him, Uncle Soon, who lives alone, became bored. As the days passed, he became more anxious about his future. This led to sleepless nights and aimless days where he would simply sit at home and “fa dai” (be in a daze). “My mind started to imagine all the worst-case scenarios and circle round and round,” he recalls. He knew something was not right and sought the help of his GP, Dr Grace Ong from Frontier Medical Associates (Canberra), where he was prescribed medication for anxiety. However, he was unsure about taking it long-term and
lapsed in his medication regimen. This resulted in a worsening of his condition. One day, over coffee with a friend, Uncle Soon found himself “shaking with anxiety” and “about to explode”. Seeing this, his friend took him back to his GP who wrote a memo to the KTPH Emergency Department, advising that he seek support at the hospital if his condition worsened. She also invited him to connect with Yishun Health’s Regional Team to explore his options for community support [see box story]. Taking up this suggestion, Uncle Soon scanned the QR code on the poster at the clinic to request a call back from the Regional Team. Unfortunately, Uncle Soon found himself at KTPH’s Emergency Department the very next day as he felt his condition had worsened overnight. Thankfully, the memo
JOURNEYS IN HEALTH PART 1 OF 3
from his GP to KTPH’s Emergency Department allowed him to start receiving more comprehensive psychiatric care, beginning his journey towards better mental health. Serendipitously while he was there, Ng See Khee, a Regional Team Connector, who had obtained Uncle Soon’s contact from the poster he had scanned, decided to give him a call back. “When she called me that day, it felt like someone was by my side. It made me feel calm and cared for,” says Uncle Soon.
FINDING A PLACE IN THE WORLD As part of his recovery process, Uncle Soon moved in temporarily with his older sister, benefitting from the family support and companionship. See Khee also encouraged him to visit the Community Health Post (CHP) at Blossom Seeds in Sembawang so that Community Nurse, Zhang Ruyi, could guide him on his medication, ensure his compliance and monitor his progress. Over several CHP sessions, Uncle Soon made a Personalised
Care & Support Plan (read more about it on Page 18), which helped identify his personal health goals and the actions he wished to take to achieve them. One of these goals was to return to his active lifestyle, which would improve his mood and help wean him off his medication. Initially, See Khee introduced some exercise activities at Blossom Seeds, such as chair yoga and tai chi. Uncle Soon recalls that he dismissed the suggestion with mock outrage. “I said: ‘I’m a young
REACH OUR REGIONAL TEAM, HASSLE-FREE Yishun Health’s Regional Team partners primary care providers such as Dr Grace Ong from Frontier Medical Associates (Canberra) to build a stronger community of care. At these primary care providers located in Yishun and Sembawang, residents can view or receive materials on the Regional Team. Residents can also choose to walk-in to Yishun Health’s Community Health Posts to meet with the Regional Team, or scan the QR code on the posters put up within the premises to
initiate a conversation with the Regional Team of each neighbourhood. After connecting with the Regional Team, residents can discuss their interests and goals, and explore possibilities such as health-promoting activities, other resident-led groups in the community or even spending time at nearby Wellness Kampung centres. This process supports primary care providers so they can be a touchpoint and link to relevant community resources.
Scan the QR code to learn more about the Regional Team
The Regional Team with Regional Team Connector, Ng See Khee in the middle row, left, and Senior Staff Nurse Zhang Ruyi in the back row, right
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Cover Story
man!’” he says with a guffaw. See Khee then taught him to use the Healthy 365 app, which offers a variety of free virtual and on-site exercise classes. It was right up his alley and since then, Uncle Soon uses the app avidly, attending a host of exercise classes, such as kickboxing and interval training as well as piloxing and yoga almost every day of the week. He has also gone back to cycling with his buddies around trails in Singapore. See Khee helped Uncle Soon with his recovery, such as keeping track with his medication, following the doctor’s advice, offering resources as well as linking him
with other appropriate activities, depending on his needs and goals. When his condition stabilised, Uncle Soon decided it was time to give back as a volunteer. This led to him taking up the training to be a Medical Escort at Blossom Seeds. Today, when not working, he drops in at the centre regularly to help out in any way he can, from cleaning up to being a handyman and more. “I’m a young man! So I can assist the seniors and be useful,” he jokes, adding more seriously, “I know that when I have nothing to do, trouble will start, so I keep my hands and mind busy.” He has found his joy by discovering his place in the world
PERSONALISED CARE & SUPPORT PLANNING Personalised Care and Support Planning (PCSP) is a systematic process of engaging people to understand their personal life and health goals, expectations and the actions that they are ready to take to achieve them. This helps the care team find ways to support and partner them in making realistic and long-lasting changes that matter to the person. It puts people in the driving seat of decision-making and attaining their desired health outcomes. For Uncle Soon, his own plan has evolved with his needs and desires. Initially, his primary goal was to improve his mental health so that he could be discharged from psychiatric care and stop his medication. Having achieved this, he has decided on his next health goal: quit smoking. Now that he is responsible for others as a Medical Escort and volunteer, he is motivated to become healthier so that he can carry on caring for others.
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where he is needed and can serve others. He has even taken up CPR, First Aid and Psychological First Aid courses so he can be armed with more useful skills. Uncle Soon has also learnt a valuable lesson: that being active is not just about being physically fit, but mentally as well – seeking help, connecting with people and taking steps to change one’s life. “Doing this work, I can also see what I want for myself in my own senior years, and what a meaningful retirement looks like,” he says. “I know how I can take steps to continue to keep myself fit and active, mentally and physically.”
JOURNEYS IN HEALTH PART 1 OF 3
Asset-Based Community Development
A collection of residentinitiated, resident-led activities
Combined collection of co-produced activities in the community
A collection of community-based healthcarefacilitated activities
Local Area Coordination
PARTICIPATORY CARE ECOSYSTEM
Residents who live in the same geographical location, e.g. a neighbourhood
COMMUNITY SERVICES ECOSYSTEM Communities of Carers
Regional Team Connectors Community Nurses
y fet Ne
Se
t
Sa
Caring Communities
r v ic es
Partnerships with care service providers
SUPPORTING AN ECOSYSTEM OF CARE According to Elaine Toh, Executive Director, Regional Health Office, Uncle Soon’s journey of health is an example of how Yishun Health – and Healthier SG – envisions the future of care. It is one where every individual can be empowered to be an active participant in their wellness journey and easily seek support anywhere across the spectrum of care. In this transformation of the healthcare system, residents are encouraged to enrol with a family
doctor to co-develop a health plan. The strategy also calls on community partners to support residents in adopting healthier lifestyles. And this is where Yishun Health’s ecosystem will play a key role. Together with primary care partners – from GPs, community organisations, social services and more – Yishun Health will continue to support patients in managing their long-term conditions, achieving their health goals and connecting them to appropriate community resources. “We will streamline our
referral systems and mobilise our network of family doctors to deliver preventive care for residents, develop person-centric health plans that include lifestyle adjustments, regular health screening and appropriate vaccinations, as well as activate community partners to support residents in leading healthier lifestyles,” explains Elaine. This will see Yishun Health leveraging the power of partnerships to build an Integrated Care Network that delivers accessible support and care within communities and close to home.
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&A
reducing
SUGAR INTAKE Yishun Health experts answer your frequently asked questions about health, well-being and medical conditions. In consultation with Chow Pek Yee, Head and Principal Dietitian, Nutrition & Dietetics, KTPH
My parent has just been diagnosed with diabetes. To help manage our family’s diet, I am switching to low-sugar and sugar-free drinks at home. What are some tips when choosing healthier drinks? Making the switch to low-sugar and sugar-free drinks is a helpful step in reducing overall sugar intake. Do keep in mind that: • Low-sugar and no-added sugar drinks still contain 20 |
sugar and should be consumed in moderation • Drinks labelled ‘sugar-free’ may still contain carbohydrates, so it is important to check the nutritional labels • Dairy products such as milk and yogurt drinks are not considered low-sugar drinks as they contain lactose, a milk sugar, which contributes to the total carbohydrate count • Naturally sweetened drinks such as juice still contain fructose and fruit sugar, and should be consumed in moderation
Remember that when managing diabetes, there is more to it than just limiting sugar. Consider also your food choices and lifestyle. Opt for unrefined, whole foods, prioritise vegetables and keep starch portions small. For drinks, choose water whenever possible. Other healthy alternatives include unsweetened tea and coffee. Request for skimmed or low-fat milk as healthier options for your caffeinated drinks.
I would like to cut out sugar from my diet to lose some weight. Apart from avoiding sweet foods such as candy and cake, where else can I cut my sugar intake? Our sugar intake comes from more than just obvious sources like confectionary and other sweet foods. For the average Singaporean, over half of our sugar intake comes from drinks. In fact, Singaporeans consume about 60g (12 teaspoons) of sugar each day, above the World Health Organisation’s recommended daily intake of 50g (10 teaspoons). If you are cutting out sugar for weight loss, you should reduce your sugar intake to 25g (5 teaspoons) a day. Be mindful of other foods that contain high amounts of sugar too. These include cereal and cereal bars, flavoured yogurt, and condiments such as dressings and sauces. In general, sugar is empty calories and does not contain nutrients. To lose weight, we also need to watch out for fat and oil – as gram-to-gram, fats contribute double the calories as compared to sugar. To check for sugar content, look at the ingredients list as well as the nutrition information panel.
My friend has advised me to switch to honey and agave as these are healthier options compared to regular white sugar. Is this true? Sugar comes in many forms. Brown sugar and natural sweeteners such as honey, agave, maple syrup and coconut sugars are less processed versions of sugar but they act the same way as refined white sugar in the bloodstream. They are all broken down to glucose, enter our bloodstream and used as energy, with the excess stored as fat. This means that while there is nothing wrong with choosing honey or agave over white sugar, these natural sweeteners are essentially still calorie-dense sweeteners with minor differences in their mineral composition, taste and appearance.
Here’s a look at the different types of sugar and their calories per 100g
260 kcal Maple syrup
310 kcal
Agave nectar
380 kcal Brown sugar
385 kcal White sugar
400 kcal Maltose
400 kcal Honey
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veryday Heroes
TOUCHING LIVES THROUGH MEDICINE AND HUMANITARIANISM F
Dr Ramaswamy Akhileswaran, Senior Consultant, Geriatric Medicine, has learnt many invaluable lessons from his work as a radiation oncologist and palliative medicine doctor – but for him, nothing beats the perspective and experience that comes from volunteering and serving others.
or Dr Akhileswaran – known as Dr Akhilesh – good medicine is all about connection. Early in his career as a radiation oncologist, he would always strive to build rapport with his patients diagnosed with cancer and try his best to get to know them within the limited opportunities during consultations in clinics and treatment reviews. This search for connection took on greater meaning when he attended an oncology conference in India in 1988. There, he heard a talk on palliative medicine – then a new concept even in Singapore. Palliative care is a specialised multidisciplinary care approach for people living with serious illnesses. Provided at any age and stage of illness, regardless of whether active treatment is ongoing, it aims to 22 |
improve the quality of life for both patients and their families. “It made a lot of sense to me,” he says. In his radiation oncology practice, he noticed that about 50% to 60% of his patients were for palliation rather than cure. This led him to train in palliative medicine at Oxford University and Cardiff University, and he juggled both specialties for the next 12 years. He found that palliative medicine was vastly different from, but complementary to radiation oncology. “The cliché we used was that radiation oncology is high-tech but low-touch, and palliative medicine is low-tech but high-touch,” he says. This makes palliative medicine a “soul-satisfying experience”. Eventually, Dr Akhilesh decided to focus on palliative care full-time, joining the Hospice Care Association
as Medical Director and later, Chief Executive Officer. Today, at KTPH’s Geriatric Medicine Department, he continues to be a passionate advocate for palliative care.
DEEPER CONNECTIONS THROUGH VOLUNTEERING Beyond his love of connecting with patients in medical practice, Dr Akhilesh has also been an avid volunteer in the community. In fact, it has been a lifelong passion and one that he has embraced since he was a medical student in the late 1970s. From free clinics to medical missions and disaster relief, he has also extended his service in volunteerism efforts to the area of palliative medicine. As a Singapore International Foundation (SIF) Specialist International Volunteer since 2009,
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veryday Heroes
“Charitable work is not just a matter of ‘giving handouts’ but about alleviating some of their worries about day-to-day living.” Dr Ramaswamy Akhileswaran Senior Consultant, Geriatric Medicine, KTPH he has helmed three projects and gone on more than 25 trips to build palliative care capabilities in Indonesia. By imparting his knowledge, he has trained over 100 Master Trainers and set up palliative teams in nine hospitals. For his impactful work, Dr Akhilesh received the SIF’s highest award, the Global Citizen Award in 2022. This cascading of skills and knowledge to others is an important way to make a bigger impact that can benefit others, says Dr Akhilesh, who says the work has been “very life-enhancing”. “You get to learn about diverse cultures and communities and expand your knowledge and perspective. It is very meaningful,” he shares. The experience is always eyeopening and humbling. “You get to
see people do so much with so little,” he observes. It is the dedication of doctors, nurses and volunteers, their resilience, stories and even humour of patients at the end of life that keep Dr Akhilesh endlessly inspired. This work, he says, makes him a better doctor, colleague, friend, and person. Most recently, Dr Akhilesh brought his passion for volunteerism to Yishun Health. As a patron and volunteer of a non-profit organisation, Hao Ren Hao Shi (Good People, Good Deeds in Mandarin), he was recently part of a mobile charity initiative with 2022 Singaporean of the Year Mr Anson Ang. The mobile charity initiative was held on 17 July 2023, and it provided groceries and household essentials to patients and staff in need. “In our work in the hospital, we know there are many who are affected by a loss of
The Hao Ren Hao Shi mobile charity initiative in July 2023 benefitted about 120 patients and staff
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job or income, or in difficult personal circumstances. This initiative allows us to alleviate some of their worries about day-to-day living,” Dr Akhilesh says, adding that charitable work is not just a matter of ‘giving handouts’. Dignity is a crucial component of good palliative care, and this is something Dr Akhilesh always keeps in mind when he volunteers. As such, these mobile charity events are also mindfully structured to instil a sense of personhood. Rather than giving out pre-packed items, invitees have the autonomy to select what they need. Student and staff volunteers were also roped in to help invitees carry their items to their homes or means of transport. He shares a story from Mr Ang about how the latter once helped a student through his university education. Later, that same student went on to graduate and start work, where he saved up and donated $10,000, becoming the first donor to contribute such an amount to Hao Ren Hao Shi. In this way, Dr Akhilesh believes, good work truly begets virtuous deeds, and he hopes that by being part of a greater network of volunteers, he gets to do more than just treat illness — to heal, grow and enliven communities. It is in this way that he gets to uplift people, honour their strengths and stories, and find ways to empower them.
Dr Akhilesh (in grey) together with Yishun Health staff and volunteers from Hao Ren Hao Shi
ive Well
Grooving Her Way
to Wellness
For over three decades, Fauziah Bte Saban has dedicated herself to the nursing profession. The work of journeying with patients through their ailments and afflictions can be challenging, but her active lifestyle keeps her going physically, mentally and emotionally. | 25
ive Well
D
ressed in her brightly coloured workout outfits, Fauziah is always a cheerful sight to behold during Yishun Health’s weekly Zumba sessions at the KTPH Promenade. The trim and active 57-year-old helms the Thursday evening exercise sessions with energy and joy, leading class participants in an hour of music and movement. Over her 36 years as a nurse in both the medical and surgical arenas, Fauziah has come to appreciate the importance of making the most of her leisure time, health and all the little blessings life has to offer. In her role as Nurse Clinician at KTPH’s Major Operating Theatre, she often sees patients come in for surgery for trauma and major injuries. This has given her a deep perspective on sickness, death, recovery and life after a serious illness. “In my work, I get to see my patients’ strong and resilient spirits and how they choose to fight on in challenging times,” she says. “Apart from being inspired, I also learn a lot about life.” Helping people through these difficult times is also why she has stayed on in her career for so long. “When you can do something – even small things – to help people feel and get better, you know you are doing something right,” she reflects. It also reminds her to better appreciate her health, mobility and abilities.
ACTIVE BODY, HAPPY MIND, HEALTHY LIFE Even though her work hours are long and she is on her feet all day, Fauziah makes it a point to exercise regularly. Not only does it keep her fit and able to handle her daily work, it also helps her stay mentally alert.
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Her typical day starts with a workout at about 6am. Arriving at KTPH, she finds her favourite spot at one of the indoor linkbridges, puts on her headphones and immerses herself in the music, dancing one of her Zumba routines. This little bubble of ‘me time’, set to the heart-
She also loves the opportunities it gives her to build her social circle. Not only is she part of a Zumba instructor community, but the classes help her connect with many people from all walks of life. In fact, the Thursday class at the Yishun Pond – organised by
thumping beats of salsa, samba and merengue sets her up for the day ahead. “I am always so energised afterwards,” she says. Fauziah took her first Zumba class seven years ago and fell in love with the music and movement of this Latin dance-based fitness programme. She went on to take up a number of trainer courses to become a certified instructor. “I like Zumba because of the music and workouts, which are a combination of coordination and cardio,” she shares.
Yishun Health’s LifeWorks! Team – is attended not only by staff, but members of the public. A mix of different ages and backgrounds, her regular class participants even include two young children. “When I asked them to join a kid’s class, they told me they prefer mine!” Fauziah laughs. There is a strong sense of community in this group; people look out for one another, hang out together and even come up with special themes during festive seasons. “Sometimes, some of them even ask me for medical advice,” Fauziah says. “I gladly give it to them!”
“I carve out time to care for myself so that I can take care of others. Not just my patients, but my friends and family too.” Fauziah Bte Saban Nurse Clinician MAJOR OPERATING THEATRE, KTPH
Nurse Clinician Fauziah Bte Saban leading a Zumba workout at the KTPH Promenade
EATING HER WAY TO HEALTH Beyond her active lifestyle, Fauziah also keeps an eye on her nutritional intake. “Even though I have always been active, I found it difficult to keep the weight off as I got older,” she shares. Since March 2023, she has made an effort to plan her meals better, focusing on the ‘healthy plate’ concept. “I eat a low carb, high protein and high fibre diet,” she says. On some days, this means packing a salad with a protein like chicken
or salmon. If she dines at the food court, she opts for brown rice and plenty of vegetables. This gives her energy for the day and she has healthy snacks such as nuts and fruit in between to keep her going. “I learned that we need more protein as we age to maintain and build muscle mass,” she shares. As they say, ‘you can’t outrun a bad diet’. Her healthier diet resulted in a 10kg weight loss and this outcome has motivated her to stick with it. Just like her exercise, she has made a routine of her healthy meals with
the occasional ‘cheat day’. “Zumba is my form of self-care,” says Fauziah. “I carve out time to care for myself so that I can take care of others. Not just my patients, but my friends and family too.” Her dance routines are not only good for her health but help build mental discipline. “Sometimes in life you face adversity, but you need to find something worthwhile to overcome it. Dancing keeps me happy and gives me something to look forward to. I just keep moving and keep going.”
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potlight
Serving with
Pride and Joy, Together!
Wherever you are in the healthcare spectrum, allied health and pharmacy services will form part of your care. Bringing together this diverse range of professionals, Yishun Health has formed a division to create greater opportunities for strategic cohesion and collaboration.
H
ighly integrated into almost every multidisciplinary team, the role of allied health and pharmacy professionals cannot be understated. From diagnosis to treatment and rehabilitation, they journey with patients across the care spectrum and are essential players of a care team. 28 |
According to Teresa Foong, Director, Allied Health Services & Pharmacy (AHS&P) and Senior Principal Clinical Psychologist, Psychology Services, the AHS&P Division was formally established in 2019 to bring together allied health professionals and pharmacists under one family group. This, Teresa says, brings everybody together with one vision and strategic direction.
“By coming together, we get to build relationships, collaborate and synergise,” she says. “We also have a structured approach to ensure that all our clinical standards are maintained across each professional group, and develop and share best practices across professional groups for a wide range of areas.” For instance, under the Training and Research portfolio,
Mabel Yum, Head and Principal Clinical Psychologist, Psychology Service, leads her committee to ensure AHS&P members get to broaden and develop their transdisciplinary knowledge and skillsets. This includes knowledge sharing across the allied health disciplines to improve familiarity with the basics of each one, such as the safe use and management of medications, simple stress management strategies and appropriate footwear tips. “By doing this, we build and increase their breadth of practice. Armed with foundational knowledge from our peers, we can easily and immediately provide useful and accurate information to our patients without the need for referrals. This ensures timely and safe delivery of care,” she says. This aligns with the approach of Healthier SG, which will see Yishun Health’s AHS&P moving more into primary prevention, working
with GPs and other primary care providers in the community and offering broad general assessment for less complex conditions. Under the Care Transformation and Integration portfolio, projects play an important role in improving patient care experiences and outcomes. Two notable ones are the One-Rehab and Community Hospital Aged Care Transition (CH ACTION) that have shown tangible improvements. One-Rehab is led by Ng Lih Yen, Head and Senior Principal Physiotherapist, and Adon Chan, Deputy Head and Principal Physiotherapist from Rehabilitation Services. It aims to improve patient rehabilitation outcomes through standardised criteria for rehabilitation and a common IT system. This enables therapists across acute hospitals, polyclinics and community settings to better plan, access data and facilitate care
for patients as they transit across care settings. This pilot was officially rolled out in September 2022, with Yishun Health working closely with our community partners to empower patients who need rehabilitation for amputation, hip fracture, total knee replacement, non-surgical musculoskeletal conditions and stroke. CH ACTION, led by Chua Ee Cheng, Head and Principal Medical Social Worker, Medical Social Services, addresses the need to formulate the care model and workflow to facilitate the transitional care of complex elderly patients and discharge them safely back home. This project demonstrated a significant decrease in the readmission rate which in turn reduces demand for manpower and resources. It also resulted in annual cost avoidance of $2.26 million and $2,805 cost savings per patient in KTPH.
A COMMON VISION FOR A HEALTHIER COMMUNITY This has enabled the development of a shared vision for Yishun Health’s AHS&P to have:
• Excellent clinical • Good leadership and capabilities
supervisory skills
• Compassion and care for themselves and others
• Innovativeness, flexibility and
adaptability to changing needs
In order to achieve this vision, the AHS&P division is guided by five portfolios that are led by senior members of the team, who ensure:
• Clinical
competency
• Development through training and research
• Opportunities for specialisation and progression
• Care transformation
and integration through projects and upskilling of staff
• Staff engagement to ensure each member is supported
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potlight
AHS&P are also ensured clarity on career progression pathways that create opportunities for staffdirected professional development. Yishun Health does this through a collaboration with other NHG institutions to develop the NHG Allied Health Professional Career Framework. Launched in September 2023, this is led by Teresa, who guides the implementation of the framework for a successful onboarding of staff and to achieve its goals, with the support of the Human Resource department.
WORKING TOGETHER TOWARDS BETTER OUTCOMES To celebrate and raise awareness of AHS&P, the Division organised the inaugural AHS&P Day, held on 7 July 2023, to highlight its roles within Yishun Health. During the event, over 300 staff came together to celebrate and recognise the work of AHS&P across the disciplines, including a wide range of inter- and multidisciplinary
projects and award-winning research. Awards were also given out to acknowledge AHS&P staff for their dedication and service. And as a physical representation of AHS&P values and the interconnected nature of the work, a large wall display was unveiled, its honeycomb structure signifying the interconnectedness and importance of every discipline to the greater healthcare network. And when it comes to showcasing the integrated nature of work,
there are plenty of examples to be found across Yishun Health – both within AHS&P itself and with other clinical disciplines. In fact, as Chelsea Law, Manager and Senior Principal Podiatrist, Podiatry, notes, “AHS&P is an essential facet in the care of many, if not all, patients.” Podiatric care, for example, is a fundamental aspect of diabetes management as it prevents and manages foot complications that can result in serious infection,
At the inaugural AHS&P Day, accolades such as the (from left) Promising Allied Health Award, Allied Health Excellence Award and Allied Health Assistant, Technician or Support Person of the Year Award were given to recognise and celebrate outstanding staff
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amputation and even death. Chelsea points out that Yishun Health’s Diabetes Foot Service is a collaboration between surgeons, endocrinologists and podiatrists who hold weekly multidisciplinary discussions on complex inpatient cases and provide joint consult clinics to deliver seamless and integrated ‘one care’ plans. This consolidates all plans across disciplines clearly and removes ambiguity between various healthcare providers. Patients are also involved in these discussions. As for interdisciplinary collaborations, this includes work in developing and enhancing the nutritional quality, appeal and safety of food for people with dysphagia (swallowing difficulties) due to stroke, dementia or other conditions. Head and Principal Dietitian, Nutrition & Dietetics, Chow Pek Yee shares, “We work closely with our speech therapy colleagues, as well as Food Services, to ensure that texturemodified foods are palatable.” The challenge, she shares, is that when food is modified in texture so that it is safer to swallow, it can become bland and look unappetising. There is also limited variety and lower nutritional density. Working together, they have created a range of texture-modified menu options for inpatient meals, including the new ‘Easy to Chew’ diet since September 2020. Another instance of both interand multidisciplinary partnerships is the new e-learning programme codesigned by medical social workers, psychiatrists, psychologists and nurses. Ee Cheng shares that this programme trains Yishun Health staff to respond to patients undergoing a mental health crisis, especially if they are exhibiting suicidal ideation. “It enables all staff to have the basic know-how to de-escalate such situations for timelier intervention.” These examples only scratch the surface of how deep and
HOW ALLIED HEALTH SERVICES & PHARMACY PLAY A PART IN YOUR CARE JOURNEY:
1 PREVENTIVE HEALTH
Routine care that maintains health, picks up issues early, prevents complications and supports a healthy lifestyle. This may range from dietary advice and foot assessments to hearing and eye tests.
2 PREHABILITATION
Physiotherapy, dietary advice and/or other activities that are given prior to a surgical procedure or other treatment to improve function and/or raise the baseline health of a patient to improve recovery.
3 DIAGNOSIS
From x-rays and scans to blood tests and more, radiographers and medical laboratory technologists enable an accurate and timely diagnosis.
4 TREATMENT
Working as part of care teams, a range of allied health specialists contribute to the active treatment process. This spans acute to critical care. For instance, in intensive care, Respiratory Therapists monitor the respiratory function of acutely ill patients in the recovery process. There are also prompt medication reviews by pharmacists who work closely with doctors to reconcile patients’ medications and empower them to manage their own medication. Pharmacy Technicians and Pharmacy Assistants also do their part in the safe dispensing of medications.
& 5 REHABILITATION LIFESTYLE MODIFICATIONS
Medical social workers, physiotherapists, prosthetics & orthotics, occupational therapists, speech therapists and psychologists journey with patients from their acute illness and beyond, guiding them in their recovery and recuperation.
6 PALLIATIVE AND HOSPICE Allied health professionals help patients understand their goals, how they want to be cared for and help them to achieve that.
intertwined AHS&P is throughout the care spectrum. Ultimately, Teresa says, “AHS&P plays an important part in the whole ongoing journey of health.” She envisions
that as a division, AHS&P will be able to continue to add value to a transforming and thriving healthcare landscape, as a part of the NHG River of Life. | 31
Things About...
5 THINGS ABOUT…
Salt & Blood Pressure
Did you know that there is a strong link between how much salt we eat and how high our blood pressure can get? In fact, lowering salt intake for just a few weeks can lead to a fall in blood pressure in most people! Here are 5 facts about blood pressure and salt. In consultation with Dr Benjamin Lam, Head & Family Physician, Senior Consultant, Family and Community Medicine, KTPH, and Department of Nutrition and Dietetics, KTPH
1
SALT IS SALT Whether you are using ‘natural sea salt’, ‘pink Himalayan salt’ or ‘organic salt’, all salt is basically the same. While it can vary in size, texture and even price, it is chemically the same thing: sodium chloride. This means that whichever salt you use has the same impact on blood pressure. 32 |
2
SALT HAS A CLEAR IMPACT ON YOUR BLOOD PRESSURE AND HEART The sodium in salt increases blood pressure because we tend to retain water when we eat too much of it. This means the kidneys must work harder to remove excess fluid, which builds up in the system and increases blood pressure. This increased pressure pushes against the blood vessels, making them stiff and narrow. When this happens, the flow of blood and oxygen to the organs decrease, and the heart has to work harder to pump blood through the body.
4
3
SALT IS HIDDEN IN ALL KINDS OF FOOD Preserved and processed foods are not the only kinds of food that are high in sodium. In fact, hidden salt can be found in dry food such as bread and cereal, as well as tomato sauce and sambal. Typically, 75% of the sodium we consume comes from salt, sauces and seasonings in stir-fries, marinades or stock. About 20% comes from processed food like biscuits and sausages, and another 5% naturally from meats and seafood.
2,000MG IS THE MAGIC NUMBER The recommended amount of salt per day is about 1 teaspoon (about 5g). This translates to about 2,000mg of sodium per day, which is roughly the amount of sodium you’ll find in a bowl of ban mian (handmade noodles). To keep within a healthy sodium intake, use spices, herbs or zests to flavour your homecooked food instead of salt or sauces. When eating out, be sure to follow these tips to help you eat healthily!
EATING OUT
Outside foods are generally higher in sodium Ask for your food to be prepared with less salt and sauces
Choose fresh ingredients (e.g. egg, tofu, steamed chicken or sliced fish)
Avoid heavily seasoned dishes (e.g. braised or marinated meats)
Ask for no gravy Choose plain / brown rice instead of flavoured rice
5
Leave behind soup and gravy
Avoid using salt and dipping sauces
CONSIDER USING POTASSIUM-ENRICHED SALT If salt is necessary for your cooking, opt for a potassium-enriched salt substitute instead of regular salt. This salt, chemically known as potassium chloride, is lower in sodium and thus has less impact on blood pressure. However, too much potassium is not advisable for some people, so speak with your doctors to check if potassium-enriched salt is suitable for you. | 33
aily Dose
MAKE SENSE OF NUTRI-GRADE
TO MAKE HEALTHIER CHOICES With Nutri-Grade, you can see at a glance whether a drink is high or low in sugar and fat. Take a deeper look into the grading system and how it is coded so you can make better and healthier choices on your next thirst quencher. In consultation with Gladys Wong, Senior Principal Dietitian, Nutrition & Dietetics, KTPH
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R
olled out in 2023, the Nutri-Grade was introduced as an indicator of sugar and saturated fat content in drinks. They complement the existing Healthier Choice Symbol and nutrition information panel and aim to help Singaporeans make informed and healthier choices.
DOES YOUR DRINK MAKE THE GRADE? Currently, you can find the Nutri-Grade label on:
Drinks dispensed from automated beverage dispensers
Three-in-one drinks, cordials and mixes that may be in powdered or concentrated form
Soft drinks, milk and fruit juices sold in bottles, cans, cartons or packets
From end-2023, Nutri-Grade will also apply to freshly prepared, customisable beverages such as coffee, tea, juices, smoothies, bubble tea, and herbal drinks.
WHAT DO THE LETTERS AND NUMBERS ON NUTRI-GRADE MEAN?
The Nutri-Grade shows four colour-coded alphabets and a percentage. The alphabets represent the grade, and the sugar level is displayed as a percentage of the total volume of the drink.
A
B
C
D
SUGAR CONTENT (grams per 100ml)
1 and no sweetener
>1 to 5
>5 to 10
>10
SATURATED FAT CONTENT (grams per 100ml)
0.7
>0.7 to 1.2
>1.2 to 2.8
>2.8
NUTRI-GRADE LABEL
Nutri-Grade label is not mandatory
Nutri-Grade label is not mandatory
Nutri-Grade label is mandatory
Nutri-Grade label is mandatory and advertising is prohibited
LOOK FOR THE TAG TEAM While the Nutri-Grade focuses on sugar and saturated fat levels in drinks, the Healthier Choice Symbol is a voluntary scheme for both food and drink products. Look out for this symbol to check if your food and drinks are also in the healthy range for other nutritional components such as calcium, sodium, wholegrains and saturated fats. You may also want to take a good look at the nutrition information panel, where a listing of ingredients shows you the amount of nutrients per serving of food or drink. Read the ingredient lists to understand what you are putting into your body and how it contributes to your overall nutritional needs. Together, these labels give you a clearer idea of what is a healthier option when comparing food and drink in the same category.
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akan Time
SEAFOOD CURRY
cut & keep
Spicy, sour and flavourful, this seafood curry can be served over brown rice for a wholesome meal. Recipe provided by Ali Saikh Arsed, Chef de Partie, Food Services, in consultation with Nutrition & Dietetics, KTPH
INGREDIENTS
METHOD
Serves 4
1. Mix curry spices with 300ml water to form a paste 2. In a pot, heat oil and sauté the onion, ginger and curry leaves until fragrant 3. Add the seafood and bring to a simmer 4. Add the curry spice paste and stir well to combine 5. When the seafood is cooked through, add the assam water and mix well 6. Transfer the curry to a bowl and serve hot
• 45g pre-mixed curry spices • 20ml cooking oil • 300ml water • 150g onion, chopped • 15g ginger, minced • 5g curry leaf • 25g assam, mixed with water • 400g mixed seafood (100g each of prawns, flower crab, squid and dory fish)
NUTRITIONAL INFORMATION (PER SERVING) Energy
143kcal
Carbohydrates
3.0g
Protein
19.5g
Fat • Saturated • Polyunsaturated
5.5g
• Monounsaturated
0.6g 1.6g 2.9g
Cholesterol
120mg
Dietary Fibre
1.1g
Sodium
618mg
Potassium
977mg
Phosphate
174mg
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it & Fab
What you ‘knee-d’ TO Know about knee pain Does your knee click, pop or hurt when you move? If so, you may have a knee injury. Learn what to look out for and when to seek medical help. By Dr Teoh Chin Sim, Senior Consultant, Sports and Exercise Medicine Centre, KTPH
38 |
T
he knee joint is subject to many demands and forces. Repetitive actions such as running, lunging and jumping may bring about pain over the front of the knee due to overuse injury to the patella (kneecap). Sometimes, forceful twisting and turning, and quick changes in direction can tear ligaments and meniscus (cartilage) or even fracture a bone. One may also sustain bruises and strain muscles around the knee such as the hamstrings and quadriceps. Do consult a doctor if you experience: • Limping • Pain and/or swelling that does not subside after several days • Difficulty straightening the knee or squatting • ‘Jamming’ or ‘locking’ of the knee • A sensation that the knee ‘gives way’ when you attempt to change direction During your consultation, your doctor will likely ask about your activities and medical history leading up to the knee pain and do an examination to come to a diagnosis of the problem. For minor injuries, self-help advice such as getting rest, refraining from aggravating activities
Some common complaints following knee injury include pain, swelling, clicking, locking and giving way. Though diagnoses may vary, some common symptoms may point to specific problems:
ANATOMY OF THE HUMAN KNEE Side view (Right Knee)
Quadriceps
Hamstring
Kneecap
Calf muscles
and taking pain relief medication is usually sufficient. However, for more serious injuries, further imaging investigations may be ordered, together with a referral to the physiotherapist for treatment and rehabilitation. In addition, you may be given medication, a knee brace, and/or crutches, depending on the problem. Arthroscopy – a minimally invasive surgery using small incisions and thin tube-like instruments – is sometimes needed for treatment of a torn cartilage or ligament to restore function to the
knee. Your doctor will also be able to advise on other suitable surgeries for more severe injuries. Having knee pain does not mean limiting your physical activity entirely. It is helpful to discuss with your doctor and physiotherapist the appropriate modifications you can make during the interim period between injury and complete recovery. For example, non-impact activities such as cycling and resistance training for muscles around the knee may still be gradually carried out before returning to your usual activity levels.
Pain when climbing the stairs and squatting suggest kneecap problems
‘Clicking’ and ‘locking’ sensations may mean a torn meniscus
A sensation that the knee is ‘giving way’ may indicate a torn ligament
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