KTPH 10 - Growing Excellence by Yishun Health

Copyright Information Growing Excellence This commemorative publication has been produced in celebration of Khoo Teck Puat Hospitalâ&#x20AC;&#x2122;s 10th anniversary. Produced by KTPH Corporate Communications Department Published by Khoo Teck Puat Hospital Copyright @ Khoo Teck Puat Hospital, 2020 Khoo Teck Puat Hospital 90 Yishun Central Singapore 768828 Khoo Teck Puat Hospital (KTPH), a 795-bed general and acute care hospital, opened in June 2010. Serving more than 550,000 people living in the northern sector of Singapore, KTPH combines medical expertise with high standards of personalised care, set within a healing environment, to provide care that is good enough for our own loved ones. From intuitive wayfinding to logical clustering of services, KTPHâ&#x20AC;&#x2122;s design is focused on providing a comfortable and hassle-free experience for patients. The building has garnered numerous awards for its green and energy efficient design, with wards that have views of greenery and naturally cool air. KTPH also provides a wide range of outpatient specialist services. KTPH is part of Yishun Health, a network of medical institutions and health facilities of the National Healthcare Group in the north of Singapore, which also includes Admiralty Medical Centre, Yishun Community Hospital and community extensions such as Wellness Kampung. All rights reserved. No part of this book may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or means without the prior permission of the copyright owner. ISBN: 978-981-14-8313-4 Growing Excellence - Celebrating 10 Years of KTPH 2010-2020 Designed by Oxygen Studio Designs Pte Ltd Printed by Oxygen Studio Designs Pte Ltd

G R O W I N G

E X C E L L E N C E

CELEBRATING 10 YEARS OF KTPH 2010 - 2020

n behalf of the NHG Board, I would like to express my sincere congratulations and well-wishes to Khoo Teck Puat Hospital. I am honoured to witness and celebrate its 10th anniversary, a new milestone for the institution which has won the hearts of the people it serves in the north. When KTPH opened its doors in 2010, it brought with it innovative ideas dedicated to caring for its patients, its people and community and its environment. Ten years later, the team’s dedication to serve continues to be upheld in the face of a global pandemic. When COVID-19 reached our shores, KTPH went beyond reaching out to its residents and expanded its community programmes to lend greater support and care for residents in the north. I have been truly impressed with KTPH’s health promotion, and public education efforts. It continuously strives to revolutionise its medical, educational and community services. KTPH’s continuous improvement initiatives also allow it to create and implement novel ideas to meet everchanging healthcare needs. Its work is interwoven with the life of the population it serves.

CHAIRMAN’S MESSAGE

Ensuring the health of our population requires us to expand our care networks into the community, and to closely examine the physical, social and economic factors and influences that affect lifestyle behaviours. There is much truth in the saying that “it takes a whole kampung” to keep a person well and responsible for their health. Various care settings are involved, each playing an equally important role — lifestyle hubs, senior activity centres, primary care, hospices, community hospitals, nursing homes, senior care centres, and homecare. Given such diversity, close collaborations between private and public care providers is paramount in creating effective place-based care in the community. The NHG Family has always regarded leadership as a shared journey, and a collective achievement. I would like to extend my gratitude to everyone at KTPH for their tireless service and devotion to healthcare. Many are taking on multiple roles because of our ever-evolving landscape, and especially in this eventful year’s unexpected COVID-19 crisis. Healthcare workers are special — they persevere and build resilience in the face of adversity. At KTPH, our people continue to move beyond healthcare to health, beyond hospital to community, and beyond quality to value. KTPH has made strides in improving outreach to the community and in improving the population’s quality of life. It is my hope that KTPH will continue in its purpose and on its path of excellence. M D M KAY KU O K C H A I RM A N O F T H E B OA RD N AT I O N A L H E A LT H C A RE G RO UP

t gives me much pleasure to congratulate Yishun Health’s (YH) Khoo Teck Puat Hospital on the occasion of its 10th anniversary. This much loved institution in the HDB heartlands of the north houses some of Singapore’s most renowned and well-respected specialists. I reflect on KTPH’s past decade with pride. Pride because from its humble beginnings, it has grown to create and implement groundbreaking ideas and initiatives. Pride because it has been conferred with a diverse range of national and international awards, from the arena of clinical excellence to nursing, from architecture to environmental sustainability. This year, when Singapore battled the COVID-19 pandemic, KTPH’s response to the challenges demonstrated its unity, resilience and dedication. Since its early days in Alexandra Hospital, YH’s vision has always been aligned with that of NHG. “Adding Years of Healthy Life” goes beyond merely healing the sick to the more difficult and infinitely more rewarding task of preventing illness and preserving health and quality of life. KTPH has been innovative in their committed efforts to move upstream and focus on preventive care in NHG’s River of Life (RoL) framework. Designed to meet current, evolving and future healthcare needs, RoL adopts a more holistic view of health and

GROUP CEO’S MESSAGE healthcare by considering the determinants of health to shape our care according to the needs of our population. Through greater integration of health and social services, we design targeted programmes and timely interventions to support our population through the different stages of their life. The RoL therefore engages multiple stakeholders in our five Segments of Care — Living Well, Living with Illness, Crisis and Complex Care, Living with Frailty, and Leaving Well. YH’s Unified Care Model (UCM) and One Care Plan are key areas of work that complement the RoL, enabling the shift from service-dependence to self-management through capability-building and community development. The UCM ensures that all residents whom YH serves have a One Care Plan emphasising a fit and healthy life, as well as hassle-free access to dignified, safe and value-driven care by collaborative teams and networks. YH is putting in place an ecosystem that supports and enables residents to manage their own health so that they can tap on public healthcare at the right point, resulting in lower cost to both patient and provider. YH’s model of care encompasses service provision, collaboration with community partners and healthy lifestyle activation of the population. 10 years is only the beginning. I wish KTPH continued success as they move forward in their care integration efforts to serve the population in the north with dedication and excellence.

PROF PHILIP CHOO G RO UP C H I E F E X E CUT I V E O F F I C E R N AT I O N A L H E A LT H C A RE G RO UP

CEO’S MESSAGE

n a heartbeat, Khoo Teck Puat Hospital, our little “hospital in a garden”, is 10 years old. I can vividly remember the early days of planning to build KTPH. More than 20 teams came together and put their heart and soul into creating our sustainable, healing hospital. From day one, we aspired to go beyond a hospital’s traditional mission of caring for its patients, to one that also supports our wider community to stay active and healthy. We had wanted to create a green environment with pockets of space that would encourage community presence and involvement. We embraced the new opportunity that was given to us in the form of this unique location which allowed us to practise Salutogenesis — the approach that focuses on supporting a person’s overall well-being. Over the past 10 years, we have constantly sought to improve the way we deliver care. After careful deliberation, we launched the Yishun Health Unified Care Model in 2017, which will be our compass in the years ahead to bring about more person-centric, integrated, hassle-free and safer care for our community. Instead of treating diseases in an episodic way when our patients visit us, we will move upstream to support them to monitor their conditions at home via our Self-Managed Autonomous Regional Teams (SMART) to help prevent and delay diseases and complications. For our residents who are healthy, we will strive to activate them to adopt healthy lifestyles and influence their communities. As KTPH celebrates our 10th anniversary, an unforeseen global pandemic has put us through the toughest test yet. COVID-19 challenged

us all, in mind and body. But in the midst of this ongoing fight, we saw unprecedented unity, courage and a strong sense of purpose and mission. Adversity gave rise to innovations such as our telehealth initiatives that allowed us to care for our patients as they stayed within the safety of their homes. Many moving stories and anecdotes came to light of staff selflessly caring for our patients and going beyond the call of duty. The “kampung spirit” we had cultivated over the years bore fruit. It fills me with great pride and satisfaction to witness the unity that binds us as an institution. This special commemorative book traces the origin of our care journey from when we set foot in Yishun 10 years ago, and highlights our plans as we move into the future. As you turn the pages, you will observe themes of “10” as a reflection of our 10 years. We have captured the essence of the profound ideas that have guided us from “trailblazers” who are our pioneer leaders and inspirational insight from “thought leaders”, our current senior team who will lead us into the future. Interspersed among the pages are 10 features which give us a glimpse into what drives KTPH — our Kaizen DNA, Speak Up for Safety culture, efforts in care integration, and clinical and operational improvement initiatives, and embracing wellness as a whole. Last but not least, we feature our most important asset — our people — and the great work they do as they share with us what motivates them and brings them joy in work. So many people have contributed in big and small ways to our growth as an institution. It is impossible to list them all down in this book. I would like to express my sincerest gratitude and appreciation to all who have been a part of our humble journey. I believe the lessons we have learnt in the past 10 years will inspire us to amplify our vision to add many more years of healthy life for our patients and community. M RS C H E W KWE E T I A N G C H I E F E X E CUT I V E O F F I C E R K H O O T E C K PUAT H O S PI TA L A N D Y I S H UN H E A LT H

VISION

Adding years of healthy life

MISSION

Provide good quality, affordable and hassle-free healthcare with science, love and wisdom

CARE PHILOSOPHY

Care that is good enough for our own mothers without making special arrangements

OUR CORE VALUES PEOPLE-CENTREDNESS We value diversity, respect each other and encourage joy in work. INTEGRITY We commit ourselves to the highest standards of ethical conduct. COMPASSION We care with love, humility and empathy. STEWARDSHIP We are responsible for the care of our people, patients and population.

T H E Y I S H U N H E A LT H WAY OF CARING ■

Caring for Our Patients

■

Caring for Our Community

■

Caring for Our Environment

■

Caring for Our People

CONTENTS

CHAPT ER 1

OUR ROOTS, OUR JOURNEY

C HA PTER 2

PARADIGM SHIFTS

CHAPTER 3

A CULTURE OF INNOVATION AND EXCELLENCE C HA PTER 4

62 82

CARE INTEGRATION IN THE HOSPITAL AND BEYOND

CHAPTER 5

FACETS OF COMPASSION

CHAPTE R 6

ROOTED IN EXCELLENCE

110 128

OUR PEOPLE

CHAPT ER 8

UNITY IN TIMES OF CRISIS

142 158

CHA PTER 7

CHA PTER 9

HEART-TO-HEART, HAND-IN-HAND

CHAPT ER 1 0

THE FUTURE STARTS TODAY

O u r R oo t s, Our Journey

Khoo Teck Puat Hospital (KTPH) began serving the population in the north in 2010. We had aspired to create a hospital in a garden, a garden in a hospital, that is community-centric and rooted in compassion whilst providing our patients with quality, affordable and hassle-free healthcare. As we celebrate our 10th anniversary, we look back at our history and reflect on our core values and principles which have guided us in our accomplishments. We honour our benefactors, thought leaders and trailblazers who have paved our incredible journey and continue to drive us towards excellence.

THE BEGINNINGS

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KTPH’s history is deeply rooted in one of Singapore’s oldest healthcare institutions, Alexandra Hospital (AH). Through the decades, our pioneers faced their share of successes and trials. When the Ministry of Health (MOH) began restructuring Singapore’s public healthcare system to meet evolving healthcare needs in the mid1980s, our leaders rose to the challenge, sowing the seeds of transformation and advancement. EMBRACING CHANGE AH was officially placed under the National Healthcare Group (NHG) on 1 October 2000. Veteran changemaker in healthcare, Mr Liak Teng Lit, was appointed its Chief Executive Officer (CEO).

GROWING EXCELLENCE

Shortly after, Mrs Chew Kwee Tiang, current CEO of Yishun Health (YH), joined him as the hospital’s Chief Operating Officer (COO). They recruited a significant number of experienced healthcare professionals, including A/Prof Sum Chee Fang and Prof Pang Weng Sun, both highly-regarded clinicians in their respective fields of practice. Together, the remaining old guard and new blood embraced the process of redefining healthcare — metamorphosing AH into a future-ready healthcare institution. HARNESSING OUR STRENGTHS Focusing on our expertise and strengths, we rapidly created a niche for ourselves in Diabetes and Geriatric care, pioneering advanced practices in both specialisations. By the early 2000s,

LEARNING FROM TH E BEST Raffles Hotel We learnt how to transform the old colonial AH building, and housekeeping and service standards of Raffles Hotel. The success of the hotel inspired AH to be a “six-star” hospital.

* Please see page 95

health promotion had become the new focus of Singapore’s evolving healthcare system. This shift into disease prevention and early detection aimed to mitigate an expected increase in illness complexity and chronic diseases brought on by the country’s ageing population. We adopted the Head-to-Toe Lifelong Anticipatory Care model to serve a growing number of patients with comorbidities. In line with health promotion, we started the Community Outreach Programme in 2001, equipping people with skills to live confidently, well into old age. More cohesive, holistic and sustainable healthcare delivery began, marking the formation of the hospital’s patient-centred and hassle-free ethos. AH’s efforts paid off when it topped the MOH Patient Satisfaction Survey (PSS)* from 2004 to 2009.

While improving on its clinical outcomes, the hospital team also sought to achieve service excellence by learning from the best practitioners across different industries. The Ritz Carlton The hotel taught us how to establish a strong culture of hospitality — WOW! teams, modelled after the hotel’s WOW! level of service, were formed at AH to provide good service.

Singapore Airlines We gained knowledge on service, training and workflow improvement. Singapore Zoological Gardens The zoo taught us to improve AH’s amenities — we renovated the AH toilets to include new features such as automatic cleaners and nappy changing stations. Singapore Airport Terminal Services and McDonald’s We learnt efficient processes to improve workflow and outcomes in Kitchen Services.

HEALTHCARE THE TOYOTA WAY AH’s transformation was heavily influenced by car manufacturer Toyota. Its managerial and production principles, also known as the Toyota Production System (TPS), were published in a 2001 book titled The Toyota Way. Mrs Chew attended a workshop on Toyota thinking, conducted by the book’s author, Jeffrey Liker. She then introduced the hospital to The Toyota Way, which soon became compulsory reading for all hospital staff. Many terms used in The Toyota Way became codified into our approach to healthcare. In brief, The Toyota Way defines the core business values staff at Toyota apply in their everyday work processes, at every level of the company, worldwide. It is the foundation of Toyota’s corporate culture. The Toyota Way is built on two pillars: Continuous Improvement, which takes in the concepts of Challenge, Kaizen and Genchi Genbutsu, and Respect for People, which embraces Respect and Teamwork (see Chapter 3).

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Continuous improvement of work processes helped to maximise quality, minimise waste and improve efficiency — a goal that both manufacturing and healthcare share. Respect for People was vital in creating a patient-centric hospital as well as a positive work culture. The TPS became a foundational tool in the planning, building and managing of KTPH.

GROWING EXCELLENCE

I N SER V ICE TO T H E N ORT H A nationwide effort to address the gaps in healthcare provision indicated an urgent need for a hospital in the northern region, setting in motion our relocation.

In a Parliamentary Debate on 18 March 2004, then-Minister for Health Mr Khaw Boon Wan issued a challenge to the AH team: “Build a hospital designed with patients unambiguously at the centre of the focus, with technology fully exploited for the benefit and convenience of patients. It will be a hospital which is well linked, a hassle-free hospital.”

The growing realisation that the environment is an important part of well-being paved the way for the Hospital Planning committee to create a green and sustainable building design, in line with a new generation of architecture. The KTPH building is a departure from past practices, where plans were shaped by the perspective of patients and the community. THE RESIDENTS SPEAK After KTPH’s site was selected, the Hospital Planning committee spoke with the residents, listening to concerns and expectations, during focus group sessions and by attending weekly Residents’ Committee meetings. The team built close relationships with community leaders. Mr Ong Ah Heng, thenNee Soon’s Member of Parliament (MP), lent his support in many ways. Mr Ong, Mr Liak, and MP and Senior Minister of State, A/Prof Ho Peng Kee, lobbied very hard for the construction of the hospital in the north. Their efforts were vital in rallying the neighbourhood’s support.

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A SUSTAINABLE H E A LT H T R O P O L I S From the early stages, the management team aimed to build a “hospital in a garden, and a garden in a hospital” that would instill tranquility and a sense of well-being. The hospital would educate and encourage the community and internal workforce to be healthy, using the principles of Placemaking and taking a preventive approach to disease. PLACEMAKING Placemaking inspires people to collectively reimagine and reinvent public spaces as the heart of every community to deliver healthier lives and help prevent avoidable disease. It is a collaborative process that strengthens the connection between people and the places they share by capitalising on local assets and potential. THE PERFECT SITE FOR OUR ASPIRATIONS The Yishun site, located next to a bare and underused storm water pond, presented the ideal canvas to bring our vision to life. It presented the perfect opportunity to create spaces that promote equity, health and wellbeing. The pond would be converted into a healthpromoting pond, to encourage residents to engage in healthy activities. The team engaged the help of CEOs

from the Housing Development Board (HDB), Urban Redevelopment Authority (URA), Public Utilities Board (PUB), Land Transport Authority (LTA) and National Parks (NParks) to assist with funding of the pond and to build up greenery around it. It remains today as a symbol of their collaboration. The pond is managed by PUB, the Lookout Tower by HDB, the surrounding land by National Parks Board and the Promenade by KTPH. “When we interviewed residents before the hospital was built, they told us that they did not want a building that was too jarring, they wanted the hospital to have no gates so that they could walk through it freely,” said Ms Yen Tan, Chief Operating Officer, KTPH and YH. A garden hospital would attract nearby residents to visit for leisure, opening a channel to engage them in health education and influencing them to make healthier lifestyle choices. The hope was that a healthy community would translate into lesser patients being admitted to the hospital, reducing reliance on healthcare services. The active decision to choose a plot adjacent to Yishun Pond laid the foundation for developing spaces that enabled active Placemaking.

GROWING EXCELLENCE

A welcoming, walkable, and engaged neighbourhood helps improve residents’ mental health, physical well-being, and social capital.

PL AC E MA K I N G I S ...

COMMUNITY-DRIVEN

COLLABORATIVE

Volunteers harvesting rooftop garden produce.

Flea Market at KTPH L1 Lobby — held in collaboration with our partners.

SOCIAL & INCLUSIVE The late Mr Jasper Yeo manned the Dignity Mama Book Stall at KTPH L1 Lobby and was a friend to many.

DYNAMIC

FLEXIBLE

Exercise sessions being conducted at Wellness Kampung.

Our spaces are used by members of the community in many ways.

TRANSFORMATIVE Health-promoting activities at the Yishun Pond Promenade.

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The nursing team using lego blocks for infrastructure planning.

HOPES, DREAMS AND ASPIRATIONS To build a hassle-free hospital, the Hospital Planning committee sought the advice of experts and leaders from service, business, design and academia. Innovations from AH, such as its openconcept restrooms and wide corridors, were also incorporated. The planners and architects had foreseen that the demand for hospital services would increase sharply in the subsequent decades, given Singaporeâ&#x20AC;&#x2122;s ageing population. Furthermore, the Severe Acute Respiratory Syndrome (SARS) epidemic that had affected Singapore in 2003 had impressed upon the team the need for lockdown contingencies. Designing the hospital was a collaborative

effort of the clinical, nursing and administrative departments. The planning team incorporated service objectives into the hospitalâ&#x20AC;&#x2122;s infrastructure for efficient patient flow and work processes.

Building this hospital was about piecing together all the hopes, dreams, and aspirations of every individual involved in the planning process, from the engineers and architects, to the staff, to the patients and residents in the area. M R D O N A L D WA I D I RE CTO R, H O S PI TA L PL A N N I N G & I N F RA ST RUCT URE

Some members of the Hospital Planning committee, clockwise, Mr Donald Wai (top), Mr Stewart Tai and Ms Esther Yap.

GROWING EXCELLENCE

A NEW DAWN We had a kampung-style celebration on 25 June 2010 as a symbol of our entering a new village in the north. Many of us stayed overnight, testing out the beds, toilets, showers and kitchen food. Early the next morning, I took a walk around the hospital and took a photograph at 6.57am. It was quiet and tranquil, a contrast to the joyous laughter the night before. It was a new beginning, a new dawn. What was once an empty piece of land, drawings on paper, dusty scaffoldings on concrete walls, was now gently reflected in the still waters — almost silently saying “I’m here.” In that moment, I asked “What kind of hospital are you going to be?” The buildings were silent. As if they were waiting for an answer... from me. From us. From those who will live and walk through its hallways; for they will determine if this will be a hospital with integrity, one that truly cares and walks alongside patients and their families, one that nurtures and builds generations of healthcare workers. Then someday, someone will stand on the same spot, ask the same question, and the old crumbling buildings will silently say, “A great hospital.” PRO F PAN G WEN G SU N DE PUTY GROUP CEO NH G , POPUL ATION HEALTH

Photo taken by Prof Pang Weng Sun on 25 June 2010, at 6.57am

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THE THREE TOWERS AND WAYFINDING

HASSLE-FREE E L E M E N TS IN KTPH BUILDING

There is very deep detailing in the infrastructure. Every step is counted and measured. Hassle-free elements were put in place down to the most minute of details, this included the way the hospital was laid out, the clear naming conventions and signage, and putting the departments with close functional relationships in proximity. MRS CHEW KWEE TIAN G C HIEF E XE CUTIVE OFFICER

Towers A, B and C were named for easy recall. Tower A houses both the A&E and the “A” or private wards. Tower B houses subsidised wards. Tower C houses our Specialist Outpatient Clinics (SOC). The three towers of KTPH were all designed to allow additional floors to be added upon the existing structural provisions — Towers A, B and C can accommodate 1.5, 0.5 and 2 additional floors respectively should the need for vertical expansion arise.

Each tower was assigned a colour for easy identification, with consistent colour coding to help patients orientate themselves at any level. Clearly visible pendant signages establish a clear line of sight from a distance. Signages in the Geriatric Medicine clinics are bigger and in more readable fonts to cater to an older demographic group.

GROWING EXCELLENCE

ACCESSIBILITY AND LINKAGES

Distance travelled upon arrival at KTPH was deliberately planned with consideration of the urgency of the visit. From the drop-off point, it is just 10 metres to the emergency department; 50 metres to the clinics; and 100 metres to the subsidised wards.

INTUITIVE CLUSTERING

Services are clustered together to aid wayfinding, ensuring a calming and stress-free experience for patients.

Tower A also houses the Day Surgery Centre, a one-stop facility that handles surgical procedures without the need for hospitalisation. Its proximity to the pickup and drop-off point ensures easy access for arriving and departing patients.

The three towers of the hospital are wellconnected on the first, third and fourth levels. Patients and visitors can head to their next destination without returning to the ground floor.

The Medical Intensive Care Unit (MICU) is next to the Department of Diagnostic Radiology (DDR), while the Surgical Intensive Care Unit (SICU) is next to the Major Operating Theatre (MOT) to facilitate transfers of patients requiring intensive care after surgery. Both ICUs are in the same tower as the subsidised wards for patientsâ&#x20AC;&#x2122; convenience. Their location and scalability allowed us to be adaptable in meeting challenges during crisis situations such as COVID-19.

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Tower C

UNCONVENTIONAL IDEAS FROM NURSING

Today, many patient cubicles in Singapore’s healthcare institutions contain a toilet — a feature that was pioneered in KTPH by our innovative nursing team. This feature helped reduce falls, improve infection control, and reduce time used assisting patients to the toilets.

In Tower C, clinics are co-located based on relationships, stacked by specialisations and patients’ overlapping healthcare needs. For example, clinics for X-Ray services, Orthopaedic Surgery, General Surgery and Rehabilitation Services are all located on Level 3.

In the towers’ basements, the Nutrition and Dietetics department (N&D) is located next to Kitchen Services to facilitate both departments’ involvement in meeting patients’ dietary needs. The carpark Loading Bay Area leads directly to the kitchen and the Materials Management Department (MMD) facilitating the flow of goods.

There is a Linen Chute placed in every ward, facilitating the transfer of soiled linen directly to a collection point.

The team took their dedication to hassle-free building one step further, staying overnight before KTPH’s opening to test its facilities. They tested everything from the showers to the food, keeping an eye out for areas for improvement. They ensured that all these features made the patients’ experience hassle-free and improved time-efficiency, as stipulated in The Toyota Way.

GROWING EXCELLENCE

A VISION COMES TO LIFE Bust of Tan Sri Khoo Teck Puat The hospital was named Khoo Teck Puat Hospital in acknowledgement of the generous $125 million donation by the estate of the late philanthropist Tan Sri Khoo Teck Puat towards the hospital’s endowment fund. A bust of Tan Sri Khoo stands in the hospital’s lobby today as a symbol of the hospital’s gratitude towards the Khoo family.

Throughout the hospital planning and building process, TPS principles of simple, safe and efficient work processes always guided our decisions. Because of the clarity of this thinking, we were able to communicate our visions to the hospital architects. It brought us closer to building a hospital that works for us, and the residents in the north whom we serve. MRS CH EW KWEE TI AN G C HIE F E XE CUTIVE OF F ICER

KTPH’s groundbreaking ceremony took place in November 2006. The hospital has a built-up area of 110,000 square metres, sitting on 3.4 hectares of land. Construction took place concurrently with the conversion of the storm water pond into a “healthpromoting pond”. The Hospital Planning committee, together with a dedicated group of volunteers, some of whom were experts in flora and fauna, were also involved in an extensive landscaping effort. Their know-how created the “hospital in a garden” which KTPH is known for today. In 2008, Alexandra Health System (AHS) was formed, with KTPH as its cornerstone, to be a regional health system for the population in the north. KTPH’s Topping Out Ceremony took place on 26 June 2009. In preparation for the hospital’s first phase of opening, the SOC and Day Surgery Operating Theatre (DSOT) teams worked vigorously to ensure that the facilities were operationally ready. As scheduled on 28 March 2010, these facilities officially opened their doors to the public. The soft launch generated much excitement — visitors streamed in throughout the day, eager to take a first look at both the newest addition to the north, and the first public hospital to open in a decade. This was quickly followed by the A&E, Inpatient Wards, ICU and MOT opening on 28 June 2010. The hospital opened three months ahead of the original target of September. Departments such as A&E received more than twice the projected number of 50 patients on its first day. Despite the unexpectedly high numbers, the ground teams rose to meet the challenge.

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THE GREAT E ST H ON OU R KTPH was officially opened by the late Minister Mentor Lee Kuan Yew on 15 November 2010. In his speech, Mr Lee congratulated the architects and Hospital Planning committee on the well-designed hospital, likening KTPH to “a hospital in a garden”. He also emphasised the need for continuous innovation to tackle future challenges and the importance of building healthy communities by actively engaging them, citing KTPH’s dedicated community networking efforts. Minister Mentor Lee Kuan Yew with then-Chairman Ms Jennie Chua.

GROWING EXCELLENCE

T H AN K I N G O UR B EN EFACTO RS Over the years, KTPH has received the support of benefactors and well-wishers who have greatly contributed towards the successes of the institution. We would like to thank everyone who has dedicated their time, talent and effort, including our past and present board members. Our biggest benefactor is the Khoo Family, in particular, Ms Elizabeth Khoo, board member of both Alexandra Health Fund (AHF) and AHS, and Ms Mavis Khoo, former board member, AHS Board and Patron of KTPH. Last but not least, our champion Ms Jennie Chua, Former Chairman, AHS Board. We would also like to express our sincere appreciation to:

Mr Jerry Ong and team from CPG Architects for working with us to create our â&#x20AC;&#x2DC;hospital in a garden, garden in a hospitalâ&#x20AC;&#x2122;

Mr Tay Kheng Soon and Mr Ng Cheow Kheng (pictured) for their insights towards creating a green KTPH

Mr Ng Lang, Mr Khoo Teng Chye and Mr Lau Joo Ming for their insights and contributions in converting the storm pond to a health-promoting pond

Dr Wee Yeow Chin (pictured) and Mr Richard Yeo Ying San for sponsoring plants for our gardens

Mr Richard Helfer for his inputs on the architecture and service standards at KTPH

A/Prof Ho Peng Kee and Mr Ong Ah Heng for lobbying for a hospital in the north and introducing KTPH to the local community

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Mrs Pauline Ong began serving as Chief Volunteer of AH from 2004 onwards. She initiated the Greeters and Guides Programme where volunteers gave visitors a tour of the hospital and served as patient greeters, answering queries and guiding patients and visitors to wards and clinics. She also stress-tested our systems and service standards in the wards and gave us her invaluable feedback.

Thank you to the following benefactors for their expert knowledge on flora and fauna and help in creating the gardens at KTPH:

Dr Ho Hua Chew

Mr Lee Chiu San

Dr Tan Hwa Luck

Mr Anthony Seah

Mr Tony Tan

Mr Seah Moon Ming

Thank you to our landscape designers and agents for always going the extra mile:

Mr Glenn Bontiago

The late Mr RP Jickky

Mr K Rajendran

GROWING EXCELLENCE

A SPECIAL M E N T ION Ms Mavis Khoo (centre) established the Mavis Khoo Nursing Leaders Scholarship in 2018, which enables high-performing nursing talents to pursue learning and development opportunities to become future nursing leaders. She has also generously advocated for and supported the hospital’s efforts in expanding its research capabilities, and driving innovation. Ms Khoo has been instrumental in our healthpromoting and community-centric initiatives. The conversion of a storm water pond next to KTPH into a ‘waterfront health-promoting park’ was made possible with funding support from the Alexandra Health Fund. The beautiful and functional park has encouraged residents to keep fit and keep the kampung spirit alive, while bringing comfort and peace to patients and visitors.

Ms Jennie Chua served as Chairman of the AHS board from 2008 to 2017. In her time as Chairman, she swiftly assembled a team of experienced professionals with the dedication and passion to achieve the leadership team’s vision. Ms Chua also worked in tandem with Ms Khoo and Mr Liak to achieve the conversion of the storm water pond into a health-promoting pond, and the area around it into a health-promoting park. The founding leaders of the hospital remember her as a hands-on Chairman who not only provided great insight to strategic directions, but who would pay attention to small details in order to make sure that the hospital’s staff and patients were well taken care of. When the hospital was deciding on staff uniforms, Ms Chua made the effort to assess different materials and styles to ensure both functionality and comfort for staff in various roles and settings.

Mr Liak Teng Lit’s contributions have been instrumental in the conceptualisation and building of KTPH. His ideas are at the heart of the thriving healthropolis that we see today. Mr Liak is a visionary whose understanding of the evolving healthcare landscape and foresight led to the development of our health-promoting and community transformation programmes. We thank him for his dedication, wisdom and guidance over the years.

CHAPTER 1

O U R R O O TS , O U R J O U R N E Y

KTPH’s journey of providing quality care for its patients has been one marked with many significant moments.

OUR STORY IN MILESTONES

OUR JOURNEY BEGINS HERE 2010s A New Era of Hassle-Free, Quality Healthcare

2017 ■

■

Merger of the Six Healthcare Clusters AHS merged with NHG. AdMC, YCH and KTPH were collectively referred to as Yishun Health (YH). Launch of Unified Care Model (UCM) The UCM framework, aligned with NHG’s River of Life (RoL) aims, is implemented through the One Care Plan — emphasising a focus on the salutogenic model to seed healthy lifestyle habits in our community.

■

Progressive Opening of KTPH (March 2010 onwards) Start of Ageing-In-Place Programme (September 2011)

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First Community Nurse Post in the north (October 2011)

■

Official Opening of KTPH (15 November 2010)

■

Official Set-Up of Population Health (April 2014)

■

Groundbreaking Ceremony for Yishun Community Hospital (YCH) (23 August 2013) Groundbreaking for Admiralty Medical Centre (AdMC) (23 August 2014)

■

Official Opening of YCH (28 November 2016)

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Official Opening of AdMC (12 May 2018)

2018– 2019

UCM

■

Early Achievements of UCM Safe and value-driven care by collaborative teams and networks led to the planning and implementation of successful initiatives such as those by the Acute Geriatric Assessment Unit (AGAU), Hip Fracture Unit (HFU), and our community programmes.

GROWING EXCELLENCE

1980s – 1990s

1970s ■

1938– 1970s ■

The Beginning In 1938, the British Military Hospital was built to principally serve the British Military in the Far East. It continued to serve the British for 26 years following World War II.

■

Making Singapore’s Medical History The British Military Hospital was handed over to the Singapore government and renamed Alexandra Hospital (AH) in 1971. It opened to the public on 15 September, providing pioneering care to Singaporeans.

Threatened by Changing Landscape Government hospitals were being restructured, rebuilt or relocated. AH felt the need to improve its weathered facilities, basic equipment and limited range of services.

2000s

■

Becoming KTPH (17 March 2004) Then-Minister for Health Khaw Boon Wan announced a new regional hospital in Yishun. AH planned for the move and was later renamed Khoo Teck Puat Hospital (KTPH). Groundbreaking of KTPH (28 November 2006) Formation of Alexandra Health System (AHS) Board (7 October 2007)

■

Establishment of AHS Cluster (2008)

■

Topping Out Ceremony at KTPH (29 June 2009)

2020 ■

YH Tackles COVID-19 YH harnesses its collective strengths, trust and relationships to support and reassure our community during times of crisis.

A Decade of Transformation AH restructured on 1 October 2000 and became part of the National Healthcare Group (NHG). New management overhauled its facilities, services and adopted best practices to deliver quality healthcare. ■

The SARS Outbreak (2003) One of the biggest health crises in Singapore showed AH staff displaying their professionalism and resilience.

Paradigm Shifts

The completion of KTPH brought us closer to our vision of an integrated and holistic healthcare cluster in the north. At the same time, Singaporeâ&#x20AC;&#x2122;s evolving healthcare landscape spurred us to anticipate future challenges and deploy a new model of care to serve the population. Aspiring to improve the health and well-being of our community, we seek to build a new approach to healthcare based on collective strengths, shared goals, trust and relationships.

CHAPTER 2

INSPIRE

PA R A D I G M S H I F TS

SEEDING THE M O D E LS O F C A R E

ingapore’s healthcare system faced a series of challenges which included rising public expectations of better care provision, rapid technological advancement and escalating healthcare costs. We needed to re-examine the way healthcare was provided — a task undertaken by the AH team when we went through restructuring and subsequently when we planned for the new hospital. In the early planning stages, thenMinister Khaw reminded the team that the hospital needed to adopt a bigger role to change the way healthcare was being delivered in the community. It needed to be more than just a hospital and empower the community to live healthy lives for as long as possible. GERMINATING NEW IDEAS The hospital leadership team led planning sessions with a team of clinicians, nurses, allied health professionals and administrative staff to discuss methods of bringing about a sea-change in healthcare. The team conceptualised an approach that embraced wellness and set in motion a gradual departure from episodic treatment and illness care. The model of Fast, Cruise and Slow Medicine was developed in AH to provide “whole person care”, giving appropriate attention to each category of patients, according to their needs. Prof Pang Weng Sun with a patient

‘Cruise’ Medicine

Patients with chronic illness requiring systematic care plans to manage the illness over a long period of time

‘Fast’ Medicine

Acutely ill patients needing fast diagnosis and treatment by an efficient team

‘Slow’ Medicine

Patients and elderly with advanced illness, whose illness management involves appropriate goal-setting rather than rapid treatment

GROWING EXCELLENCE

HEAD-TO-TOE LIFELONG ANTICIPATORY HEALTHCARE OF WHOLE PERSON

PRE-ILLNESS ILLNESS

Health Maintenance Vaccination ■ Public Health Education ■ Health Screening ■ Workplace Health Promotion ■

Illness Care ■

This model required specific institutions to undertake roles that would meet the needs of different target groups within the population. While KTPH provided the north’s ‘Fast’ Medicine, Yishun Community Hospital (YCH) and the neighbourhood/nearby Wellness Kampung, when ready, were to provide ‘Slow’ Medicine care. Admiralty Medical Centre (AdMC) and Sembawang Primary Care Centre, when ready, were to support the region’s ‘Cruise’ Medicine needs. “We try to anticipate what may happen to our patients as their illnesses progress and conditions deteriorate. We need to look at our healthcare system, know our community — whether people, patients or providers of

Cost effective, efficient care ❒ System Processes ❒ Clinical Pathways

POSTILLNESS

Health Recovery ■ Skills-for-life ■ Homecare support ■ Follow-up support

healthcare — and be able to anticipate what needs to be done in preparation to meet future needs,” said Prof Pang Weng Sun. The model of care was implemented through various pilots and initiatives and continually strengthened. “There was a strong sense of camaraderie, as we believed we were trailblazing a new model of care at KTPH,” said A/Prof Kenneth Mak. Currently the Director of Medical Services at MOH, he joined AH in 2005 to head its Department of Surgery. KTPH’s trailblazing model of care, as we know it today, is the result of profound reflection, research and understanding of patients’ needs and well-being.

CHAPTER 2

A MODEL OF EMPOWERMENT

In 2012, then-COO Mrs Chew Kwee Tiang was appointed the Chief Executive Officer of KTPH, while Mr Liak was promoted to Group CEO of AHS.

SALUTOGENESIS Mrs Chew is a firm believer in Salutogenesis, defined as a medical approach focusing on factors that support human health and well-being, rather than on factors that cause disease (pathogenesis). The “salutogenic model” of health focuses on the relationship between health, stress, and coping. The term was coined by Aaron Antonovsky, a professor of medical sociology.

PROMOTION HEALTH EDUCATION

n its first year, KTPH was already seeing a full patient load, particularly in some service units such as the A&E, which was attending to almost 300 patients a day. The team that transitioned from a small hospital to KTPH had to attend to a much higher volume of people. The new staff that had been recruited were still unfamiliar with the culture of the team that had moved over from AH. Through a challenging transitionary period, both pioneers and new recruits rallied and rose to the occasion. They knew that a paradigm shift was imminent.

G TO

ENE S

QUALITY OF LIFE & WELLBEING

ASPIRE

PA R A D I G M S H I F TS

PREVENTIVE

Mrs Chew began her new role with two priorities at hand: firstly, re-engineering KTPH’s model of care. Secondly, succession planning — as she knew that this re-engineering process would need the expertise of a group of revolutionary thinkers.

PROTECTIVE CURATIVE

DEATH, DISEASE

Adopting salutogenesis (origins of health) as a model for public health practice rather than pathogenesis (origins of disease) allows healthcare providers to focus on factors that support and increase well-being rather than on factors that merely prevent disease. This promotes healthful behaviours that increase people’s sense of well-being.

CEO Mrs Chew Kwee Tiang

GROWING EXCELLENCE

emphasising a fit and healthy life, as well as hassle-free access to dignified, safe and value-driven care by collaborative teams and networks.

UCM

RIVER OF LIFE YH re-integrated into NHG smoothly. Although our paths had diverged, our visions had remained aligned. The UCM, designed to help the population to remain healthy, covered the five segments of care in NHG’s RoL Framework — Living Well, Living with Illness, Crisis and Complex Care, Living with Frailty, and Leaving Well. The RoL includes the physical, mental and social dimensions — and is founded on the principle that everyone wants to live well from cradle to grave.

UNIFIED CARE MODEL In October 2017, AHS was re-integrated into the NHG as part of a nationwide restructuring of healthcare clusters. That same year, YH was formed, comprising KTPH, YCH, AdMC and Population Health and Community Transformation (PHCT). YH’s Unified Person-Centric Clinical Care Model, or Unified Care Model (UCM) in short, was also born that year. The UCM ensures that all residents have a One Care Plan

RIVER

Determinants of Health

Sanitation • Education • Food • Housing • Water • Employment

LIFE

Determinants of Outcomes

Better • Faster • Cheaper • Safer

SYSTEM EXCELLENCE

BETTER CARE

SM EC ART OS YS TE

Triple

AIM

MC KT

Community Nurse Posts

Primary Care Network

Living Well

US MP CA FLOW

Acute Service Lines Elective Service Lines Complex Care Clinics

Schools

Organisation

People Renewal

I UN

FIE

NT-CENTRIC CLINICAL CAR ATIE EM DP O

LIFELONG

CARE

7W ay s

Nursing Homes

QU ALI TY,

SOSI

Crisis & Complex Care

CE, AFF CIEN ORD ABLE & ITH S HASSLE-FREE HEALTHCARE W SS

less op ne Pe tred n Ce

Living with Illness

Patient Value Compass

General Practitioners

BETTER PEOPLE

Elder Care Centres

Polyclinics

大家喝

ity egr Int

CCoo mpp m aassss iioonn

tteeww aarrdd sshhii pp

Living with Frailty benny

Cam󰇴󰇴󰇴󰇴󰇴󰇴 Op󰇷󰇷

Energy for Performance

Toyota Production System

Fin󰇧󰇧󰇧󰇧󰇧󰇧󰇧󰇧󰇧󰇧 Sec󰇻󰇻󰇻󰇻󰇻󰇻󰇻󰇻󰇻

Cy󰇨󰇨󰇨󰇨󰇨 Sec󰇻󰇻󰇻󰇻󰇻󰇻󰇻󰇻󰇻󰇻󰇻󰇻󰇻

In󰇳󰇳󰇳󰇳󰇳󰇳󰇳󰇳󰇳󰇳󰇳󰇳󰇳 & Tec󰇬󰇬

Knowledge & Learning

Leaving Well

Leadership & Relationship

SYSTEM HEALTH

Gre󰇪󰇪󰇪󰇪󰇪󰇪 Sus󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹󰇹 Designed by Benny Tan, Yishun Health Corporate Communications. Adapted from Central Health Model of Care by Tan How Sun, TTSH.

CHAPTER 2

REVOLUTIONARY THINKERS In 2014, Mrs Chew roped in the National University of Singapore’s Institute of Systems Science (ISS)’s CEO, Mr Khoong Chan Meng, to conceptualise a Business Process Reengineering project and enable a systematic approach to transforming care. The transformation project, which involved more than 200 staff across KTPH and YCH, was led by A/Prof Terence Tang, Chief Clinical Informatics Officer, Deputy CMB, Clinical Informatics, Innovation and Patient Engagement, and Mr Alvin Ong, iHIS Chief Information Officer for AHS , and driven by Dr Ng Yeuk Fan, Director of Corporate Development, YH & KTPH.

People and communities are inherently creative, resourceful and whole. Our belief that there is an abundance of these assets in the Yishun zone is at the heart of our health system redesign using the UCM. By Dr Ng Yeuk Fan partnering with our people and our communities, we will not only improve health, we will forge meaning, build identities, and enable people to celebrate the joy in life. DR NG YE U K FAN D I R ECTOR, CORPORATE D EVELOP MEN T

UNIFIED CARE MODEL (UCM) The UCM ensures that all residents have a One Care Plan emphasising a fit and healthy life, as well as hassle-free access to dignified, safe and value-driven care by collaborative teams and networks. The UCM represents our aspiration to co-create with all staff and our communities the highest form of integrated care — care that is person- and community- centred, built upon collective strengths and shared goals, trust and relationships.

PA R A D I G M S H I F TS

In 2016, A/Prof Pek Wee Yang was appointed as KTPH’s Chairman of the Medical Board. In 2017, Prof Pek was tasked to lead a group of 16 senior staff in the YH Retreat Planning Team (YHRPT) to examine gaps in care and service. The YHRPT culminated in a series of intense leadership envisioning workshops, during which the leadership team collectively forged a new model of care — the YH Unified Care Model (UCM). The UCM reorientates and integrates conventional models of care that are institution- or setting-centric, profession- or specialty- or disease-centric, into a single unified person-centric model of care. The UCM is designed to be the highest form of integrated care. The UCM facilitates the implementation of the RoL in the Yishun Zone. ONE CARE PLAN The UCM will enable all residents to have a lifelong One Care Plan that is jointly developed with the resident by a transdisciplinary care team. The purpose of the One Care Plan is to put the resident at the centre of his/her own care, within his/her own community, for the duration of life — hence “lifelong”. The care team will implement this, together with the resident, as well as with various shared care partners in the resident’s community, to jointly optimise outcomes systematically over the life course of the resident. “When we initiate a transformation project like the UCM, we build on existing values, ethos and culture, with the objective of going beyond acute care and illness care to sustain wellness,” shared Dr Ng. The One Care Plan starts at a “basic” level for all residents who are Living Well. Additional One Care Plan elements are added, in a

GROWING EXCELLENCE

MOHâ&#x20AC;&#x2122;S 3 BEYONDS

To enable Singaporeans to receive appropriate care in the community and closer to home. Collaboration with YCH, AdMC, General Practitioners & primary care providers to provide seamless, hassle-free care

Beyond Hospital to Community

Beyond Healthcare to Health

modular way, for residents who are Living with Chronic Illnesses, Living with Frailty, or who are Leaving Well. ALIGNING VISIONS â&#x20AC;&#x153;In October 2017, we officially became YH and reunited with NHG. With a new identity, we ushered in a new chapter for our organisation. Our mission remains unchanged and relevant today â&#x20AC;&#x201D; to provide good quality, affordable and hassle-free healthcare with science, love and wisdom. This new identity presents a wonderful opportunity for AdMC, KTPH, YCH and PHCT to collaborate more effectively as one healthcare team,â&#x20AC;? Mrs Chew said. In November 2017, MOH announced its new strategy for a sustainable healthcare system i.e. the 3 Beyonds: Beyond Hospital to Community, Beyond Healthcare to Health, Beyond Quality to Value. â&#x20AC;&#x153;Through engaging the community, we are also doing a fair bit of relationship

Beyond Quality to Value

To nurture a community of healthy people. Empowering the community to take ownership of their health, through engagement in health-promoting activities and programmes To offer patients both quality and value in healthcare. Building care plans around patientsâ&#x20AC;&#x2122; medical and non-medical needs, and mapping their care journey from beginning to end

building. We aim to build a self-sustaining and resilient community network in tandem with NHGâ&#x20AC;&#x2122;s RoL. We will teach people how to care for themselves, providing the tools and resources. This is more sustainable compared to the traditional way where we send a team to deliver a A/Prof Pek Wee Yang service. To some extent, we are still doing that for some areas that are very specific. But the majority of our efforts will focus on empowering the community,â&#x20AC;? explained A/Prof Pek. â&#x20AC;&#x153;The ability to do what you want with your life is the goal. We want to empower people so that they have health to pursue whatever they want to do. As health is Yishun Healthâ&#x20AC;&#x2122;s goal, we need to provide healthcare, implement prevention, develop education, and build strong partnerships,â&#x20AC;? said Dr Ng.

CHAPTER 2

PA R A D I G M S H I F TS

REFLECTIONS F RO M OU R ADV IS O RS KTPH’s achievements to date would not have been possible without the unwavering support and invaluable contributions of the previous and current board members of Yishun Health and Alexandra Health Fund Limited. As KTPH celebrates its 10th anniversary, some of AHS1 and AHF’s2 previous and present board members share their memories and reflections on the hospital’s journey.

Khoo Teck Puat Hospital has committed itself admirably to caring for its patients, the community it serves and the environment while championing research and innovation. I am proud to have been part of this journey. I hope that KTPH will continue to play a significant role in the advancement of holistic and sustainable healthcare, not only for the residents in Yishun and Sembawang, but for the nation. I am sure the 10th anniversary celebration of KTPH will be a fruitful and memorable event. May Khoo Teck Puat Hospital always find success in its endeavours!

Ms Jennie Chua

CHAIRPERSON, AHS & YH, 2008 – 2017

1 Yishun Health, formerly known as

Alexandra Health, currently manages Khoo Teck Puat Hospital, Yishun Community Hospital and Admiralty Medical Centre. After becoming Yishun Health under the National Healthcare Group in October 2017, the team ushered in a new chapter for their organisation. 2 The Alexandra Health Fund Limited (AHF) was incorporated on 19 September 2014 to manage the Alexandra Health Endowment Fund (AHEF). The AHEF was established on 1 February 2010 to receive contributions and donations for the pursuit of medical and health-related education, research and development and the promotion, development and provision of medical and health-related services and devices in Singapore. The AHF has been approved as an institution of a Public Character (IPC) since 19 November 2014.

When KTPH was first being built, the newly formed Board was fortunate to be working alongside an experienced team under Alexandra Health. We were given the fulfilling task of developing a hospital that would trailblaze a new model of healthcare, integrating the campus with its surrounding greenery. KTPH has lived up to the promise of its vision. Congratulations on your 10th anniversary, and all the best in continuing to live by the mission of the hospital.

When KTPH opened in 2010, it was the first hospital to truly bring the community into its planning and design, offering a unique “hospital in a community garden” concept. Congratulations to all who helped to establish and support the hospital, and a big thank you to the family of the late Tan Sri Khoo Teck Puat for their generous donation and setting up the endowment fund to assist needy patients. Happy 10th Anniversary!

Mr Dilhan Pillay Sandrasegara

Mr Roy Quek

MEMBER, AHS, 2008 – 2011

MEMBER, AHS, 2008 – 2012

GROWING EXCELLENCE

KTPH has won many awards for its medical care, education, research and leadership. The team spirit displayed under the stewardship of CEO Mrs Chew Kwee Tiang sets KTPH apart. The respect shown to every person in the hospital shows the tremendous value the staff have placed on diversity. I am proud to see the milestones achieved by the hospital and wish for their continued success.

Ms Elizabeth Khoo MEMBER, AHS, 2008 – 2010 & AHF, 2010 – PRESENT

It gives me great pleasure to congratulate KTPH for its many milestones and achievements since its inception 10 years ago. KTPH has always strived to provide the opportunity for its people to maximise their potential and achieve excellence, for the common good of the community. Over the past decade, it has successfully nurtured compassionate and empathetic healthcare providers who in turn nurture and protect the community. I wish to extend my best wishes to KTPH for its continued path to success over the coming years. Congratulations on the occasion of your 10th anniversary and many more brilliant milestones to come.

The best memories of my time on the board include the excitement and anticipation of seeing a new hospital built from scratch. Also, the many innovative ideas from the management team then — from the rooftop gardens to the community step-down care facilities. Happy birthday, KTPH. I am proud to have played a role in your history and may you continue to grow from strength to strength.

Ms Tan Su Shan MEMBER, AHS, 2008 – 2011

Ms Mavis Khoo

MEMBER, AHS & YH, 2008 – PRESENT

KTPH is a hospital in a garden rich in flora and fauna, with a beautiful rooftop garden with fruit trees and vegetables, and a large pond that allows people to walk and exercise. The hospital is unique — a mini replica of the Botanic Gardens, a world heritage site, even down to the toilets which include elements of nature. This creates a conducive environment for healing and the well-being of patients, visitors and staff.

Dr Quek Peng Kiang MEMBER, AHS, 2008 – 2016

KTPH has a vision for its patients as well as its healthcare workers and visitors. One needs only to visit the hospital to feel the permeating aura of wellness, the care and concern of its staff, the ambience and the surroundings. I have been associated with the hospital for 8 years and it has left an indelible impression of it not only as a hospital, but what an institution should be. Bravo!

Mr Anthony Seah MEMBER, AHS, 2008 – 2016

KTPH has a track record of outstanding service to its patients and applying kaizen to assure quality, improve productivity and enhance patient experience…I am proud to be part of the KTPH team that opened the hospital on time, with IT systems up and running, deployed within a tight budget. We made effective and efficient use of IT to strengthen and sustain the strong performance.

Mr Robert Chew

CHAIRMAN, YH BOARD COMMITTEE, 2018 – 2020 MEMBER, AHS & YH, 2008 – 2017

CHAPTER 2

PA R A D I G M S H I F TS

Continue to blaze the trail for the next 10, just as KTPH has done for the past 10. Never lose the passion each and everyone at KTPH has, and hold steadfastly to the promise of delivering the best healthcare available to Singapore and its residents, now and always.

KTPH provides an environment in which patients are taken care of by well-trained, passionate and committed staff in an environment that is eco-friendly and conducive to healing. As it turns 10, I wish KTPH a future journey that makes a significant impact on the life of its patients, caregivers and stakeholders. May KTPH continue to innovate in its efforts to provide better patient care.

When I joined the KTPH family, I envisaged the hospital placing the interests of its patients (i.e. heart-ware) at its core. Over the past 10 years, KTPH has been delivering quality, affordable and hasslefree, patient-centred healthcare through smartly exploring new clinical methods as well as leveraging technologies (i.e. hardware and software) in its system and processes. Excellent and well done!

Mr Ramlee bin Buang

Mr Seah Moon Ming

I have been very inspired by the “dareto-try, dare-to-do, if it has not been done before, try it” spirit of KTPH. For the next 10 years, may you not just always think out of the box, but think as if there is completely no box. I will be cheering KTPH on, as you trailblaze and transform healthcare in the next decade. All the best!

Being the first health-promoting hospital in Singapore sets KTPH apart from others, with its innovative health-promoting programmes having successfully won many prestigious national and global awards…The achievements and sterling work of KTPH staff over the last 10 years is truly commendable and a testament to the strong leadership at KTPH.

KTPH has a legacy left by Mr Liak Teng Lit. He set the tone from the word “go”. From the days at Alexandra Hospital, the green environment, exercise, health and nutrition became the hallmarks of Alexandra Health…From the many public surveys for AH previously and KTPH presently, there is little doubt that the service is top class. The patients are well cared for in life and in death.

Ms Teoh Zsin Woon

Ms Chu Swee Yeok

Prof Chee Yam Cheng

MEMBER, AHS, 2012 – 2017

MEMBER, AHS, 2016 – 2017

MEMBER, AHS, 2008 – 2017

Mr Tan Boon Khai MEMBER, AHS, 2008 – 2017 MEMBER, AHF 2014 – 2016 CHAIRMAN, AHF, 2016 – PRESENT

GROWING EXCELLENCE

It is truly an honour and a privilege to be part of the inception, birth and growth of KTPH over the years. Uniquely designed to deliver care for patients in an inclusive environment promoting peace and calm, KTPH’s staff have played a sterling role in bringing this vision to reality with their dedication and excellent service. May KTPH continue to be a paragon for the healthcare industry for many, many years to come. Happy Anniversary!

Mr Douglas Foo MEMBER, AHS, 2008 – 2017

Our staff, who put their fears aside to care for patients with exemplary dedication, are truly inspiring. I admire all at KTPH, who have prepared well, with professionalism, innovation and love, to take on the challenges of the global pandemic. You have achieved Readiness, Response and Recovery in Hospital Outbreak Management. I am proud to be associated with KTPH and wish you many more years of achievement in serving the healthcare needs of our community.

Mr Tow Heng Tan

MEMBER, AHS & YH, 2016 – PRESENT

At that time, being the only restructured hospital in the north, a heavy patient load became a fact of life at KTPH. Every board meeting, we studied the number of admissions, discharges, and locations of the bottlenecks and congestion...The innovative spirit that I saw has been seared into KTPH’s DNA...I hope it will continue to break new grounds, and play its role in improving our healthcare system.

Mr Ong Ye Kung MEMBER, AHS, 2011 – 2017

KTPH led the pack in pushing new boundaries in community care in the past decade, and in the course of it positively impacting the lives of many residents in the community.

Mr Patrick Tay

MEMBER, AHF, 2016 – PRESENT

Several years ago the CEO took me on a tour of the hospital and its unique gardens. An incident that is etched in my memory was going to the rooftop garden and tasting fresh organic fruits that he plucked there. Over the years, KTPH has largely succeeded in practising patient-centred care, and in always keeping quality and safety in mind. I hope KTPH strives to remain as the hospital of 1st choice for patients.

Prof Raj Nambiar MEMBER, AHS, 2011 – PRESENT

I am inspired by the team’s unrelenting pursuit of care and this ranges from innovation to enable affordable care to holistic research aimed at timely monitoring and management of leading indicators of diseases such as diabetes. My hope is that we are able to support the right investment into research to increase our understanding of and the management of diseases, to benefit our patients.

Mr Sam Kok Weng MEMBER, AHF, 2019 – PRESENT

A Culture of Innovation and

Excellence Continuous improvement is at the heart of our unique identity, anchored in the early days of restructuring at AH. Over the years, it has crystallised into a formalised philosophy. At KTPH, continuous improvement initiatives drive our people to uphold quality standards and empower them to champion innovative ideas.

CHAPTER 3

INSPIRE

IMPROVEMENT IS THE O N LY CO N STA N T

he fundamentals of quality never change, according to A/Prof Wong Moh Sim, Deputy CMB, Clinical Quality & Manpower Development. “Some integral priorities include reducing falls, pressure injuries, medication errors and healthcareassociated infections such as MethicillinResistant-Staphylococcus Aureus (MRSA). As the patient population, technology, clinical standards and practices evolve, healthcare professionals need to keep themselves abreast of these developments.” THE IMPORTANCE OF A DATA-DRIVEN, SYSTEMATIC AND LOGICAL APPROACH Developing continuous improvement or kaizen strategies requires a two-pronged approach. The first is adopting new technology and using a data-driven approach. Second, and more challenging, is getting people to understand common objectives and streamline processes, thus making it easier to harness the right technology.

A/Prof Wong Moh Sim

A C U LT U R E O F I N N O V A T I O N AND EXCELLENCE

“Data helps us make informed decisions, allowing us to ensure that we are giving patients appropriate care,” said A/Prof Wong. She believes that success stems from having the commitment and engagement of a dedicated team. NO COMPROMISE ON QUALITY With years of experience as Director of Quality and Risk Management, Ms Cheong Choy Fong is a thought leader in merging quality patient care and patient safety. Staff need to be equipped with the skills to detect potential errors that could compromise patient safety and healthcare quality. As such, all of them are trained in Root Cause Analysis (RCA) and Failure Mode and Effects Analysis (FMEA). “Quality has been ingrained into our culture. It is done on the ground. Staff need to identify potential risk areas and collect data. With the data, we can measure infection rates, falls rates etc., then we can find ways to improve patient outcomes. We can shorten turnaround time and reduce appointment lead-time,” explained Ms Cheong. Building a kaizen culture requires a lot of perseverance as well as platforms to facilitate, engage and showcase outstanding initiatives. Such a culture shows that like-minded people coming together can achieve the common goal of ensuring good quality care for our patients.

Ms Cheong Choy Fong

GROWING EXCELLENCE

ASPIRE

AN INSPIRING CU LT U R E

successful kaizen initiative must first have a strong objective in mind, putting the patient at the centre, and a strong team leader who believes in its merits,” Ms Bong Ai Wei, kaizen leader, said. KTPH staff attend core workshops which include “7 Habits of Highly Effective People”, “Lean Quality Management”, and “6-Sigma”. “People are our most valuable assets and we should develop them to be good managers and leaders,” Ms Bong shared. Staff are also required to adhere to service standards care learnt from partners such as The Ritz Carlton. “The 20 Basics remind staff of the service standards we expect on the ground daily. Some of the basics are practices, habits and reminders; while some serve to inspire but not to instruct. This is critical in shaping the culture and service mindset of many of our staff today,” Ms Bong said.

on the ground and continually review results through multiple Plan-Do-Study-Act (PDSA) cycles. Results are transformed into policies, protocols, Standard Operating Procedures (SOPs) and Standard Work Instructions (SWIs) for future reference and sustenance. Kaizen initiatives are presented at weekly administrative meetings, where the decision for further improvement or implementation is made collectively. This common mindset of continuous improvement has inspired staff to try new methods to accomplish outstanding results in Better, Faster, Safer and Cheaper care for the patient. “It would be good for everyone to always be willing to try new things. We have to see that there are many roads that can lead us to achieve our end goal. It doesn’t have to be only one,” Ms Bong said.

Ms Bong Ai Wei

Ms Joanna Tang, kaizen leader, who runs the in-house Kaizen Facilitation workshops with Ms Bong, added, “Mandating core or compulsory training programmes ensures that all staff are equipped with the knowledge and skills to improve their work processes.” In their daily work, staff apply the principle of genchi genbutsu (real location, real thing). This validates solutions and smoothens processes, preventing kinks during the implementation of new projects. KTPH’s senior management are firm believers and practitioners of “walk the ground, see it for yourself”. A TPS principle known as hansei (self-reflection) enables staff to respond quickly to changes Ms Joanna Tang

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B E T T E R , FA ST E R , SAFER AND CHEAPER Kaizen spurs teams across all departments to practise design thinking skills, innovate and put in place initiatives contributing to a hassle-free experience for our patients. KTPH defines a hassle-free experience as “Doing things right for the patients and delivering value safely — from the time they enter, to the time they are discharged from the hospital.”

The Toyota Way creates a disciplined yet flexible method to approach zero defects, just in time, with no waste. Treating patients is not the same as manufacturing. Manufacturing can be done on a conveyor belt system where everything can be pre-planned. On the other hand, when dealing with patients, many interactions cannot be predicted. However, there are many principles that can still be applied to improve our productivity and efficiencies in a healthcare system. MRS CHEW KWEE TIAN G C HIEF E XE CUTIVE OFFICER Discussions contributing to continuous improvement

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CO N TI N U O US IM P R OVE M E N T I N I TI ATI V E S @ KTP H

SPOTLIGHT ON

SUPPLIES ON-THE-GO Realising that precious time was taken up shuttling to and from the supply room to patients’ bedsides, a team of nurses at Alexandra Hospital developed the Kaizen Trolley to eliminate the excess time. As one of the earliest kaizen projects, this trolley uses 5S (Sort, Set in Order, Shine, Standardise and Sustain) principles that maximise efficiency and utility, and acts as a “mini supply room”. This expediency in delivering patient care is crucial and could save a life in some situations.

Before: The old nursing trolley at AH

The trolley has been refined over time to adapt to the needs of patients and teams. For example, a shadow board was added so items could be returned or refilled easily. When the team moved to KTPH, the trolley’s role expanded to include items used for patient admission. Reducing Muda (Waste) in Nurses’ Workflow Kaizen Team: Nursing

After: A streamlined and more organised version

The team behind the updated Nursing Trolley kaizen

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REFER, FIND, GO In the supply room, staff may spend too much time searching for ward items. Members from Nursing and Materials Management Department (MMD) teamed up to rectify this problem, stocking and packing ward items according to a colour coding system that is based on the frequency of use. A simple directory reduces reliance on memory for both old and new staff. Nurses spend less time looking for items and have more capacity to focus on clinical care. Staff from MMD can also stock up on supplies faster after the reorganisation. Speeding Up Supply Room Searches Kaizen Team: Nursing and MMD

BUTTERFLIES ON BLANKETS & MINI-REFERENCES Replacing torn blankets is a necessary yet costly endeavour. Using embroidered butterflies to hide the small tears in blankets saves costs and cheers patients up at the same time. These embroidered blankets are currently used by patients in A&E and the Diabetes Clinic. The Patching Holes with Butterfly Motifs kaizen salvaged up to 30% of the torn blankets, and shows how staff can improve patientsâ&#x20AC;&#x2122; experience even without direct patient contact. Realising that older team members or those who have just joined often had trouble differentiating and sorting hospital garments, mini samples of each type of garment were made for easy reference. This Training with Tiny Uniforms kaizen orientates new staff to the different functional roles attached to the uniforms. Over the years, both have remained well-loved kaizens. Saving Costs & Improving Productivity Kaizen Team: Environmental Services

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MANY PATIENTS, ONE BOARD Having oversight of patients’ vital information may be difficult when there is a high volume of patients involved. This is simplified with the help of “Andon boards”, a Japanese term in Lean manufacturing for a dashboard device that simplifies visual management of a production line. Our Andon systems dashboards are mounted strategically on walls in the wards or departments to give healthcare staff an overview of each patient’s vital information. Many kaizen projects have harnessed the efficiency of Andon boards. Here are a few examples.

A. Nursing Andon Boards for Better Workflow Rolled out in 2012, the Nursing Andon Board pulls data from various systems and displays quick real-time views of patients’ medication, investigation orders and results, improving nurses’ awareness of patients’ key needs. The latest enhancements update nurses on the status of discharge medications. This has improved staff communication and productivity, enabling them to deliver timely care to patients. Streamlining Information for Effective Care Delivery Kaizen Team: DDR, iHIS, Laboratory, Medical Informatics, Nursing, Nursing Informatics, Pharmacy

B. Patient Information at a Glance At YCH, Patient Information Boards (PIB) are placed at the head of each bed and display selected information about the patient. This keeps staff informed of important care information (e.g. drug allergy and falls precaution) and improves communication with patients. Streamlining Information for Effective Care Delivery Kaizen Team: Nursing, N&D, MMD, Innovation

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ONE DROP AT A TIME In line with our efforts to support environmental sustainability, considerable efforts were made to reduce water consumption, with methods including using recycled water for first floor wash and ensuring 50% dishwasher load before washing. These yielded a reduced water consumption by 50% from 2015 to 2018 and total average savings of $32,872. Promoting Water Conservation in Food Services Kaizen Team: Food Services, Facilities Management, Clean Solutions Pte Ltd

YCH and KTPH are part of an ecosystem, and I hope to see our collaboration reach greater heights. Aside from timely transfers and a hassle-free experience, I would like people staying in the north to see us

TIMELY TRANSFERS Seamless transition of care is essential to ensure faster and smoother recovery for patients. Using the Plan-Do-Study-Act (PDSA) method, a simplified one-page referral form and a fast track workflow with defined criteria was implemented for patients with total knee replacement and stroke. This initiative shortens turnaround time by 53% on average, leads to productivity savings of 1,647 patient days a year, and provides a seamless patient flow, resulting in a hassle-free experience for patients. Expediting Referrals from KTPH to YCH Kaizen Team: Inpatient Services, Operations, CMB Office, Medical Services, Nursing Administration, Referral and Admission Unit, Patient Service Centre

as a hospital that truly cares, a hospital with a soul, one that they would be proud to refer their loved ones to, knowing that our hospital has their interest at heart. Working closely as a family, we can achieve those goals. D R L E E KO K K E N G M E D I C A L D I RE CTO R, YC H

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We work closely with our nursing and podiatry colleagues to provide comprehensive medical

care to patients with endocrine

RESTORE TODAY, HEAL TOMORROW To free up beds and improve patient outcomes in the intensive care units, early optimal mobilisation was introduced in the Surgical Intensive Care Unit (SICU), reducing length of stay in the ICU by an average of 0.7 days. It has now been implemented in the Medical Intensive Care Unit (MICU) and Coronary Care Unit (CCU). Early ICU rehabilitation has proven to be safe and welltolerated. It improves patients’ functional status and quality of life. Early Rehabilitation For Faster Recovery Kaizen Team: CCU, MICU, Rehabilitation Services, SICU

Ms Chelsea Law, Senior Principal Podiatrist

disorders. This is evident in Clinic D38 where our outpatient services are augmented by these collaborations and are therefore able to cater to our patients’ healthcare needs. D R P H UA E N G J O O S E N I O R CO N S ULTA N T, E N D O C RI N O LO G Y

ASSESSMENT ON THE SPOT Delayed access to care for patients with foot conditions increases the risk of amputations and unnecessary admission, which may be costly for both patients and the hospital. Oncall podiatry services were thus introduced in the A&E to allow patients with foot conditions to be immediately assessed for admission or treatment. It led to reducing unnecessary admission and freeing up 32 bed days, thereby saving $20,800. The service also reduced waiting time from 12 weeks to 1 day for 36 patients. “In podiatry, our patients come first. We strive to provide better care to patients via improved access to surgical care, co-ordination between departments caring for the patients, and also better discharge planning and management,” said Ms Chelsea Law, Senior Principal Podiatrist. Reducing Potential Admissions and Ensuring Faster Access to Podiatry Care Kaizen Team: Podiatry, Acute & Emergency Care Centre

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BILLING RIGHT To maximise accuracy in the process of bill charging for patients, an e-referral and charging process was implemented for all disciplines in January 2018 to streamline processes and minimise charging errors. The project led to an 86% reduction in blue letter referrals. It helped to avoid dropped charges amounting to $144,000 per year and achieved time savings of 1,983 hours on blue letter charging per year. This initiative ensures that patients receive accurate hospital bills and get an earlier appointment to see the specialist. Electronic Blue Letter Referral Charging in Inpatient Wards Kaizen Team: Patient Service Centre, Office of Clinical Informatics, Inpatient wards

MANAGING MEDICATION The written prescription process can lead to errors or take up precious clinical care time. Paperless prescribing makes obtaining a prescription hassle-free and efficient for nurses and reduces the phone calls for interventions from the pharmacy. The project enhanced productivity, optimised resource utilisation and reduced administrative costs. It also led to a faster turnaround time and better and safer medication compliance and efficiency for patients. Improving Efficiency With E-Prescriptions Kaizen Team: Ageing-In-Place Community Care Team (AIP-CCT), Pharmacy

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CLINICAL CON T IN U OUS IM PR OVE ME N T I N I T I AT I V E S

Our dedication to continuous improvement encompasses clinical quality as well. Clinical improvement projects at KTPH have innovatively refreshed work processes to bring our services to higher standards of excellence for the benefit of the community we serve.

INSULIN ON TIME â&#x20AC;&#x201D; SYNCING INSULIN DELIVERY TO REDUCE HYPOGLYCAEMIA To better manage the blood sugar levels of patients with diabetes, Dr Ester Yeoh formed a multi-disciplinary team together with Singapore Healthcare Improvement Network (SHINe) Medication Safety Workgroup and Clinical Services. The team aims to achieve a 30% reduction in hypoglycaemia among inpatients, particularly in preventable cases. Together with our Food Services department, the team developed a coding system and delivery process to match meal times with insulin administration. Food trays of patients on insulin were clearly labelled to prioritise their delivery, while assessment of a patientâ&#x20AC;&#x2122;s food intake was also improved to better adjust diabetes medications. Since the implementation of the programme, the team has achieved a 21% reduction of hypoglycaemia events in Renal Wards and a 27% reduction of hypoglycaemia events in all Pilot and Spread Wards. Project Team: General Medicine, Nursing, Pharmacy, Clinical Services, Diabetes Centre

Certain diabetes medications must be given close to meal times, and if food delivery or medication rounds are delayed or out of sync, it can increase the risk of a hypoglycaemia event. D R E ST E R Y E O H S E N I O R CO N S ULTA N T, D I A B E T E S C E N T RE , A D M C

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REDUCING RISKS & COORDINATING CARE — HASSLE-FREE INTEGRATED CARE FOR EMERGENCY LAPAROTOMY (ELAP) For patients with acute abdominal catastrophic conditions such as bowel obstruction and perforation, ELAP poses a significantly higher risk of mortality and post-surgical complications. With transdisciplinary collaboration, KTPH redesigned and introduced an integrated emergency laparotomy pathway in 2019, which has led to better patient preoperative assessment, increased specialist presence in surgery and holistic geriatric management in the general ward. The ELAP team strives to improve the quality of care for patients through value-driven tools such as the Optimal Care Index (OCI) and constant transformation of clinical practice. Project Team: General Surgery, Anaesthesia, Geriatric Medicine, Acute and Emergency Care, Operations Administration

PATIENT SAFETY GOES DIGITAL — SINGAPORE’S FIRST ELECTRONIC BLOOD TRANSFUSION PROCESS To improve the accuracy and efficiency of the blood transfusion process, the Laboratory Medicine department, in collaboration with the Office of Clinical Informatics, implemented an electronic process for the collection of Type and Screen specimens. This improvement makes the entire blood transfusion process, from collection to transfusion, entirely electronic. This includes bi-directional communication between the Blood Bank Information System and the Electronic Medical Record System, and is a first in Singapore. The fully electronic system improves patient safety by ensuring the blood product is issued to the same patient that the type and screen sample was collected from, thanks to electronic patient identification. Additionally, the system allows for better data collection that can be used to improve blood utilisation, reduce wastage, and improve efficiencies. Project Team: Medical Informatics, Nursing Informatics, (Office of Clinical Informatics) iHIS, Laboratory Medicine

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OPTHALMOLOGY AND VISUAL SCIENCES (OVS) — SEAMLESS CARE ACROSS THE LINE One Pack Wonder (OPW) is a collaborative project involving Ophthalmology and Visual Sciences (OVS), Specialist Outpatient Clinic (SOC), Operations (Ops) and MMD to reduce costs associated with packing materials for the intravitreal (IVT) injection day surgery procedure. The project aims to:

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Save costs by $58,560 annually

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Save man-hours by 249 hours

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We find that by actively seeing things from the patient’s perspective, we are able to serve them better. DR SANDEEP UPPAL HEAD OF DEPARTMENT AND SENIOR CONSULTANT, ENT

Save time during preparations, allowing 260 more IVT cases to be added in a year

“It is important to maintain quality, improvement and the advancement in level of care — not only to provide the best care for patients, but also to be better, faster and more costefficient,” explained A/Prof Yip Chee Chew, Head of Department and Senior Consultant of OVS. Both medical education and patient care are important aspects in raising healthcare standards, with self-regulated learning to ensure everyone works at the top of their licence. Project Team: OVS, MMD, Operations

EXPEDITING GERIATRIC TREATMENT — FROM ADMISSION TO REFERRAL WITHIN A DAY Geriatric patients usually attend multiple appointments at KTPH, which inconveniences them and their caregivers. Having poor mobility also makes these trips challenging. These called for hassle-free same-day direct access to ENT services. A patient seen by the Geriatric team will be referred to the ENT doctor on the same day — a special arrangement secured by the counter Patient Service Associate. The ENT team then ensures that the patient is assessed promptly, without the usual delays of a standard ‘walk-in’ on the same day. This resulted in a reduction of multiple trips to the hospital and lead-time to secure another appointment, which was lauded by patients and family members who were able to save on transport, time and cost for making multiple trips. Project Team: Geriatric Medicine, ENT, Nursing, Operations

Minister for Home Affairs and Minister for Law, Mr K. Shanmugam, at an eye-screening

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INSTRUMENTS OF O R C H E S T R AT I N G C A R E THE YISHUN HEALTH HOUSE Inspired by the “house” of the Toyota Production System (TPS), the YH House is built upon a strong and stable foundation of basic thinking. At its Heart is our people, who dedicate themselves to achieving our goals. Flanking our Heart are two main Pillars which support our overarching goals and aspirations placed at the top of the house.

N ECC U NI O F I ED A RAERMEO P D ELA L (N UCM) BETTER, FASTER, SAFER & CHEAPER

INNOVATION

JIDOKA (自動化) 5

Stop To Fix The Problem

Make Problems Visible/Visual Management

現地現物

(Genchi Genbutsu)

- Automatic Stop - Andon Board - 5S - Error Proofing - Balanced SC

反省

(Hansei)

MUDA

People And Teamwork

Scientific Methods

- Root Cause Analysis - Ask 5 Whys - Use PDCA - CPIP - 6 Sigma - Design Thinking - SOSI

Level the Work Schedule/Workload

Simplified & Standardised Processes

Continuous Process Flow & Eliminate Waste

Philosophy, Service Ways & 20 Basics Building Blocks Of Safer Care

Yishun Health House

Foundation The house stands on the building blocks of safer care, rooted in our service, care and 20 Basics philosophies. Continuous improvement initiatives are also embedded in our foundation to help us reduce all manner of wastes — Muda, commonly known as the seven wastes and are non-value adding processes or action; Mura, seen as an unevenness or a lack of stability and flow, thus driving the creation of Muda; and Muri, simply defined as an overburden, expecting

too much, with defining process or not having the correct skills or tools. Eliminating each type of waste is seen as part of a business improvement initiative. Our foundation lies at all stages of our work, allowing us to simplify and standardise processes to produce a paced and level daily workload. The Heart Our people adhere to the principles of L.O.V.E. and Hansei in our daily work. L — Listen; O — Offer help;

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G — Give Value; and E — Engage Patients. Hansei, self-reflection or mindfulness, guides our thoughts and actions in achieving our mission to provide good quality, affordable and hassle-free healthcare with science, love and wisdom. Genchi Genbutsu or going on the ground and observing for oneself, and Hansei are characteristics that we inculcate in our people. Both, when combined with wisdom, create a mindset that empower our people to make well-informed decisions, including those of a clinical nature in patient care, from Living Well to Leaving Well. Autonomation The Jidoka pillar stands for autonomation — automation with human touch or human intelligence — which is how we design, execute and improve work processes without wasting resources. We facilitate management through the use of Andon boards, where data is presented in a visible and accessible manner, enabling us to stop to fix problems as they arise in order to achieve quality from the start. Reducing all three kinds of wastes, autonomation improves productivity and enables us to create the best value in our care provision. Human intelligence and intervention is an essential component of autonomation. Science Everything we do and improve on must be based on science. The second pillar flanking our Heart holds core competencies we want our staff to develop. The core training modules — including Root Cause Analysis, Six Sigma, Plan-Do-Check-Act (PDCA) methodology and Design Thinking — arm our people with science and data, equipping them to make informed decisions on areas for improvement. The Top of the House The roof of our house — representing our ultimate objective — holds the UCM, which is the framework we use to implement quality healthcare at the best value for our patients.

Our people lie at the heart of the Hassle-Free house — nurses at a planning session.

PATIENT VALUE COMPASS & STEPS OF SYSTEMATIC IMPROVEMENT In 2017, a Care Integration Group (CIG) was formed and led by A/Prof Terence Tang and Dr Ng Yeuk Fan to jump-start value-driven care efforts through care integration. Building upon the hospital’s focus on Hassle-Free, 5S and the TPS, the team sought to embed continuous improvement deeper into clinical care and at a more connected systems level. The CIG team created new value-based care methodologies such as the Patient Value Compass (PVC), OCI as well as the Clinical Logic Model (CLM). These data-driven, value-based care methodologies enable care teams to measure and trend the “value” that patients receive from us, enabling continuous improvement efforts to be directed to where it matters most, i.e. outcomes that are valued by residents and patients.

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The PVC and OCI also allow the quantification of health system value creation, through the aggregation of PVC scores across care units, or “clinical microsystems”. The CLM guides a care team to articulate their care strategies needed to achieve value-based outcomes, and thereafter envision the processes needed to achieve this. The resources needed to execute those processes are then used to quantify the organisation’s cost to deliver on outcomes and are used to calculate the value delivered by the organisation.

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Functional Outcome Physical Functioning Perceived Well-Being Mental Health Social Role

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W SE

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Experience Outcome Quality of Healthcare Delivery ■ Perception of Health Benefits Received ■ Delights/ Disappointments ■

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N Clinical Outcome Mortality Morbidity Complications Signs & Symptoms Side Effects

S Costs-to-Patient Outcome Direct Costs ■ Indirect Costs ■

CLM and PVC enable staff to better understand how their unit inputs, processes and outputs lead to patient value creation. This eliminates redundant tasks and reallocates manpower, thereby optimising care across the entire treatment cycle. Steps of Systematic Improvement (SOSI) is an improvement method developed in-house that brings together a suite of improvement science tools to enable clinical teams to achieve breakthrough performance using a four-step process. The four steps are:

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STEP 1 — PURPOSE : Articulate the care team’s concept of service using a CLM STEP 2 — MEASUREMENT: Develop and measure PVC outcomes using Value-Driven Care Dashboards STEP 3 — ACCOUNTABILITY: Facilitate the formation of strong teams around the task of creating patient value STEP 4 — SYSTEMATIC IMPROVEMENTS: Conduct systematic improvements using targeted kaizen activities and improvement tools

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SOSI M E T H ODOLO G Y

SYSTEMATIC IMPROVEMENT

ACCOUNTABILITY

MEASUREMENT

PURPOSE

This allows management to visualise value measurement and full system performance across all care units. Many value-improvement initiatives have been implemented successfully at KTPH. These include the Hip Fracture Service, Lean Care Path for Cataract Surgery and Total Knee Replacement Service (see Chapter 4).

KTPH has adopted NHGâ&#x20AC;&#x2122;s Clinical Practice Improvement Programme (CPIP), designed to develop clinical leadership within multi-disciplinary healthcare teams to deliver evidence-based care.

SOM E SUCC E SSF U L C PIP IN IT I AT I V E S AT KT P H : 1 REDUCTION OF UNWARRANTED BLOOD GLUCOSE MONITORING Problem Excessive blood glucose monitoring (BGM) can lead to wastage of supplies, time and money, and increased discomfort for patients. The BGM CPIP team at YCH found that there were no local or international guidelines providing information on the recommended frequency of blood glucose monitoring for patients with Type 2 Diabetes in community hospitals. Solution The team aimed to reduce BGM by 30% within six months without compromising patient safety at two selected wards. They created an algorithm to guide and standardise BGM, collected results

weekly and educated nursing and medical teams on the updated practices. The project achieved a total cost savings of over $19,500 and time savings of over 1,500 man-hours per year. Patients also reported increased satisfaction with less finger pricks and less pain. These strategies were later spread to all YCH wards. Team Members: Dr Guo Weixiao, Resident Physician, Medical Services, YCH Dr Lin Lin Myint Kyaing, Resident Physician, Medical Services, YCH Dr Aye Khine Thwin, Staff Physician, Medical Services, YCH Ms Florence Chng, Clinical Standards and Improvement, Office of Clinical Governance, YH Ms Chua Chiou Hann, Nurse Manager, Ward D58, YCH Ms Koi Poh Leng, Nurse Manager, Ward D57, YCH Ms Lim Wen Ti, Staff Nurse, Ward D58 Ms Siow Jia Yee, Senior Staff Nurse, Ward D57

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2 MEDICAL-DEVICE RELATED PRESSURE INJURY (MDRPI) Problem Up to one-third of all pressure injuries are device-related, and the most common site for MDRPI occurrence is around the ears. Pressure injuries are associated with increased morbidity, mortality, length of hospitalisation and healthcare costs. There is also a lack of evidence-based practice guidelines on MDRPIs available. Armed with this information, the multidisciplinary MDRPI CPIP took steps to curb this problem. Solution The team aimed to reduce the incidence of newly developed pressure injuries from the use

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of oxygen masks in four pilot wards from 100% to 0% within 12 months. After implementing strategies such as establishing an Oxygen Mask Pressure Injury Prevention Protocol and sourcing for padding materials to reduce MDRPIs, the team was able to achieve its target of 0% MDRPI in the pilot wards within eight months. The initiative was later extended to other wards in the hospital. Team Members: Dr Mansha Khemlani, Lead Consultant, Geriatric Medicine Ang Po Lian, Senior Staff Nurse, Stoma & Wound Care Sim Lai Kiow, Nurse Clinician, Palliative Care Hazeena Banu, Senior Staff Nurse, Palliative Care Ruth Chua, Registrar, Geriatric Medicine (currently Associate Consultant) Wishva Panagoda, Resident Physician, Geriatric Medicine

THE DRIVING FORCE KTPH’s healthcare leaders are driven by the success of their continual efforts in transforming patient care and outcomes. For Ms Cheong, her greatest reward and joy comes from seeing the positive impact her work has on the patients and the healthcare quality. “Every day when I come to work, I look at the incidents in the hospital. It makes me happy when I see a huge reduction in the percentage of incidents and adverse events,” she said.

What drives me is the ability to serve the people and provide better care for the patient. When you see improvement in the system, you see that staff are happy and patients are happy. That gives me great joy. A/PR OF PH OA LEE LA N DEP UTY CMB , CARE IN TEGRATION AN D CLIN ICAL STAN DA RD S

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Dr Christopher Willis demonstrates proper hand hygiene technique.

1 EMBRACING PAT I E N T SAFETY “Patient Safety should be the foundation of excellent care in Yishun Health. It is important for everyone to embrace patient safety as a priority,” said A/Prof Pek. “Patient safety stems from a culture of openness… All team members, as well as patients and caregivers, must be forthcoming in sharing information. We must create an environment where people feel psychologically safe to talk about problems and incidents. And we must all be willing to learn from incidents which could have been avoided,” said Dr Desmond Ooi, Consultant, General Surgery. There are four key areas in the field of patient safety: Infection Control, Fall Awareness, Pressure Injury Prevention and Medication Safety. “I always view Patient Safety as doing something small but making big changes,” says Dr Guo Weixiao, Senior Staff Physician, Medical Services, YCH. Patient Safety initiatives in the four key areas are hence critical in reducing harm and safeguarding patients’ overall wellbeing.

INFECTION CONTROL Infection control covers a vast spectrum of hospital activities throughout the healthcare system. Dr Christopher Willis, Senior Consultant, General Medicine, explained, “The field of infection control is very broad. It covers everything to do with preventing, managing and responding to the spread of infectious disease.” Together with his team, Dr Willis monitors in-hospital infection rates, establishes infection control protocols and ensures that all staff are trained on infection control practices. This training includes mandatory mask fitting and proper usage of personal protective equipment (PPE). Dr Willis and his team did a study on the effect of a disinfectant called chlorhexidine (CHG) on the spread of Methicillin-Resistant Staphylococcus Aureus (MRSA) for inpatients. Patients identified to be MRSA-carriers were bathed daily with chlorhexidine. After analysing the data collected over three years, the study revealed that chlorhexidine baths are very effective in infection prevention.Consequently, all patients with a length of stay of seven days or more were recommended to have a daily CHG bath while getting tested for MRSA. Once they tested negative, patients stopped receiving CHG baths to prevent CHG-resistant organisms from forming. The study was the largest of its kind and was published in the International Journal of Infection Control in 2015. Despite the increasing patient load over the past 10 years leading to an increase in risk of inhospital infections, the team led by Dr Willis has been successful in keeping infection rates low while patients are hospitalised.

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FALLS AWARENESS Diagnosing and treating a patient after a fall requires collaborative effort from different departments. The Mobility and Balance Clinic in KTPH which sees mainly elderly patients offers a comprehensive service in assessing the different factors that contribute to a fall. Dr Jagadish Mallya, Senior Consultant, Geriatric Medicine, works with a team that comprises a nurse, a pharmacist, physiotherapist, and sometimes a podiatrist to prescribe targeted interventions for patients. Dr Mallya is a strong believer of “prevention is better than cure” and advocates raising awareness about fall prevention. He explained, “Falls prevention is about educating the public and what they can do to keep themselves active, healthy and independent.” KTPH also provides a Home Assessment Service to help fall-proof one’s home.

PRESSURE INJURY PREVENTION The Pressure Injury Workgroup, which comprises doctors, nurses, physiotherapists, occupational therapists, podiatrists, dietitians, and respiratory therapists was formed in May 2016. The workgroup aims to raise the level of skill and awareness of pressure injury. Dr Khemlani Mansha Hari, Senior Consultant, Geriatric Medicine and a specialist in palliative care, said, “We also look at various literature to standardise guidelines and update protocols according to the evidence.” To train clinical staff and equip caregivers with the skills in prevention and management of pressure injury, the workgroup organised the “STOP Pressure Injury” event held on 29 November 2018. Dr Mansha elaborated, “Historically, pressure injury prevention and management come under nursing. However, the practice of medicine has evolved to team-based care.”

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Dr Jagadish Mallya

MEDICATION SAFETY A Medication Safety Workgroup was formed to ensure safe and efficacious prescription of medications for patients. The workgroup investigates medication errors and near misses reported in the hospital’s electronic hospital occurrence report (eHOR) using a Ruler for Medication Safety. This framework supports a culture of trust while addressing errors and their root causes holistically. Changes are then implemented in systems and processes to prevent a recurrence. Over the last few years, the workgroup has evolved from nurturing an open and transparent culture of trust and addressing inappropriate polypharmacy, to updating drug prescription protocols for better patient outcomes through drug optimisation. “Patient safety is an ongoing process and we need to consistently strive to eliminate preventable harm to our patients,” Dr Liaw Chen Mei, Consultant, Anaesthesia, reiterates. “Beyond that, it should also be the responsibility of all healthcare workers, where everybody works together as a team to improve patient safety outcomes.”

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Hospital-based initiatives aside, KTPH also recognises the need for public education and raising awareness on self-care. In line with KTPH’s motto of providing patient-centred care, a number of safety and reliability initiatives were rolled out in recent years. PATIENT SAFETY MONTH On 1 July 2019, YH launched its inaugural Patient Safety Month to raise public awareness in four areas: pressure injuries, infection control, falls prevention, and medication safety. The campaign also served to reinforce the importance of SAFE care: ■

■ ■

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Strive to uphold the highest standards in patient care Advocate for patient safety Fully support clinical quality projects that provide quality healthcare Educate patients, caregivers and staff on ways to protect patients from harm

behaviour in confidence and track department safety records. This accountability framework allows a respectful and collegial approach in managing disruptive or unprofessional behaviours. Dr Loh Seow Siang, Senior Consultant, Acute and Emergency Care, hopes that these initiatives will achieve the following outcomes: 1 Develop a just culture — where speaking up for safety without fear of repercussion becomes a habit 2 Decrease preventable adverse events — having open communication and constructive feedback about errors. Staff understand the importance of reporting incidents 3 Staff are happy to work in a safe, supportive environment where they perceive management to be fair and non-punitive

The inaugural Patient Safety Month 2019 exhibition at the KTPH lobby.

IF YOU SEE SOMETHING, SAY SOMETHING “See something, say something” — this adage, coined by then-CMB A/Prof Kenneth Mak, is the foundation for our Speak Up for Safety (SUFS) programme today. Introduced in February 2017, SUFS aims to promote a culture of patient safety and professional accountability. The programme trains and empowers staff to raise patient safety concerns with colleagues using the C.O.D.E. (Check, Options, Demands, Elevate) approach. The Promote Professional Accountability (PPA) Online Reporting Tool was launched on 1 September 2018 to provide a safe and secure avenue for staff to report positive or negative staff

Survey feedback showed that staff recognised the need to speak up and felt more confident giving feedback on behaviour that compromises patient safety. A/Prof Koh Kwong Fah, Senior Consultant, Anaesthesia, affirmed, “SUFS equips us with a tool to voice our concerns when there is a possible patient safety issue. Everyone is a ‘checker’, ‘looking out for one another’ and a ‘patient advocate’.” Every three years, public healthcare institutions in Singapore undergo a Patient Safety Culture Survey. Since 2005, AH has also been a participant. This tradition continues in KTPH. “The results of the survey indicate the progress we have made over the years. It also demonstrates whether staff feel that they are part of this movement. I’m proud that our last survey showed that we have a proactive Patient Safety Culture,” A/Prof Wong concluded. Many departments contribute to our Patient Safety Culture in their own unique ways. At the heart of this culture are the people who go the extra mile to serve patients as they would a loved one.

Care Integration In the Hospital and Beyond We aim to transcend episodic care, moving upstream to help delay the onset of illness by encouraging and embracing wellness. Our starting point is the community itself. For those who are well, we will support them to stay healthy and active. For those who are unwell, we will help them get back on their feet and stay well.

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I N T E G R AT E D C A R E — H O L I ST I C , S USTA I N A B L E A N D PAT I E N T- C E N T R I C

ight from the start in our AH days, we have striven towards creating a community-centric hospital. Health and sickness are a part of life; we need to reduce the fears, create public awareness and acceptance,” shared Prof Pang, reminiscing on the first years of building a holistic healthcare approach. YH’s league of respected thought leaders, which includes Prof Pang and A/Prof Sum, among others, were part of the pioneer team that restructured AH and gave it newfound respect with the excellent care they provided in their respective niches. A/Prof Sum is Head of Department and Senior Consultant of the Diabetes Clinic. His name is synonymous with diabetes management and research in Singapore. The multi-disciplinary Diabetes Centre he set up in AH attracted healthcare professionals who shared his vision of holistic patient care.

“Back in 2001, I was in private practice, but joined AHS because I knew that the restructuring would give me an opportunity to do something I had always wanted to do — start one of the first few one-stop diabetes clinics in Singapore. I’m particularly proud of our integrated healthcare team: our nurses, podiatrists, dietitians and other allied health colleagues play just as important a role as our doctors. Working together, we are better able to care for our patients,” said A/Prof Sum. During the last decade, the world has seen different models and approaches to integrated care being widely applied and documented across a variety of settings. At YH, our own UCM presents a comprehensive strategy for our care teams to identify common care goals for patients and to prioritise and streamline interventions. Integrated care straddles the spectrum — from the acute hospital and the community hospital, to empowering the community to stay healthy. “We want to build community health by helping people to see their own potential in helping themselves stay healthy. The community — its GPs, community nurses, families and social networks — is a rich resource in and of itself. This seamless flow from the community to the hospital and back to the community should be one of the key characteristics of this new care model. Our healthcare resources should follow the patient so that, no matter where they go in the healthcare system, they will receive the support that is right for them,” said Dr Wong Sweet Fun, Chief Transformation Officer, Deputy CMB, Population Health, and Clinical Director, PHCT. Prof Pang Weng Sun (left) and A/Prof Sum Chee Fang (right)

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ASPIRE

A SUCCESSFUL CRISIS & COMPLEX CARE PLAN

A/Prof Tan Kok Yang

are integration to enable better crisis and complex episodic care is about building a culture where, regardless of where the patient is sited within the campus, our doctors readily cross boundaries to provide consult so that patients receive timely medical care,” A/Prof Phoa Lee Lan explained. She stressed that to achieve true care, teams must be energised by empathy, and driven by our passion for healthcare to achieve safe, reliable and quality care for our patients. “YH’s UCM allows every single healthcare worker who is looking after the same patient to see the patient’s entire journey,” shared A/Prof Pek. Should any resident living in the Yishun zone suffer from a healthcare crisis or require complex care, the hospital needs to ensure that the crisis and complex care plan is aligned with the needs of the residents’ lifelong care plan. This improvement entails more than the re-organisation of hospital processes and operations. “We need to ensure that our doctors have the right capabilities and aptitude to cross the boundaries of traditionally siloed care.” Going beyond the medical, doctors must also build care plans around the patient’s emotional, psychological, social and functional needs. “The idea of care integration may seem very process-driven, but it is a mindset issue. We simply need to think of delivering care to patients as if we were doing so for a beloved family member,” said Dr Lee Kok Keng, Medical Director, YCH. A successful crisis and complex care plan requires the care team to build high-performing and trans-disciplinary working relationships bringing together medical, nursing, allied

A/Prof Phoa Lee Lan

Dr Lee Kok Keng

health, ancillary services professionals and community partners to form a tightly knit partnership with the patient. “To build a strong enabling culture for care integration, effective communication is at the crux of collaboration between different clinical departments across YH,” said A/Prof Tan Kok Yang, Deputy CMB, Service Development, Head of Department and Senior Consultant, General Surgery. “Multidisciplinary care must evolve towards transdisciplinary care. This approach moves away from episodic ad-hoc care, enhances the communication and collaboration between every medical professional, and builds a greater sense of ownership of every patient,” A/Prof Tan said. As KTPH moves into the future, A/Prof Tan hopes we will continue to deliver care that is good enough for our loved ones, and nurture a group of healthcare workers who are more willing to give than to take. He firmly believes that when we practise the following — love yourself, speak yourself, love others, speak with a meaning and purpose — we will be able to work more efficiently towards what really matters in the hearts of our patients.

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To improve patient experience and achieve greater efficiency and value, our teams have redesigned clinical care to address fragmentation in patient services over the years. We work continuously towards enabling better coordinated and seamless care, in particular for our ageing population managing chronic conditions. At the heart of our efforts is the goal to ensure our communityâ&#x20AC;&#x2122;s well-being and improve their quality of life.

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SPEEDY TRAUMA CARE To better serve patients, the General Surgery department and Emergency Department (ED) at KTPH developed the Critical Haemorrhage to Operation Room Patient (CHOP) Protocol in 2018. CHOP targeted critically injured trauma patients or those with potentially severe bleeding, who make up a third of the A&E’s inpatients. At-risk patients are identified early, trauma surgeons are speedily activated, and resuscitative measures such as blood transfusions are initiated early. Within a year of its implementation, definitive care has been initiated with an average time of 73 minutes, achieving an overall mortality rate of 1.8%, one of the lowest among Singapore’s acute hospitals. FASTER SURGICAL TREATMENT WITH ESAT The Emergency Surgery and Trauma (ESAT) Service, established in 2014, is Singapore’s first dedicated acute surgical unit. Instead of being tended to by surgeons who are on call, patients receive care from the ESAT’s consultant-led emergency team. ESAT doctors on call focus on either an elective caseload or emergency and trauma cases, allowing faster surgical review and treatment for emergency patients, performed with direct senior supervision. As of 2018, the implementation of ESAT has significantly improved patient outcomes, including shortened hospital stays (from 4.7 days to 3.4 days) and ICU stays (from 8.6 to 4.9 days).

The ESAT allows KTPH’s Emergency Department to dedicate manpower more effectively to provide prompt and timely care. A / P R O F TA N KO K YA N G H E A D O F D E PA RT M E N T A N D S E N I O R CO N S ULTA N T G E N E RA L S URG E RY

This patient-centric innovation allows a subset of fitter, more independent patients to benefit from acute medical care without the need for hospital admission. This aligns with Yishun Healthâ&#x20AC;&#x2122;s drive to strive for valued care and design services around patient needs. D R TH O F IQ UE ADAMJ EE CO NSULTANT GENE RAL ME DICINE

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EXPEDITED MEDICAL TREATMENT AT THE A&E The Acute Medical Unit (AMU) developed the Ambulatory Emergency Care (AEC) service to care for patients who have an acute medical condition and choose not to be admitted. Acutely unwell patients are provided expedited medical assessment, investigations and treatment over eight or more hours, but are not required to be warded. They may also return the day after for review and further treatment as necessary. Over a five-month period, the implementation of the AEC avoided 128 admissions, while saving an average of $419 from subsidised patientsâ&#x20AC;&#x2122; hospital bills. INTEGRATING CARDIAC CARE WITH PRIMARY CARE Beyond hospital-based clinical improvements, the Cardiology department works closely with NHGP (Woodlands and Yishun Polyclinics) and a growing network of GPs. This has improved the right-siting of our patients, and improvements in clinical outcomes, appropriateness of care, and affordability. Among the various services that the SOC team (pictured below) supports include the Chest Pain Clinic. The team reserves slots for non-invasive stress tests for these patients, allowing a rapid turnaround.

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Individualised Cardiology Care The Chest Pain Clinic, an integrated effort involving the Cardiology department, Cardiovascular Centre (CVC), Cardiology SOC, and ED, risk-stratifies patients with chest pain so that they receive care based on their individual risk profile. The consultant-led Clinic admits low-risk patients twice a week, allowing the ED to swiftly discharge them with prompt follow-ups. This service sees 20 to 30 patients per month, and has reduced waiting times from the ED to Cardiology appointment by 14 days. Improving Outcomes with the Heart Failure Unit The Integrated Transdisciplinary Heart Failure (HF) Unit comprises cardiologists, case managers, Advanced Practice Nurses, cardiac pharmacists, allied health professionals and operation administration. The HF Unit aims to reduce readmissions and improve clinical and functional outcomes of patients upon discharge; and provide high quality cardiac care at an affordable cost. Enhanced approaches to care delivery have resulted in consistently reduced readmission

and inpatient mortality rates from 2017 to 2019, as well as high numbers of early medication initiation and review. TRANSDISCIPLINARY CARE FOR RECONSTRUCTIVE PROCEDURES The KTPH Plastic and Reconstructive Surgery Service epitomises transdisciplinary team-based care. Close collaboration with various specialties within YH is a norm for the team, enabling surgeons to tackle more challenging and complex cases with reconstruction as an available option. Our reconstructive procedures have allowed our patients to achieve: ■

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Salvage of limbs that were otherwise destined for amputation Surgical clearance of cancers and infections that were not possible without reconstruction Restoration of patients’ self-image and confidence Earlier wound healing of complex wounds, allowing earlier return to function Better scarring and cosmesis

IMPROVING OUTCOMES WITH PULMONARY REHABILITATION The newly established Inpatient Pulmonary Rehabilitation (PR) Programme in YCH is run by KTPH’s respiratory team, rehabilitation services team, dietitians and medical social workers. Targeting Chronic Obstructive Pulmonary Disease (COPD) patients, the PR programme aims to improve their dyspnoea symptoms, quality of life and exercise tolerance, as well as reduce hospital readmissions caused by acute exacerbation. Six patients have participated in the programme since its implementation, relaying improvements in mobility and self-management. Ultimately, PR aims to partner with our community team to extend PR to the community setting and allow patients to continue with exercise programmes in the community, engage patients who have benefited from PR to be ambassadors for the programmes, and start support groups for COPD patients. REDUCING RISKS FROM THE START The “Start-to-Finish” (STF) programme, an initiative under the Geriatric Surgery Service (GSS), was developed to reduce the risk of complications and improve elderly surgical patients’ functional outcomes. Suitable patients spend two weeks pre-surgery undergoing ‘prehabilitation’, learning strengthening exercises, and undergoing nutritional intervention and education. After discharge, patients continue rehabilitation either at the outpatient clinic or at home. HOLISTIC GERIATRIC CARE The ED set up the Acute Geriatric Assessment Unit (AGAU) in 2018 to address the unique care needs of geriatric patients and offer more holistic team-based geriatric care in an acute setting. Jointly operated by the hospital’s ED and Geriatric Emergency Medicine (GEM) department, the AGAU provides full multidisciplinary assessment and management for geriatric patients. Elderly patients

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The intensive preoperative optimisation by the geriatricians and careful intraoperative management by the anaesthetists allow for surgery to be carried out by the orthopaedic surgeons to restore function in the elderly. D R A LV I N TA N CO N S ULTA N T, O RT H O PA E D I C S URG E RY

are safely discharged from the ED, with appropriate referrals to and follow-ups at an Early Review Clinic, the geriatric SOC, AIP-CCT or community hospital. TRANSFORMING CATARACT SURGERY To enhance patient care experience, a transdisciplinary unit — comprising OVS, Anaesthesia, Day Surgery Centre, and Nursing — transformed the cataract surgery process. The team implemented process improvements which benefited around 1,800 patients, garnered an estimated total savings of approximately $577,880 and saved 1,345 man-hours per year. In 2018, Project REMOVE (Removal of Eye Medications for Value-add and Efficiency) was introduced to complement the Lean Cataract Surgery care path. It led to the omission of Prophylactic Pre-Operative Antibiotic (eye) Drop (PPAD), which is not crucial to reduce post-operative eye infection, three days prior to surgery. REMOVE helped to achieve a total of

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A/Prof Yip Chee Chew, Head of Department and Senior Consultant, OVS

1,982 Cataract Surgeries performed without PPAD within a year, a zero post-operative eye infection rate, $1684.70 in savings and 1,982 hours saved from December 2018 to December 2019.

Patients are holistically supported and empowered to achieve their goals by a care team comprising physicians and surgeons, psychologists, as well as allied health professionals such as dietitians, physiotherapists and medical social workers. Co-located in a single centre, the team members consult each other, assess cases, develop care plans, and optimise medications for seamless care coordination. Some patients may benefit from a non-surgical weight loss programme, while others may need weight loss surgery and major dietary changes. A psychologist is on hand to offer help on other important issues, such as anxiety, depression and low self-esteem. This pioneering initiative supports YHâ&#x20AC;&#x2122;s philosophy of moving beyond episodic treatment of specific diseases and organs to providing comprehensive, long-term care that equips patients with the skills and knowledge to be active participants in their own health. Using SOSI Methodology, the ICOD team was able to measure value delivered to patients, helping the team to drive continuous value enhancement for patients.

Using Lean Thinking, Innovation and the SOSI Methodology, the team was able to systematically identify opportunities to improve outcomes to patients and reduce cost-to-deliver care.

MANAGING DIABETES AND OBESITY A new transdisciplinary initiative was launched in June 2017 to tackle obesity and comprehensively manage risk factors such as diabetes. The Integrated Care for Obesity and Diabetes (ICOD) programme is a one-stop platform where weight loss surgery, medical weight management, and diabetes management are offered in conjunction with psychological care, nutrition recommendations, and physiotherapy.

Some members of the ICOD team

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PARTNERSHIPS TO IMPROVE DENTAL HEALTH The Dental Surgery team provides comprehensive and multidisciplinary dental care services for our patients. The team comprises a close-knit team of dental specialists, general dentists and support staff. In addition to community outreach programmes, the department also conducts ongoing oral health education and awareness efforts. In 2019, the department collaborated with the Central Sterile Supplies Uniy (CSSU), Facilities and iHIS, to implement DSORT, a major project undertaken to address the need for a system to record sterility of instruments, trace instruments and track their usage to the specific patient. Dr Sylvia Tay, left

We teamed up with the Diabetes Clinic and Department of Geriatric Medicine to care for their patientsâ&#x20AC;&#x2122; oral health. Strong evidence shows a two-way relationship between diabetes and periodontitis. Diabetes increases the risk of periodontitis and periodontal inflammation, negatively affecting glycaemic control. For the elderly, a common sequela of poor oral health is the risk of aspiration pneumonia. This is exacerbated by functional decline, feeding problems and dysphagia. D R SYLV IA TAY HEAD OF DE PARTME N T AN D S EN IOR CON S U LTAN T DENTAL SURG E RY

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EARLY DIAGNOSTIC SCANS The Department of Diagnostic Radiology (DDR) partners with other clinical disciplines to expedite early diagnostic and interventional procedures. The team conducts regular rounds to discuss complex cases and the approaches to handle these with the aim to create a hassle-free experience for patients and their families. In setting up the Fine Needle Aspiration & Cytology (FNAC) Clinic in 2017, waiting times for FNAC procedures were reduced from 4 weeks to 1-2 days leading to earlier definitive treatment plans and less anxiety for the patients. “Our collaborations with A&E on certain EDTU pathways such as Chest Pain pathway, Hip Contusion pathway, TIA pathway, etc have led to diagnostic scans being performed within 24 hours of the EDTU admission, allowing clinicians to either discharge the patients or admit with clear treatment plans, reducing the length of stay in the wards,” said Mr Michael Chin, Manager and Principal Radiographer, DDR. SUPPORTING A HEALTHY MIND In July 2018, the Psychological Medicine department collaborated with HCA Hospice Care to deliver mental health support for patients in HCA’s Home Hospice Care (HHC) programme. Staffed by a multidisciplinary healthcare team, the service provides round-the-clock medical, psychosocial and caregiver support island-wide, allowing patients with life-limiting illnesses to be cared for comfortably at home, with their loved ones. Recognising the growing mental health needs among Singaporean youths, the department also began a pilot collaboration with Republic Polytechnic (RP) in May 2019 to provide schoolbased mental health screening assessments. 75% of the students who opted to seek follow-up care at KTPH were seen by the same psychiatrist who had performed the initial assessment, enhancing the continuity of care. “Through a range of comprehensive services, close partnerships between departments, and agencies

linking patients seamlessly between community and restructured hospital, we strive to achieve a unified One Care Plan for all our patients. The foundation of an effective One Care Plan lies in constant engagement and communication within and beyond boundaries. The whole is greater than the sum of its parts when we work in synergy,” said Dr Clarence Goh, Head of Department and Senior Consultant, Psychological Medicine. AN ACTIVE LIFE FOR GOOD HEALTH The multidisciplinary Sports Medicine Centre encourages our community to remain active throughout all stages of life. In 2018, it expanded its acupuncture service beyond KTPH to AdMC — providing medical expertise from the east and west under one roof. Efforts are ongoing to include general sports medicine care so that active seniors in the north can receive care at Kampung Admiralty. In addition to its committed partnerships with Sport Singapore, WAKO Kickboxing Singapore, Powerlifting Singapore and Singapore Weightlifting Federation, the Centre also conducts informative courses and classes. General sports medicine care for active residents

Together with the Alexandra Academy of Clinical and Emergency Sonography, the Centre has directed courses for local sports physician specialist training. It also actively shares orthopaedics and Sports Medicine knowledge through platforms such as the 2018 Orthopaedic and Sports Medicine Masterclasses series and classes at the Lee Kong Chian School of Medicine in Nanyang Technological University.

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DAY REHABILITATION CENTRE (YCH) Some patients — such as those from community hospitals — may still require care after discharge. To support this group of patients, YCH launched its outpatient day rehabilitation centre in 2016. The holistic programme comprises physiotherapy and occupational therapy. Patients undergo detailed assessments and customised treatment programmes, aimed at maximising their mobility and functional independence. By providing the necessary care and follow-up for patients, healthcare flows back to the community as they continue to be supported in their journey to recovery. PATIENT CENTRICITY IN PHARMACY Always at the forefront of innovation, our Pharmacy department was the first in Singapore to establish medication reconciliation. In 2005, this initiative at AH, led by then-Chief Pharmacist and currently Director, Operations Administration, Ms Fatimah Moideen Kutty, saw our pharmacists reconciling new and previously prescribed medication, avoiding certain Ms Fatimah Moideen Kutty combinations and reducing overlapping 2019, is a service aiming to provide convenience for effects. It reduced wastage by preventing the the patients, enabling them to place medication unnecessary build-up of medication in patients’ orders via online platforms. The average turnaround homes, while also saving patients money. time is one to two working days. After the move to KTPH, the team led by thenIn February 2020, it collaborated with the Office of Head of Department Ms Doreen Su-Yin Tan, Clinical Informatics (OCI) to implement electronic initiated Project Cutterpillar, aiming to reduce prescription (e-Rx) of controlled drugs (CD), polypharmacy and pill burden by moderating the resolving the need for manual prescriptions. number of medications prescribed. This boosted The system can preserve the legal requirements medication adherence, and reduced the risk of of a CD prescription without reiteration, and negative events such as drug interactions. is protected from fraudulent prescriptions by a double authentication requirement upon In July 2019, it implemented Medibox — a fast, e-prescribing. convenient and simple way of collecting medication from the KTPH outpatient pharmacy. Users can INCREASED PALLIATIVE CARE SUPPORT place their medication orders through this service Since April 2018, the palliative care team has and collect them after one working day. Home expanded its services by opening more dedicated Delivery in Outpatient Pharmacy, established in

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acute palliative care beds and SOCs. To further palliative care support, a 16-bed sub-acute palliative unit in YCH was formed on 1 November 2018. This has benefited some 276 patients with interim care and provided them with slow-stream rehabilitation, symptom control, caregiver training, and a comfortable stay while they waited for inpatient hospice placement. The Palliative Service-CCT brought specialist-level palliative care into homes, maximising time and quality of life for patients who were diagnosed with advanced cancer, advanced organ failure, and advanced stages of clinical frailty. Building on this, the team partnered the Singapore Cancer Societyâ&#x20AC;&#x2122;s home hospice team to provide visiting consultancy services, and collaborated with nursing homes to provide end-of-life care for patients.

Shared decision-making is fundamental to a One Care Plan. Medication management is a collaboration between the prescriber and the one who administers it. We work closely with doctors and nurses to set up new medication protocols, including training needs. We engage in multidisciplinary team rounds and also have prescribing collaboration with doctors, assisting them to see patients in clinics to reduce wait time and costs. Patients too must be involved in the care and management of their illness. We discuss their desired quality of life and therapy plans. For healthcare to be sustainable, patient empowerment needs to be intrinsic. M S S U PA D H A RA RA M A I YA H H E A D O F D E PA RT M E N T A N D PRI N C I PA L C L I N I C A L PH A RM AC I ST

FACILITATING CONVERSATIONS FOR MEDICAL DECISIONS Our Advance Care Planning (ACP) programme addresses end-of-life issues by facilitating conversations between individuals, loved ones, and healthcare professionals on what matters to a person in life, illness and death. Individuals can articulate their care wishes in a plan, which guides the medical team in the event that they lose the ability to make decisions. ACP ensures

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that medical decisions are made in accordance with their goals of care. First launched in 2013 at YH as a pilot in various departments, ACP is now an integral part of many of our programmes and departments. The ACP Office advocates the importance of ACPs at an institutional level and continues to train and support ACP advocates and facilitators in the community, allowing more Singaporeans to access information about end-oflife care in their neighbourhoods.

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A GLIMPSE INTO THE FUTURE OF CARE As we strive towards care integration as a hospital, we have achieved progress all around. Departments showcased here have made great strides in being future forward in their collaborations with other teams and agencies to redesign care processes and establish more seamless, coordinated and holistic care plans for our patients. EXPEDITING INDEPENDENCE RECOVERY FOR HIP FRACTURE PATIENTS Operational since 2013, the Hip Fracture Unit (HFU) is a tripartite team with members from the Geriatric and Anaesthesia departments. Their interdisciplinary approach provides three key areas of hip fracture service: falls prevention screening conducted at polyclinics and Community Nursing Posts; fractures treatment that is handled by the HFU integrated team from A&E admission to surgery and recovery; and rehabilitation overseen by the HFU and YCH teams that starts the day after surgery, to expedite mobility and independence recovery. Using YH Suite of Value-Driven Care methods, the Hip Fracture Service team was able to enhance patient value systematically for elderly patients with acute hip fractures in the Acute Surgical Flow.

REDUCING STROKE DAMAGE KTPH’s Acute Stroke Unit (ASU), set up in 2013, aimed to reduce the damage of the first stroke, prevent future strokes and bring patients closer to prestroke independence. ASU’s approach maps all stages of a patient’s hospital journey: assessing their neurological and risk factors, promoting early rehabilitation and discharge planning. Patients with high recovery potential are identified and transferred to YCH for rehabilitation. Post-discharge, they are directed to services that allow them to continue rehabilitation at home or a day care centre.

ENHANCING RECOVERY AFTER TOTAL KNEE REPLACEMENT The Enhanced Recovery After Surgery for the Total Knee Replacement (TKR ERAS) initiative provides pre-operation rehabilitation, multimodal pain management and early post-operative mobilisation so that patients undergoing total knee replacement are back on their feet immediately after surgery. A team comprising a physiotherapist and occupational therapist conducts rehabilitation which begins the day after surgery. The team considers the patient’s medical status, physical fitness and personal goals to plan an individualised rehabilitation programme. Using SOSI Methodology, the TKR ERAS team was able to enhance patient value systematically. The clinical outcomes and experience were improved with reduced cost-to-deliver outcomes. Works are in place to further improve patient value by reducing the cost-to-deliver care.

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ALLIED H E A LT H AND PHARMACY A patient’s healthcare journey will be enhanced through the expertise of passionate individuals at different touchpoints. Patients are holistically supported and empowered to achieve their goals by a care team comprising physicians, surgeons and nurses as well as allied health professionals such as dietitians, physiotherapists, pharmacists, psychologists and medical social workers. These professionals are vital to implementing our One Care Plan.

Ms Teresa Foong

“The One Care Plan demands us to step out of our comfort zones. The dynamics have definitely changed because now we work with other professionals, including community partners. We have greater synergy, have sharpened our vision and can focus on improving the flow of patients through the campus and back into the community,” said Ms Teresa Foong, Deputy Director of Allied Health Services and Pharmacy. “Building a culture of collaboration within the campus and community partners is crucially important to allow seamless and timely information exchange, with clear communication to facilitate appropriate care to patients,” Ms Chua Ee Cheng, Head of the Department of Medical Social Service (MSS), remarked. The MSS team helps to harmonise patient care plans by providing psychosocial perspectives to ensure that their social and health care plans are aligned, contributing to their overall well-being. “Ownership is the most important factor for an effective One Care Plan. Clinicians must own their patients, Ms Isabel Nissa Iman, Speech Therapist, in action

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Traditionally, the bulk of our services are rendered to patients by nurses and doctors. In recent years, therapists have also increasingly taken on the lead in communicating with patients and their loved ones on their rehabilitation journeys and plans, while negotiating and navigating among the multidisciplinary care team to advocate for a patient-centred goal in their recovery. MR ADO N CHAN DE PUTY H E AD OF D EPARTMEN T, R EHABILITATION SE R V I C E S

coordinate care for the patients and communicate the plan to the patients’ other care providers for the One Care Plan to be effective,” Ms Low Suat Fern, Deputy Head of Department, Pharmacy, emphasised. Encouraging the community to develop health literacy and take ownership of their health would be imperative in facilitating care integration. “For healthcare to be sustainable, patient empowerment needs to be promoted and entrenched within a person’s psyche,” shared Ms Supadhara. This goal is supported by the hospital’s Pharmacy Informatics team, responsible for piloting Singapore’s first Patient Medication List (PML) for inpatients upon discharge.

Mr Halim Zul Fahmi, Physiotherapist, with a patient

To facilitate health ownership, the Nutrition & Dietetics department ensures that patients, visitors and residents have better access to healthier options. The department designs recipes for the hospital’s Share a Pot® programme, in collaboration with the PHCT team. “Dietitians play an important supporting role in caring for our patients’ nutritional status. We are dedicated to ensuring that the healthier choice is an easy choice for everyone in YH,” Ms Chow Pek Yee, Head of Department, Nutrition and Dietetics (N&D), emphasised. The Psychology Service team similarly strives to promote psychology awareness in order to help patients understand the importance of psychology in their journey of recovery. Each year, the department organises a Happiness Day event to provide psychoeducation to patients, visitors and staff. “We are committed to boosting happiness and psychological resilience for all at YH and beyond,” Ms Mabel Yum, Head of Department, Psychology Services, attested. As KTPH crosses the ten-year mark, the Allied Health Services team is seeking ways to further improve service. “As we move forward, we must move further upstream, to go beyond the acute hospital and into the population,” Ms Foong explained. “It is vital that we innovate, develop our staff, set excellent clinical standards and meet the needs of our patients.”

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LEAVING WELL

Patients at the end-of-life need the reassuring presence of a fellow human being. The love of family members and care of dedicated professionals help to make the final journey less painful. Palliative care takes a person-centred approach to care that looks at the physical, psychosocial, emotional and spiritual aspects of the patient. We see our work as a ‘journey of hearts’ because we give the patients what is essential — empathy and compassion. They share with us their hopes, plans and dreams and we try as much as possible to honour and respect them. We grow with our patients as we walk alongside them. MS SI M LAI KIO W NU RSE CLINICIAN

“When dealing with dying patients, one needs to focus on life, bearing in mind that the time left for the dying patient is short, and therefore is immensely precious,” said A/Prof James Low, Head of Department and Senior Consultant, Geriatric Medicine. KTPH’s palliative care team comprises doctors, nurses, allied health professionals and volunteers who look after patients with advanced illnesses such as cancer, lung failure and advanced stroke. Besides relieving pain and other symptoms, this multidisciplinary team also develops holistic care plans that address each patient’s physical, psychological, social and spiritual needs, as well as provide support for the family. The team aims to improve the quality of life for these patients and allow them to focus on living their remaining years to the fullest in the environment they are most comfortable in with their loved ones. KTPH’s ethos in end-of-life care began in AH, where Project “No One Dies Alone” (NODA) was implemented to ensure that our terminally ill patients would always have a ready companion in the wards. The journey continued as we brought NODA to KTPH, and it eventually evolved into what is known as the End-Of-Life Programme at KPTH. “When it comes to end-of-life care, it is very important that the patient has a voice, and that their loved ones can have closure,” explained Prof Pang.

GROWING EXCELLENCE

Through social support, home care, or access to funds or equipment, end-of-life care aims to enable patients to enjoy the best quality of life and achieve their last wishes. Patients are consulted on all their concerns, priorities and goals, and where they would want to live their remaining days. They also share any unfulfilled wishes, and where they would like to spend their final moments.

A SPECIAL MESSAGE BY A/PROF KENNETH MAK, DIRECTOR OF MEDICAL SERVICES, MOH

In July 2011, during my term as Chairman of the Medical Board, I was alerted to a matter involving attending to one of our patients who had an incurable lung disease. His condition was deteriorating. Both the patient and the senior doctors caring for him agreed that further treatment would prolong his pain and suffering. A revised care goal of relieving his pain was set and communicated to the patient and his family. However, the patient’s family had difficulty accepting the new care plan. Eventually, when the patient’s condition deteriorated again, they started an altercation in the ward, demanding that he be treated. Despite their allegations of

“Many people think palliative care is all about death and dying. They think that nothing more can be done once a patient is referred to us, so they are resistant or reluctant to accept it,” said Dr Akhileswaran Ramaswamy, Senior Consultant, Department of Geriatric Medicine and a member of the palliative care team. “On the contrary, palliative care is all about living and living well for as long as possible.”

poor care and mismanagement by hospital staff, the senior doctor remained calm throughout the incident. He patiently stayed on after the family had been escorted out and made sure that the patient, who passed away a short time later, was comfortable and properly attended to. The hospital’s senior management recognised that the clinical team was intent on easing their patient’s pain and suffering and respecting his last wishes. We chose to support our staff and affirm that the decisions they made were appropriate for the patient. Above all, we chose to turn a potential PR problem into an opportunity to educate the public on what end-of-life care was and how care goals had to shift. We extended this education to news media, sharing our plans to allow terminally ill patients to spend their remaining days in the comfort of their homes. Our actions were driven by the belief that they aligned with our ethos to provide appropriate patient-centred care, and were wellreceived by our colleagues in other hospitals. This incident is one of many that reinforced my commitment to provide good care that is evidence-based and with the patient’s best interest in mind. I know this spirit of wanting to do our best is still at the heart of every doctor, nurse and allied health practitioner in KTPH. As KTPH turns 10 years old, I wish that all KTPH staff will continue to maintain this strong commitment and fulfill their mission to their patients.

Facets of Compassion

Our nursing team is the heart and hands that are critical in accomplishing our hassle-free and patient-centric aspirations. Changemakers and inspirational role models, they have enabled positive transformation and created new opportunities in nursing. From adopting diversified and expanded roles, to looking into the most minute details to ensure the safety and comfort of patients, they continue to advance nursing care that is grounded in science, backed by wisdom and delivered with love.

2004 AH’s existing nurse leaders Ms Low Beng Hoi, Mdm Chua Gek Choo, Mr Ng Kian Swan and the late Ms Koh Kim Luan, together with their committed team, embarked on planning new hassle-free nursing practices for KTPH.

■

A DECADE OF NURSING EXCELLENCE

2009 ■

Every Patient, The Only Patient

2010 NURSING EXCELLENCE MODEL OF NURSING CARE

NURSING PRACTICE

“Providing Safe, Whole-Person Care Using Our Head, Heart & Hands”

Professional Standards Continuity of Care Evidence-based Practice Communication Patient Engagement Patient Education

Allied Healthcare Professional

Carer Family

Patient Friends

Physician Nurse

Other Department

Navigator Caring Healer Communicator Problem Solver Teacher Watchful Guardian Transformational Leader

TRAINING AND RESEARCH

Training Standardised Practice Mentoring & Coaching Leadership Research Systematic Review Publications Evidence-Based Practice

QUALITY FRAMEWORKS PROFESSIONAL PRACTICE AND ACCOUNTABILITY

■

While implementing countless improvement measures at AH, they dedicated themselves to the design until the final commissioning and licensing of “the dream hospital”. Building on the fundamentals of the profession, new ideas and processes were born. Ideas were adapted from best practices at Mayo Clinic by Mdm Chua and Ms Yiap Pok Ling, instilling a sense of identity and common purpose with our nursing philosophy, core values, education and quality frameworks in place. Amid the excitement, all nurses were orientated to the new settings and rigorous training to face the anticipated challenges of a bigger hospital. Ms Low, with her dedicated nursing leaders, led the team through a decade of…

NURSING PHILOSOPHY, YH VALUES YH’S PHILOSOPHY OF CARE, SERVICE WAYS & 20 BASICS

Continuous Learning & Development Numerous in-service education, on-the-job training programmes and workshops, conferences and engagement activities were conducted. Together, they completed numerous accreditation and licensing audits.

Educational Governance

■

YH Vision, Mission, Core Values & Nursing Excellence

Develop Initial Develop & Continuing Clinical Job/Role Specialty Competencies Competencies

Develop Competencies for Nursing Career Paths

Nurture Talent

Provide Continuing Professional Development

Nursing Competency Framework From Beginner To Expert Harness Technology And Translational Practice Of Education/training Evidence-Based Practice Lifelong Learning And Working Harmoniously With Others Professional Attributes Of The YH Nurse

2020 Accolades In recognition of their hard work, perseverance and determination, many of KTPH’s nurses have been conferred with institutional, cluster and national awards which include:

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On 28 December 2015, YCH opened under the nursing leadership of Mdm Chua. It provides intermediate care for recuperating patients with integrated care experience through a network of healthcare teams, information flow and treatment plans. On August 2017, Kampung Admiralty opened its ambulatory services in the northern heartland, with substantial contributions in its planning and design from nursing leads Ms Chia Kwee Lee and Ms Alice Leong since 2013.

Service Expansion — Advanced Practice Nurses (APN) and Specialty Nurses Nurses from all areas such as anaesthesia and critical care, emergency, gerontology, perioperative, and renal nursing are continuously trained to be future ready. An urgent demand for more specialty nurses spread beyond the acute hospital setting. Nursing practice reoriented towards care integration and meeting the needs of an ageing population.

■

Building Resilience Since AH, recruitment of new nurses and nursing leaders, and retention of skilled nurses was an uphill task. However, resilience and resourcefulness are the outcomes of turbulent times. KTPH faced a bed crunch within a year of opening, leading to the formation of a Short Stay Surgical Unit, and the expansion of the emergency nursing team and its facilities. This resilience has also served the team well when tackling COVID-19.

In 2010, a small team of five APNs moved from AH to KTPH. 2014 marked the turning point in APN growth in Singapore when the Enhanced APN Internship Programme was introduced. APN interns were required to pass the stringent National Objective Structured Clinical Examination (OSCE) Programme before they could be registered as APNs. Over the last decade, we have developed 16 Advanced Nursing Practitioners and eight specialty nurses. Our nurses are also taking up specialisations in community nursing.

President’s Awards for Nurses, the highest accolade in the nursing profession through the decade

Nurses’ Merit Awards

National Efficiency Awards

National Commendation Awards

■

Leadership Development Nursing leadership development programmes are crucial to identify talents and nurture them to their fullest potential amidst rapid change. The Charge Nurse Leadership programme was started to prepare nurses to take on leadership at departmental levels. Ms Audrey Saw and Ms P Velusamy developed the Nursing Leadership programmes to prepare a new generation of futureready nurses.

2013– 2017 ■

Alignment with National Nursing Taskforce In 2013, the newly established National Nursing Taskforce looked into the transformation of the nursing profession to provide the development and implementation of Singapore’s public policy on nursing for the future. Their strategic intents charted a new direction for nursing.

■

Role Expansion Nursing responsibilities expanded as the transition placed a strain on manpower. Nurses had to learn new skills in record time. Nurses in operating theatres were upskilled to monitor patients under Topical Anaesthesia and initiate discharges that were formerly done by anaesthetists.

CHAPTER 5

INSPIRE

FA C E TS O F CO M PA S S I O N

F O R E S I G H T , CO U R AG E A N D CO M PA SS I O N — O U R N U RS I N G P I O N E E RS

n 2004, pioneer nurse leaders Ms Low Beng Hoi, Mdm Chua Gek Choo, Mr Ng Kian Swan and the late Ms Koh Kim Luan, together with their team, were given the monumental challenge of planning new hassle-free nursing practices for KTPH. The team spent their nights and days off hard at work, driven by the need to provide a stellar care experience for future patients. To this pioneer team, leadership, team spirit and the can-do attitude are key success factors. “There was no chance to be slow, and we had to work really, really quickly. Everybody chipped in, worked as a strong team and ramped up training. We learnt how to operate new equipment and master new processes,” said Ms Low. In the course of designing their dream hasslefree wards, they became catalysts for new standards which were eventually adopted nationwide. The wards they designed would have toilets within each patient cubicle to reduce falls and improve infection control, a first for a public health institution in Singapore. Other novel features included a team room for privacy during roll call and family conferences. They advocated for improvements with passion and became known affectionately as “The Wild

Ward Women” as they would argue at the top of their voices to secure the very best outcomes for patients. Said Ms Velusamy, Deputy Director of Nursing, “Nurses are often looked upon as ‘walking encyclopedias of care’ by those we serve. Keeping this in mind, we mould our juniors so that they can best fulfil our responsibilities to our patients.’’ The responsibilities expanded as the transition placed a strain on manpower. The nurses had to learn new skills in record time. “When we first started at KTPH, nurses supported the clinicians and took on some of their roles, such as glucose monitoring and drawing blood from patients,” explains Ms Yiap, Deputy Director, Nursing Administration. Reflecting on those exciting years and the needs of the future, Mdm Chua, Director of Nursing, YCH, mused, “Building a hassle-free practice is an ongoing journey. We need to continuously manage our resources efficiently, improve information management systems, and be ready to adopt and implement big system changes when appropriate.” “The Wild Ward Women” of KTPH have become icons for the generations of nurses that followed in their footsteps. They motivate their team to incorporate new ideas while staying true to the fundamentals of the profession. “The core of nursing has not changed. It will always be about caring for humanity, and protecting lives. We must never forget that,” said Ms Low. From left, Ms Yiap Pok Ling, Ms Alice Leong, Ms Velusamy Poomkothammal, Mdm Chua Gek Choo and Ms Low Beng Hoi

GROWING EXCELLENCE

ASPIRE

BUILDING A F U T U R E - R E A DY N U RS I N G F O R C E

he next generation of nursing leaders upheld the legacy left by their mentors and continued in the exploration of new opportunities and upskilling. They in turn inspired young nurses to break new ground in the noble profession. Ms Shirley Heng, Chief Nurse, mentored by the pioneer nursing team, is herself nurturing new blood. “We need to allow nurses the opportunity to develop their leadership capabilities and to encourage them to understand and learn beyond their knowledge. This enables us to serve the entire community better,” she said. Nursing practice has shifted its focus towards care integration and meeting the needs of an ageing population. Our nurses are also taking up specialisations in community nursing. KTPH’s team of APNs and Specialty Nurses are trained in areas such as geriatrics, dementia and diabetes, to meet the onset of the ‘silver tsunami’. “There is a lot of training done for nurses to upgrade their skill levels, largely motivated by this huge paradigm shift in how we have to approach care to be future-ready,” said Ms Sharon Fun, Assistant Director of Nursing, APN and Specialty Nurses. Nurses also engage in cross-training opportunities that aim to enrich their inventory of expertise. Working together with our clinicians, allied health

From left, Ms Shirley Heng, Ms Audrey Saw, Ms Eileen Cheah, Ms Zhou Liyan and Ms Sharon Fun

professionals and administrators, our nurses have proven themselves to be innovators and leaders in care integration. The culture of continuous improvement is deep-rooted in the nursing team’s approach. Leaders encourage proactivity, curiosity and collaboration, while juniors are empowered to initiate ripples of change. “Challenging the norm will never be an easy path, but this is crucial as we grow and equip ourselves to deal with the demands of the future,” stressed Ms Eileen Cheah, Assistant Director of Nursing. “Our nurses are the stern voice to check that we deliver the best care to patients. Nursing is one of the toughest professions and yet we see the passion burning amongst our nurses to continually pioneer care, make a difference and touch lives,” said Mrs Chew. The second generation of nursing leaders’ penchant for adopting new ideas and technology have facilitated their work and empowered them to achieve higher levels of expertise. Training and development have led to immense growth in the sector. This spirit of improvement and zest for learning will guide and shape the nursing force to be ready for what the future holds.

STRIVING TOWARDS NURSING EXCELLENCE The learning never ends for the nursing team. Regular learning trips and participation in conferences enable them to pick up the latest in healthcare developments and innovations. During the early years of running KTPH, the nursing and clinical leaders embarked on a learning journey to Aravind Hospital in India, gleaning insight into how care quality can be maintained even when serving a high volume of patients. A visit to the Mayo Clinic in the United States impressed upon them the importance of creating communication tools that were tailored to the needs of patients. BREAKING BOUNDARIES Nursing events and conferences are an important part of the culture at KTPH. The first of many Nursing

CHAPTER 5

FA C E TS O F CO M PA S S I O N

Fest conferences held at KTPH in 2010 was aptly themed “Breaking Boundaries”. Held in the year that the hospital opened, the event served to reinforce to the nursing team that they were key drivers in uplifting and transforming patient care standards. To this day, the Nursing Fest conference is a muchanticipated event. Nurses also undergo regular and rigorous training to qualify for Joint Commission International (JCI) accreditation. Widely known as the gold in industry standard, this accreditation attests to KTPH’s unrelenting pursuit to raise the quality of healthcare provided. The nursing team in particular have received accolades from the JCI surveyors who felt that “the knowledge of and confidence in the nursing staff are particularly remarkable. This certainly sets the standards for so many countries to strive for”. Every year, KTPH commemorates Nurses’ Day with great pomp and splendour in appreciation of our nurses. “Our nurses not only put much love into what they do, they also do so much! The ‘3 Beyonds’ to building a sustainable healthcare system have spurred our nurses to acquire new skills and reinvent themselves to meet these future challenges with initiative, resilience and tenacity. You are an inspiration to us all,” said Mrs Chew, in a message to the nurses, at one of the celebrations.

GROWING EXCELLENCE

OPPORTUNITIES, AWARDS AND RECOGNITION

The perception of nurses as changemakers who possess wide-ranging knowledge and skills has turned the tide on the traditional notions of the profession. The opportunities offered today are the result of the courage of pioneer nurses who challenged the status quo. Their foresight has resulted in a well developed progression structure which harnesses dedication, skills and talents. As Mdm Chua shared, “Our nurses today have plenty of opportunities for career and leadership development. Their nursing career path is well planned for, from student nurse level all the way up to chief nurse level.” KTPH offers training programmes and scholarships to outstanding nurses. Most recently, we awarded the Mavis Khoo Nursing Leaders Scholarship to Ms Eileen Cheah in 2018, Ms Yvonne Yap, in 2019, and Ms Ng Siok Qi and Ms Cherie Koh in 2020. The scholarship will support the training and development of nursing leaders and equip them with knowledge and skills to design better nursing care models and influence healthcare behaviours.

The Tan Chin Tuan Nursing Award was awarded to Ms Rostihar Bte Abdul Karim in 2016 and Ms Nur Shafina in 2017. The award recognises promising and talented Enrolled Nurses who are dedicated to advancing the nursing profession locally. Founded by the D.S. Lee Foundation in 2006, the Award is open to Enrolled Nurses working in all public and private healthcare institutions in Singapore. The Healthcare Humanity Awards was conferred to Ms Toh Hai Moy in 2016, NC Ms Sangeetha D/O Sodimani in 2017, Ms Lim Chiew Peng Serene in 2018, and Ms Manjit Kaur and Ms Noor Aiyshah Binte Abdul Raman in 2019. This award recognises outstanding healthcare workers who are inspirational role models. In recognition of their hard work and determination, many of KTPH’s nurses have been conferred with institutional, cluster and national awards which include 92 Nurses’ Merit Awards and four President’s Awards for Nurses, the highest accolade in the profession.

CHAPTER 5

FA C E TS O F CO M PA S S I O N

QUOTES

JOY IN CARING Nurses build human connections while providing care. Their presence can be reassuring and calming to anxious patients and caregivers. They receive respect, but they also face challenges almost daily. We often wonder, how to they do it? Our nurses share…what gives them joy?

The sight of patients getting better, the friendships and laughter at work bring joy with a difference on how we foresee and feel about our day-to-day routines. It changed our mindset — now we see our work as what we can do instead of what we need to do.

Ms Anneth C. Tokong SENIOR STAFF NURSE, WARD B76

I am joyful to have colleagues supporting each other when on duty. We will order food delivery after we’ve had our busy shift to pamper ourselves. I am happy to see patients recover and get discharged from the ward. I feel good when I see KTPH’s therapeutic and iconic green environment.

Work fills my heart with joy At the start I was a little coy But here I am today all out to enjoy I like to nurse in style and make my patients smile My pledge, to serve from the heart As that’s what I want to impart.

Ms Tan Xin Li

Ms Bimeldeep Kaur

STAFF NURSE, B106

SENIOR STAFF NURSE, WARD D98

I cherish my personal and professional growth. My role has significantly provided me with opportunities to impact the lives of my patients and co-workers in bringing the best possible nursing care I can offer. These and more make my job very meaningful and I am proud to be a nurse.

Ms Juan Lorraine Carino STAFF NURSE, WARD D98

GROWING EXCELLENCE

What gives me joy is when patients know me by name, wave their hands when they see me from afar, and being appreciated when I go above and beyond. I enjoy the work I do and the close bonding among colleagues. My work can seem automated like an assembly production line, but I chose work that makes a difference — the opportunity to establish connections and relationships that lead to developing camaraderie.

Ms Clara Kum STAFF NURSE, SOC 26

Nursing is not just work but passion We care for patients with compassion Treat them as our beloved family And their smiles give joy to me! Also my colleagues become my friends We are helping each other all the time We even uplift each other’s spirits Especially when someone feels down.

Ms Bergonia Maria Melissa Asuncion

SENIOR STAFF NURSE, ACUTE AND EMERGENCY CARE CENTRE

The Joy of Work Time Flies Fast A decade has gone These years had taught me To always have fun! Either at work Or even at home There is joy unexplainable That you are not alone To always be thankful Through the good times and bad It is all about your perspective surely you won’t be sad

Working in healthcare means our days will never be dull or repetitive. We face new challenges every day and constantly learn new things. We will always be in touch with individuals who have their own stories and problems, looking up to us for help. There is nothing more rewarding than this.

Ms Lee Xin Yi

Mr ClarenceSoriano Yee

SENIOR STAFF NURSE, NURSING ADMINISTRATION

In patient care, we don’t just give them the best knowledge and skills that we learnt back in school. We give them a piece of ourselves, and bits of our emotions, hearts and souls. We give them love. Seeing patients recover and their families happy is my greatest joy.

Nearly 20 years in nursing has been fulfilling and challenging. Caring for patients who have undergone surgeries and who are handling chronic pain has taught me many precious lessons. Going the extra mile for them is my utmost priority. Let’s continue to care and walk the extra mile for people around us!

STAFF NURSE, MAJOR OPERATING THEATRE

Ms Gonzales Kenneth Coronado STAFF NURSE, WARD D98

Ms Claudia Quek Sock Ling NURSE CLINICIAN, NURSING ADMINISTRATION

R oo t e d i n Excellence

A space and philosophy that unite science, love and wisdomâ&#x20AC;Śwhere healing is a combination of medicine, design, environment and sustainability, and where service excellence inspires our people to serve with heart and soul.

WHERE ENVIRON M E N T AN D S ER VICE M EE T TO DE LIV E R T H E U LTIM ATE PAT IE N T E XP E R IE N C E

10 STEPS AWAY Acknowledge patient with a nod/smile

LAST Be the last to bid fond farewell

Over the years, we have created and nurtured our environment to create a serene healing space. Complementing this tranquility is service â&#x20AC;&#x201D; our staff are guided by our service ethos. Service excellence and sustainability are both equally important parts of our DNA.

10-5FIRST-LAST

The warm welcome that every patient/visitor can expect. FIRST Be the first to contact patient

5 STEPS AWAY Greet

Y ISH UN H E ALTH 20 BASICS What every staff must practise. The foundations that govern good service.

Energise Our Vision, Mission and Values

Care for Our Customers

Approach and Escort Our Customers

Own Every Complaint

Be Well Groomed

Be Models of Health and Fitness

Protect Our Assets

Seek Continuous Improvements and Innovation

Be Ambassadors for Yishun Health

See for Ourselves

Make the Solution Simple

Maintain a Neat and Efficient Environment

Learn and Share Constantly

Practise Good Telephone Etiquette

Protect Our Environment

Ensure Safety Report on Emergency Issues

Be Gracious in Our Hospitality

Maintain the Highest Standards of Hygiene

Work as a Team

Think Big, Dig Deep, Start Small and Act Fast

L.O .V.E .

What we must give and do at every patient interaction

L I ST E N OF F E R H E L P G I V E V A LU E E NGAG E PAT I E N TS

RECOGNITION FROM OUR PATIENTS We topped the MOH Patient Satisfaction Survey (PSS) from 2004 to 2009 at AH. We continued on this trend at KTPH, coming out tops in 2010, 2012, 2014 and 2015. Patients gave an “excellent” rating in all the categories surveyed, including facilities available; the care, knowledge, and skills of our doctors and nurses; and whether their clinical explanations were clear enough. MOH PSS RESULTS 2010 Top Overall Satisfaction (%) Excellent or Good Results / FY2010

J UST D O IT

The courage to innovate, the heart to serve

Believe it can be Done

Have Goals

Live Life to the Fullest

AH 05

72.6

AH 06

79.6

AH 07

83.4

AH 08

83.3

AH 09

84.7

KTPH

81.7

Hospital A

78.1

Hospital B

76.7

Hospital C

74.7

Hospital D

74.2

Hospital E

74.1

And the trend continues… Never Give Up

Prepare Well

Try and Try Again

Have Faith in Yourself

Help Each Other

FY11 (2011)

No PSS

FY12 (2013)

83.0

FY13 (2014)

80.4

FY14 (2015)

85.9

FY15 (2016)

90.8

FY16 (2017)

85.3

FY17 (2018)

87.0

FY18 (2019)

Temporarily suspended due to COVID19

CHAPTER 6

INSPIRE

ROOTED IN EXCELLENCE

A H E A L I N G E N V I R O N M E N T, D I ST I N G U I S H E D S E R V I C E

TPH today is “a garden in a hospital, a hospital in a garden”, with a living ecosystem that is inseparable from the experience of the hospital. “We are committed to performing our primary role as a healthcare provider while proactively minimising our impact on the environment,” said Mrs Chew. Driving KTPH’s sustainability and service excellence efforts is Chief Operating Officer, Ms Yen Tan. When she took on the mantle, her first priority was to hunt for people who would be perfect for hospital management and operations — people who could be mentored to become leaders and supporting officers for the next 20 years at KTPH. “I believe that healthcare is a compassionate industry, made up primarily of people who have a big heart to serve the vulnerable,” said Ms Yen.

The Operations team, which she mentors individually, is responsible for the continuity of the “hospital in a garden” and its sustainability initiatives and service excellence standards that match exemplary leaders like Singapore Airlines, The Ritz Carlton and Citibank. KTPH’s health-promoting journey comprises psychological and physical health advocacy, sustainability, and creating a green building and bringing it to life. Nature plays a fundamental role in human well-being. Biophilia — human beings’ innate desire for nature — is present in almost every public area and every ward, creating a healing environment to 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 reduces work stress, raises morale and enhances overall performance. Ms Yen and her team have driven numerous initiatives to improve service standards, and sustainability, as well as health-promoting activities. Under her direction, KTPH strengthened its commitment to promoting the health of our people and our environment by joining the Global Green and Healthy Hospitals (GGHH) network in 2016. KTPH has also partnered with GGHH under a Memorandum of Understanding to create a platform for hospitals in Asia to exchange knowledge on sustainability practices. The healing sustainable environment, care delivery and service excellence intertwine to provide an outstanding patient experience.

GROWING EXCELLENCE

ASPIRE

CHAMPIONING CLINICAL SERVICE E XC E L L E N C E

A/Prof Lawrence Tan

linical and service excellence are key factors in delivering an outstanding patient experience. Underlying our service and care delivery are the key tenets of L.O.V.E.: ■

Listen to our patients

■

Offer help

■

Give Value

■

Engage patients

“L.O.V.E. captures the human touch which guides our promise to our patients and their families. It articulates how we can love our patients, anticipate their needs, identify solutions and deliver care and services tailored to them,” said Ms Sng Yan Ling, Director, Patient Experience Office. High standards of care, professionalism, and good interpersonal skills contribute to clinical excellence. At the same time, we strive for a service culture that addresses every aspect of a patient’s journey. “To foster a great culture, people must have a platform to communicate freely, express their opinions and give constructive feedback. Ultimately, this leads to growth,” said Ms Yiap Pok Ling. Personal and professional growth assures proficiency in anticipating, meeting and exceeding the needs and expectations of guests, their families and our colleagues. It empowers our staff to make every patient feel valued and important. For A/Prof Lawrence Tan, Senior Consultant, Geriatric Medicine, empathy and compassion are of utmost importance. “Patients want to see that you really care. That is the only way that we can earn their trust. It is the basis of what we do,” he shared.

Ms Yiap Pok Ling

Ms Theresa Ee

Patients must feel safe and reassured. Their families must be confident in our care delivery, and content with our service. “The dedication to a ‘hassle-free’ patient journey, and the philosophy of “care good enough for our mothers” has kept us firmly on track,” said Ms Ip Kit Ling, Assistant Director, Patient Experience Office. “We strive to provide value and a good experience to our patients by listening to them and addressing their concerns. We often take on the additional role of liaising with internal and external healthcare partners to address social challenges that our patients may be facing,” shared Ms Chelsea Law, Senior Principal Podiatrist. “I never get tired of this work. It’s a privilege to work with patients. When patients say things like — after 10 years of having diabetes, I have finally learnt more about the condition with your help — it makes me feel like it has all been worth it,” said Ms Theresa Ee, Senior Staff Nurse, Endocrine Clinic. A/Prof Lawrence Tan, Ms Chelsea Law and Ms Theresa Ee are staff who have garnered the highest number of Service Champion Awards at KTPH.

CHAPTER 6

ROOTED IN EXCELLENCE

5 P I L L A R S O F H E A LT H — A H EALTH-PRO M OT IN G IDE OLOG Y KTPH believes in the philosophy of “a sound mind in a sound body”. While “curative” medicine is delivered to symptomatic patients who seek healthcare, health promotion and preventive intervention aim to modify the lifestyles of individuals. Our work-life initiatives and activities are embodied and aligned in a set of values called the Five Pillars of Health. The Five Pillars guide the creation of an environment that supports the health of its staff and the community we serve and is incorporated into all aspects of Hospital Planning and facilities. The KTPH Five Pillars of Health are:

Be Happy

Eat Wisely

Exercise Regularly

Stop Smoking

Practise Personal Hygiene

GROWING EXCELLENCE

“Creating a ‘hospital in a garden’ takes deliberate care and strategic choices. The goal is to maximise the potential of the hospital’s landscape,” shared Mr Wai, who adds that cultivating welcoming gardens and spaces, and organising communal activities are vital in encouraging healthier lifestyles and providing respite for patients and family members.

This included a ‘Towel and Bottles’ exercise which was organised in 2013 in which 600 residents briskly walked around the hospital premises with filled bottles as weights and performed simple exercises with towels as weights. Seeing elderly people jogging near the health-promoting pond inspired patient Mr Gopal Krishnan to kickstart an exercise routine. “It was the start of my rethinking

towards a healthy lifestyle. From 15-minute walks, I progressed to jogging longer distances of 2 to 5 km at Yishun Pond.” Reinvigorated by this new routine, his slipped disc condition improved and he was able to avoid an operation. Staff have also found refuge in the greenscape near the Health-Promoting Pond which serves as a restful sanctuary. Developing this “garden in a hospital” has brought people living in the north closer to nature, engaging them in health-related activities and enhancing their overall well-being. “The vision of a ‘hospital in a garden, garden in a hospital’ created a common conviction that the hospital was more than just a building for medical treatment but one with a healing environment as Ms Jolia Low well. This sense of purpose grew into a culture and the experiences encouraged us to design for sustainability,” said Ms Jolia Low, Assistant Director, Operations Support.

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100

AN ENV IRONM E N TALLYCO N SCIOUS IDE OLOG Y Abiding by the ethos of a garden hospital, Mr Wai had led and continues to oversee the environmental design and sustainability initiatives at KTPH. “Ultimately, we want to create a living ecosystem that would be inseparable from the experience of the hospital,” he adds.

Like-minded volunteers, suppliers and partners local and abroad came on board and created a multiplier effect in the implementation of greener operating solutions. Ms Yen added, “These partnerships have opened our eyes to green paradigms and equipped us with new systematic ways of managing sustainability.” Realising these aspirations is none other than the Operations team at KTPH, who continually strives to integrate patient-centred care with design, environment and sustainability. The 4”Rs” of environmental sustainability Refuse

Reduce Recycle Reuse

ROOTED IN EXCELLENCE

SPOTLIGHT ON

GREEN AND SUSTAINABILITY E F F O R TS AT KTPH

CLIMATE RESPONSIVE FAÇADE SYSTEM The hospital’s façade design was the fruition of a long process that involved testing and verification through scientific methods such as Computation Fluid Dynamics, Solar Modelling and Wind Tunnel Testing. These tests were conducted in collaboration with the NUS School of Design and Environment under the guidance of A/Prof Lee Siew Eang. Each face of the building has a slightly different configuration depending on the cardinal direction that it faces. The passive design of the façade is able to react to the sun’s movements throughout the day and the wind’s movements throughout the year. The combined effect of these elements has been able to reduce the number of fans required in the wards by 35%. In addition, an optimal window to wall ratio compounds the effect by resulting in a 30% reduction in electrical lighting needs.

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VENTILATION ENERGY CONSERVATION Reduced energy consumption through maximised natural ventilation and lighting. From vertical gardens in the central courtyard that draw in more breeze to floor-to-ceiling windows that allow natural sunlight into the wards, these have greatly reduced urban heating. Terraced gardens on the podium roof also recycle cold air from the operating theatres at the lower levels to cool the ambient environment.

WATER CONSERVATION KTPH employs several efficient water features to reduce water wastage. Facilitated by rain sensors, it recycles water from the rain by channelling water collected from the adjacent Yishun Pond to the hospitalâ&#x20AC;&#x2122;s irrigation system for its landscaping purposes. Vertical garden walls that utilise drip-system filtering also double up as private screens in outdoor toilets. In exchange for recycling rainwater collected on hospital premises into the pond, the PUB provides water back to KTPH at a much lower rate, resulting in nearly 50% savings in KTPHâ&#x20AC;&#x2122;s projected consumption cost.

ENERGY CONSERVATION As part of an energy-efficient system, motion-activated lights are installed in toilets, pantries and infrequently used corridors, while escalators are fitted with step sensors. Lifts are fitted with sleep mode and variable speed motors, as is the waste and linen chute system calibrated to work in sync with cleaning schedules, in efforts to reduce energy demand. Time-controlled LED lights have also been installed in car parks. Through this, the electricity saved is enough to power more than 1,400 households for a month.

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BALANCING BIODIVERSITY The growth in biodiversity in and around KTPH is a result of its efforts in replicating and sustaining the rainforest ecosystem. Over 70% of the plants found in KTPH (including many rare endangered species) are indigenous. In addition, host plants that would attract butterflies and pots for dragonflies were carefully installed and calibrated to nurture a balanced ecosystem. When the first biodiversity survey was conducted, there were only three species of butterflies found. Today, the hospital boasts an impressive population of flora and fauna.

A GREEN CULTURE Over the years, KTPH has taken part in multiple community outreach programmes through close collaboration with various public sector partners. In particular, the National Environment Agency (NEA), National Parks Board (NParks), Public Hygiene Council (PHC), Public Utilities Board (PUB) and Nee Soon GRCs have been close partners. Activities include monthly litter-picking sessions that have seen a decreasing amount of litter collected, evidence that the public has grown increasingly conscious of the need for upholding community hygiene.

ROOTED IN EXCELLENCE

LEARNING FROM INTERNATIONAL PARTNERS On 8 March 2015, we joined hands with Taiwanâ&#x20AC;&#x2122;s Tzu Chi Foundation to organise the Health Promoting Hospital & Environment Symposium. A Taiwanese international humanitarian non-governmental organisation with presence in Singapore for 25 years, the Tzu Chi Foundation and its hospitals are a role model in sustainability practices within the healthcare setting. KTPH joined the GGHH network in 2016, committing ourselves to promote the health of both our people and the environment. Since then, we have participated in the networkâ&#x20AC;&#x2122;s knowledge sharing platforms, supporting their conferences with subject expert speakers. As a partner and venue sponsor for the 5th Green Hospitals Asian Conference 2019 in October, KTPH has joined hands with the organisation under a Memorandum of Understanding to establish a platform for hospitals in Asia to share and learn from each other in the realm of sustainability practices.

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FROM FOOD WASTE TO FERTILISER A food digester was installed in KTPH in October 2018 to enhance our efforts to reduce and better manage food waste. The digester consists of a chamber for food waste where microbes digest the waste and convert this into compost within 24 hours. Thereafter, the compost can be reused as fertiliser in the garden, cutting down on waste and returning food scraps back to the food

cycle.

GREENER FOOD & BEVERAGE F&B and retail outlets at KTPH and YCH actively promote our sustainability efforts by discouraging the usage of plastic disposables among diners. Discounts are given for diners who bring their own containers, and plastic straws are no longer given out. Stores provide biodegradable plastic bags and food packaging, and encourage the use of paper or reusable bags.

GREEN SERVICES KTPHâ&#x20AC;&#x2122;s linen laundering partner, Zero Spot, has implemented various energy and water saving measures to reduce their carbon footprint. Continually upgrading their equipment has helped them to maintain a highly water-efficient laundering process. Recovering heat from the boiler process allows it to be reused for heating water, reducing diesel consumption by 104,000 litres annually. They have also redesigned the ventilation system of their premises to reduce the energy required for air-conditioning.

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KTPH’S ROOFTOP GARDENS

FO STERING COM M U N ITY FARM ING, PAT IE N T NU TRITION AN D HO RTICULTURAL T H E RAPY The rooftop gardens at KTPH have become one of its unique features. Planting the first seeds was Mrs Rosalind Tan, Senior Executive, Operations Administration. Her inspiring passion for horticulture and gardening earned her the nickname “Chief Gardener”. She was roped in to plan the gardens and rooftop organic farm. Together with her husband, Mr Tan Wee Lee, a former architect, she shaped KTPH’s rooftop gardens into a well-loved feature, delighting patients, visitors and distinguished guests alike.

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The past decade saw her building up an extensive network of volunteers to tend to the gardens’ biodiversity. Its first volunteer, Mdm Lim Chew Eng, was grateful for the opportunity to continue farming after losing a community plot that she used to tend due to urbanisation. Many volunteers have joined this venture since, bringing with them their green thumbs and knowledge passed down for generations. The expansion of this rooftop garden has also brought other helping hands including students from various institutions and corporate volunteers.

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Today, KTPH’s rooftop farming facilities also provide a healthy and environmentally sustainable supply of fresh green produce. It produces up to 720 kg of vegetables per month during peak season. Having an in-house source of ingredients has the added advantage of reducing the carbon footprint of the meals, contributing to KTPH’s aim towards environmental sustainability. Any excess is sold to the public at a thriceweekly farmers’ market sale, which features rarities like the Oyster Plant and Prunella, creating opportunities for public engagement and education. Proceeds are channelled to the Sustainability Fund that is in turn used to further the green initiatives of the hospital. This decade-long rooftop farming programme has contributed to sustaining the well-being of seniors through Horticultural Therapy. This involved patients engaging their senses of sight, scent, and touch while gaining horticultural knowledge. Mobile horticulture kits were also provided to bed-bound patients which greatly improved their engagement and functional recovery.

Mrs Tan, who has been a long-time advocate and leader of various themed gardens throughout the history of the hospital, remarks with satisfaction, “Patients can look out of the window and see us planting. They enjoy eating the fruits of our labour.” The rewards of KTPH’s rooftop gardens have been immeasurable, benefiting patients, staff and the community alike.

Environmental health is a strong determinant of human health. Changes in environmental factors like climate and air quality are slowly but surely affecting human health. This is the bigger picture underlying our belief in sustainable healthcare operations â&#x20AC;&#x201D; it would be counterproductive to treat the population if the by-product of our operations is environmental damage, which would in turn harm human health and introduce even more patients into the healthcare system. With this conviction we have sought to minimise the environmental impact of our daily operations wherever possible, without compromising patient care and safety. MRS CH EW KWE E T I A N G CHIEF EXECU TIV E O F F I C E R

KTPH achieved a green plot ratio of 3.92; the total surface area of horizontal and vertical greenery is almost four times the size of the land that the hospital sits on. Additionally, 18% of the hospital’s floor area account for bluegreen spaces and 40% of all such spaces are publicly accessible. We expanded our blue-green space by ‘adopting’ the adjacent Yishun storm water pond. Redesigned as a park and a “health-promoting pond”, it now serves residents within Yishun. A walking trail links the park to the hospital and a nearby residential estate. Following the inclusion of the pond, total blue-green space available to KTPH patients and visitors increased by 400%.

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QUOTES

L . O .V. E .

THE KEY TO SERVICE EXCELLENCE L.O.V.E. — Listen * Offer Help * Give Value * Engage Patients — is in our DNA. It guides us in making connections with patients, caregivers, staff and also our colleagues. We use L.O.V.E. to achieve service excellence, and our people show the way.

Listen — Everyone may bring various perspectives and insights. So listen! Offer Help — Be an oil can! Offer help when others have a breakdown. Give Value — Complementing each other’s skills, strengths and weaknesses, we strengthen our purpose to serve better Engage — Involve the team and we learn together

Ms Phionna Koh SENIOR STAFF NURSE, DAY SURGERY CENTRE

What gives me Joy in L.O.V.E? Joy is coming to work happily, doing something I love to do every day and believing I’m able to contribute to society. This Joy gives me inner peace, strength and motivation to overcome tough times with my coworkers and able to put L.O.V.E. in my daily work.

Ms Anne Lai

NURSE MANAGER, PERIOPERATIVE SERVICES, DAY SURGERY CENTRE

Honestly speaking, this work is quite hard and stressful physically and mentally. Despite hardships, it has given me a chance to feel a different kind of joy - that of giving our L(listen) O(offer help) V(give value) E(engage patients) to our patients. And of course, good friends and good remuneration.

Ms Zafe Ruby Ana Llana HEALTHCARE ASSISTANT, WARD D48

As the saying goes, “It is not about how much we do, but how much L.O.V.E. we put in the doing”. The same goes for everyone in healthcare. As I see it, the greatest joy at work is to serve the patients and help them recover from illness.

Ms Villanueva Janice Marie Anana ENROLLED NURSE, WARD D48

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L.O.V.E. is a learned behaviour. You have to have a culture of quality that emphasises its purpose and delivers the best experience possible for the people you serve. It is about having a great attitude, solid beliefs and exceptional behaviours that will lead and empower you to attain excellent service.

LISTEN is the commitment of adding diversity to someone’s existence. In succorance, OFFER help with compassion, as it is a gesture that creates a spectacular ripple in one’s life. Accord VALUE to people, and keep their dignity. ENGAGE people and their family through enlightenment and guidance throughout their journey of recuperation.

Humans face stress every day, the difference is only in intensity. Wholesome acts, thoughts and speech coming from purity of heart are healing. My love and service to mankind can be expressed through L.O.V.E. “When the less fortunate need help, those who are blessed must go to them.”

Ms Maniago, Mary Chiles Giron

Ms Dacug Kim Garcia

Tan Seng Wah

L.O.V.E. is a language that everyone from every background can understand. When we put this into our daily work, patients may forget your name, but they will never forget how we made them feel.

I always tell my team to do the right thing for our patients and to do this with sincerity. What we do matters to our patients and when we do our best with all our heart, patients truly appreciate it.

When we serve with heart, L.O.V.E comes naturally!

Ms Lim Shin Yin

Ms Loh Kee Chaw

Mr Lee Tuan Khong

STAFF NURSE, WARD D78

SENIOR PHYSIOTHERAPIST, REHABILITATION SERVICES

STAFF NURSE, WARD D98

SENIOR MANAGER, PATIENT SERVICE CENTRE

CLINICAL PASTORAL CARE COUNSELLOR

SENIOR MANAGER, ACUTE AND EMERGENCY CARE

Our P e op l e

“If each of us hires people who are smaller than we are, we shall become a company of dwarfs. But if each of us hires people who are bigger than we are, we shall become a company of giants.” – David Ogilvy Our campus is made vibrant and thrives because of the compassionate and empathetic individuals who have chosen to dedicate their lives to the business of caring. This includes our volunteers who have shared their time and expertise with us over the years. This chapter is dedicated to those we are honoured to call “Our People”.

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INSPIRE

OUR PEOPLE

A CU LT U R E O F C A R E STA RTS WITH PEOPLE

he people who have chosen to dedicate their professional life to KTPH are over 5,000-strong. They root themselves in different departments, job scope and scale, with the common goal of serving the population in the north. “Your team, the people around you, they help you overcome challenges daily. Good teammates with the same vision may have different personalities, but they have the same goal of wanting to do certain things for the patients,” said Mrs Chew. “Focus on people as an asset, look after them as a person and their family, and they will in turn be motivated to look after an organisation,” shared Ms Yen. A strong professional and relational culture where every staff member is an asset propels us to support our people’s professional growth. We

nurture and develop their skills and talents to their full potential. “What makes the foundation of a powerful and effective team, I think, is diversity. I try as much as possible to build a team that is made up of people that are quite different because we need fresh perspectives. We need people that can think out of the box,” said A/Prof Pek. For Ms Fatimah, success entails learning — as individuals, and as a hospital. “We are a learning organisation, constantly pursuing improvements and kaizens. By implementing change and creating success, we can raise the standards of not only the institution, but of the country,” she emphasised. “We will always have opportunities for bigger challenges and the constant need to push ourselves to do better. On the occasion of our Over time, this will lead to 10th Anniversary, all our staff received this collar improvement.” pin as a gift. As the local healthcare landscape continues to be shaped by evolving needs, expectations and innovations, KTPH looks towards leveraging on technology to drive efficiency, productivity and inclusivity. Ms Yen shared, “KTPH is a progressive employer, and forward-looking in embracing technology to automate labour-intensive work processes to drive productivity. As our population ages and people work longer beyond their retirement age, we aim to create and foster an elderly-friendly working environment to keep our people working meaningfully for as long as possible.”

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A L E G A CY O F SHAPING LIVES

A/Prof Francis Lee

Ms Chew Pei Kiang

special group of people form part of our ecosystem — those who teach and nurture younger colleagues, guide career paths and transform lives for the better. They are known for being extraordinary healthcare professionals who also possess the innate ability and desire to inspire. “Every human being has a constant need and desire to learn new things. We learn from people who are able to share the good things as we move along in life, and therefore we also have to teach and give back,” shared A/Prof James Low, Senior Consultant, Geriatric Medicine. For A/Prof Francis Lee, Senior Consultant, Acute and Emergency Care, a mentor sets the student on the right path towards achieving success. He feels that equally inspirational are the students who seek guidance and knowledge to achieve their personal and career needs. “You really have to care for the people you are mentoring, and take a personal interest in helping them succeed. Understanding of self, continuously examining ourselves and how we are contributing to this whole process is also very important,” he said. “Most people find the inspiration to teach because they are passionate about the subject. Sharing with the younger generation is the most natural thing, be it skills or lessons learnt over the years. The time and effort spent in teaching can act as a catalyst and spark an interest in an area of specialty. Through further encouragement and their own personal experience, it has been heartening to see some of my younger wards choose anaesthesia as

Dr Low Tut Choon

their career path,” said Dr Low Tut Choon, Senior Consultant, Anaesthesia.

A/Prof James Low

Mentoring is also about communicating, listening and sharing ideas and opinions. Ms Chew Pei Kiang, Nurse Educator who has guided generations of nurses, credits her engaging personality to teachers in her primary and secondary school days, and later her seniors who have all shaped her into a motivational and supportive individual. “If you can save one life, that one person then can help another person. This is how my seniors have been guiding me, and what I have learnt from them,” shared Ms Chew. “In a sense, when we teach, we are shaping and influencing the future generation of healthcare professionals. When we teach or impart knowledge, we are also leaving a legacy. Every cycle brings about an improvement. In the healthcare system, it is essential to continuously improve care for the patients, their family and the environment,” A/Prof Low concluded.

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A SOUND MIND IN A SOUND BODY Beyond its green healing space, a sanctuary that provides relaxation to patients and staff and enhances their well-being, KTPH encourages all its visitors, patients and staff to actively practise healthy and happy living by setting an example. FROM THE PEOPLE, BY THE PEOPLE, FOR THE PEOPLE In 2012, KTPH launched LifeWorks! to engage employees, promote work-life balance and increase staff retention through activities aligned with the Five Pillars of Health. A cross-functional committee organises activities for the staff, guided by the principle of “from the people, by the people, for the people”. To foster an ageless workplace, the LifeWorks! Transition Programme was introduced in 2017 in conjunction with the Centre for Seniors. Targeted at staff aged 50 years and above, the programme addresses the concerns of mature workers, such as re-employment and health. Participants were guided through an introspective journey of discovering their goals, strengths and weaknesses, whilst being taught the importance of staying healthy and active. PALS KTPH safeguards the mental well-being of its people with supportive programmes and platforms to lend a hand to staff in their times of need. The Peers Around Lending Support (PALS) programme is one such platform offering assistance, enabling staff access to various services.

Some members of the Lifeworks! Team

The DASS21 Project, where nurses complete a psychological survey. PALS team members contact nurses who are flagged to check in on their well-being and provide support

Junior Doctor Support, where psychiatrists regularly check in with junior doctors to see how they are coping

A 24/7 PALS Helpline

PALS Group Sessions, designed to support and psychoeducate staff

Online meditation sessions, which are offered twice a week

PEERS AROUND LENDING SUPPORT (PALS) SERVICES

Supporting its philosophy of “a sound mind in a sound body”, KTPH’s health-promoting efforts increase both the physical and psychological health of an individual, leading to an overall improvement in their sense of well-being.

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BUILDING A DYNAMIC WORKFORCE The workforce of the future is at hand, and with it comes the need to adapt and transform the way we approach our work in healthcare. Improvement is both a collective and individual effort, Mr Low Ming Hwee, Deputy Director, HR Development (HRD), pointed out. “The motivation to develop ourselves comes from both internal and external sources. The curiosity to learn is innate in all of us. Only by striving to be competent in our current responsibilities can we work towards preparing ourselves for the future,” he explained. KTPH has placed great emphasis on manpower planning and development in recent years. In alignment with our Five Pillars of Learning and Development, the hospital has offered a variety of opportunities to develop staff across different areas. PILLAR 1: UPGRADING STAFF CAPABILITIES Staff are encouraged to upgrade their competencies and prepare for the future through formal education programmes offered both locally and overseas. In 2018, more than 100 staff in-service sponsorships and scholarships were awarded. HRD focuses on training, education, dialogue, and creating learning opportunities for staff. Ms Janice Khoo, Senior Manager, HRD, explained, “To keep up with changing landscapes, we constantly require new skills and knowledge, which we need to learn from others both locally and internationally.” PILLAR 2: RE-PROFILING STAFF COMPETENCIES KTPH embarked on a transformation project for its Patient Service Associates (PSA), who help to facilitate care flow for patients and address administrative issues pertaining to them. Work processes for the PSA were updated to improve efficiency in the inpatient wards: ■ Digitising the process for blue-letter referrals ■

■

Printing patient labels to streamline workflow and reduce errors Collating upcoming internal and external outpatient appointments Re-engineering the process time and doing small-batch booking of non-urgent NHGP slots

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PILLAR 3: PROFESSIONAL DEVELOPMENT In 2018, YH started the NHG Healthcare Management Associates Programme (HMAP) for fresh graduates with outstanding leadership qualities. These graduates are groomed for a fulfilling career at YH, gaining exposure to a range of healthcare settings through three different job postings, shared services portfolios and care transformation projects. PILLAR 4: CAREER DEVELOPMENT YH has actively participated in NHG’s annual Workplace Health Forum since its inception in 2013. Professionals from different local healthcare institutions come together to share best practices on workplace health promotion. In 2018, KTPH had the privilege of hosting the forum, which had been transformed into an NHG cluster event. PILLAR 5: LEADERSHIP & TALENT DEVELOPMENT A Coaching For Supervisors course was introduced in 2018, aimed at equipping staff with leadership skills and instilling a coaching culture among them. Participants were walked through the fundamentals of coaching, team coaching, and coaching for multi-generations. An online microlearning platform was also introduced to enable all staff to record their coaching practices and learn from each other. “We are working towards a stronger presence of strategic HR, where learning is enabled anytime and anywhere,” explained Mr William Neo, Senior Manager of HRD. Mr Stanley Oh, Assistant Director, HR Management (HRM), shared, “The key aspects of developing and fostering a great culture are the company vision, values and the people. Every great culture starts with a vision to guide the company with its values at the core of its culture. The most important thing, however, is the people who share and embrace these core values.” These opportunities have been instrumental in building a workforce that is not only future-ready, but prepared to impart their knowledge to the next generation of leaders who will usher in KTPH’s next phase of growth.

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The volunteer recruitment booth at KTPH Lobby

OUR PEOPLE BEYOND THE H O S P I TA L The residents of the north are very much part of our volunteers and Corporate Social Responsibility (CSR) teams. They embody our core values of people-centredness and compassion. OUR VOLUNTEERS Our first volunteers joined the hospital in 2010, when KTPH started an active volunteer recruitment programme. The pioneers were a group of gardening enthusiasts who tended to the hospitalâ&#x20AC;&#x2122;s thriving rooftop garden. Nature enthusiasts also carefully cultivated indigenous species of fish, birds and butterflies in KTPH. Meanwhile, the needs of patients and visitors were attended to with the help of active volunteers in our clinics, wards and customer contact centre, as well as volunteers from the Singapore National Stroke Association.

Senior volunteers from Touch Community Services performing at our lobby

Today, our flourishing rooftop gardens are tended to by Yishun resident volunteers, most of whom are retirees. Their careful and committed work provides the hospital with a stable supply of organic produce used in patient meals. Wanting to share the health benefits of horticulture with others, the team initiated Horticultural Therapy sessions for patients to improve their happiness and well-being.

GROWING EXCELLENCE

Visitors to the hospital may encounter our friendly Sunshine Buddies who stand out in their bright orange vests. These volunteers lend a helping hand in distributing meals, assisting with wayfinding and serving as an informal support system for patients. Working closely with occupational therapists and staff nurses in the wards, they also aid in facilitating patients’ active engagement in group activities. Since the Sunshine Buddy programme began in 2017, over 110 volunteers have stepped forward to brighten our patients’ days.

Some volunteers, such as Mr Robert Lo, continue serving with us to this very day. Mr Lo is one of KTPH’s pioneer volunteers who joined the hospital as a patient greeter and gardener. He also helped the new team to organise its volunteers, going the extra mile to regularly meet up with them and update them on volunteer work. He has been an active volunteer at the hospital ever since then.

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I was one of the hospital’s early volunteers and spent time after work with the team to plan, design and landscape the hospital grounds. The vision was to bring more greenery and cheer to the sterile environment in the hospital. The spirit of transforming hospitals into healing oases that de-stress our minds, refresh the senses, and bond people together grew from there. Khoo Teck Puat Hospital and Yishun Health are testament to the far-sighted vision and strong will of its leadership, as well as to the efficiency and pragmatism of the pioneers. MR NG CHEOW KHENG G RO UP D I RE CTO R H O RT I CULT URE A N D CO M M UN I TY GA RD E N I N G N AT I O N A L PA RKS B OA RD

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OUR CORPORATE SOCIAL RESPONSIBILITY To foster strong relationships with care providers and residents, and demonstrate the importance of KTPH’s core values, our CSR team frequently engages and collaborates with other institutions in the North. “As a public healthcare provider, YH believes in doing our part to support those in need in our community, making a positive impact and difference in their lives,” Mrs Quek Ngor Koon, Chairperson of the CSR committee, elaborated. “In CSR, we do this by organising societal and fundraising activities, in alignment with our philosophy of love and care for our community.” Through CSR, we are also able to build an inclusive workforce and create job opportunities for the special needs community. In 2017, YH partnered with SG Enable, an agency dedicated to enabling persons with disabilities. 11 students participated in a 40-week internship programme in KTPH and YCH, where they learnt valuable employability skills and work experience.

Mrs Quek Ngor Koon, left, Chairperson of the CSR Committee

The CSR team also organises activities and conducts exercise sessions at nursing homes that we partner with for our CSR programme. This helps to boost residents’ functionality and well-being. In the long run, these efforts will facilitate seamless care between the hospital and these homes as well as enable the residents to live happier and healthier lives.

CSR allows us to foster strong relationships and build connections between healthcare providers and the population in the north. SISTE R MANJIT KAU R S ENI OR NURSE MANAG ER , IN PATIEN T WAR D S

Celebrating Mid-Autumn Festival with our nursing home partners

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My participation in CSR gives me the opportunity to directly impact the life of an individual, and build strong relationships in the process. MS LISA CHOO PRINCIPAL C LIN ICAL PSYCHOLOGIST PSYCH OLOGY S ER VICE

OUR CSR PARTNERS Over the years, KTPH has partnered closely with four of our neighbours â&#x20AC;&#x201D; Villa Francis Home for the Aged, All Saints Home, Sree Narayana Mission and Singapore Christian Home. These adopted nursing homes are located within close proximity to us, and we serve as their healthcare providers. In January 2018, we conducted our second CSR Flea Market at the hospital, and raised more than $5,000 for these homes.

Our CSR partners, All Saints Home, Sree Narayana Mission and Singapore Christian Home joined our 200-strong contingent to celebrate the abilities of People with Disabilities at the Purple Parade 2019.

Outing with SCH

OUR PILLARS OF SUPPORT Within our premises are many support departments who are responsible for the levels of service that allow us to run efficiently and ensure the safety of our patients and visitors. These behind-the-scenes people drive operational improvement, contribute to meeting patient needs and ensure patient satisfaction. Here are some of our pillars of support.

CONTACT CENTRE Holding the critical role of fostering and maintaining the satisfaction of current and potential patients, the contact centre handles inbound calls, manages appointments and responds to enquiries.

LINEN SERVICES From bed linens to scrubs, our Linen Services team ensures proper storage of clean linens and ensure that soiled linen is hygienically cleaned to drastically reduce the risk of disease transmission.

Biomedical Engineering Specialising in the fields of biology and medicine, biomedical engineers focus on analysing challenges and designing efficient and effective solutions to improve the quality of patient care.

Corporate Communications The Corporate Communications team builds and manages the corporate branding of Yishun Healthâ&#x20AC;&#x2122;s institutions through a variety of external and internal communications platforms and initiatives. It also works closely with various hospital stakeholders to educate our patients and residents through public events and educational materials.

FINANCE

At YH, we aim to have a human touch in anything that we do. Our job is to keep the population healthy and bring the necessary medical care there to the population at a price point that they can afford. My team’s job is to support the clinicians as they do this. MR RO GER LEO NG CH IE F FINANCIAL OF F ICER FINANCE

The Finance Department plans for, acquires, and uses resources to maximise the hospital’s efficiency. They ensure the financial effectiveness of our current operations and planning for the future.

Mr Roger Leong

Central Sterile Supplies Unit The CSSU is responsible for preparing medical and surgical supplies that are sterile and ready for use. They enable us to provide safe, inventoried supplies and equipment to our patient care areas.

Housekeeping Department The Housekeeping Department is responsible for the regular cleaning of all surfaces and maintaining a high level of hospital hygiene, ensuring the safety of our patients and visitors by keeping hospital-acquired infections at bay.

Food Services Food Services works closely with the Nutrition and Dietetics team to provide the right nutrition for our patients. When creating menus, they often take into consideration nutritional values and patients’ perceptions and expectations.

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OUR PEOPLE

QUOTES

JOY IN WORK KTPH is richly diverse. People across different departments and job scopes unite to fulfill our vision and mission while upholding our values. They share the things that motivate them and give them joy in work.

Simple smiles, cheerful laughter, Such lovely melodies that greet my day Respectful colleagues, Compassionate hearts, Pioneering care with joy every day Bless our patients, bless our souls, Such rewarding work that makes me stay Mindful caring, Grateful hearts, Spreading love with joy in every way.

Ms Alice Leong Foong Wah

DEPUTY DIRECTOR, NURSING ADMINISTRATION, PERIOPERATIVE DIVISION

Among... Hundreds of people trying to see the beauty of Singapore, Thousands of miles away from family and birthplace, Millions of hidden emotions to express, Billions of huge expectations to overcome, Trillions of promises to keep, Zillions of fears arising out of stress to face, “Xièxiè” (谢谢) from the patient I treat Gives me more joy.

Dr Basha Jan Sowkath Ali

RESIDENT PHYSICIAN, OPHTHALMOLOGY AND VISUAL SCIENCES

Every day I feel blessed way more than I deserve. It is overwhelming. And so, having a job that is of service to others is almost a way of giving back. I will continue to serve others and help them into wellness. My job is not just a job. It is a blessing.

Mr Jared Paul Salazar PHARMACY TECHNICIAN, OUTPATIENT PHARMACY, ADMC PHARMACY

Growing together with KTPH since 15 Nov 2010 and YCH since 28 Dec 2015, joy in work means: My elderly patients get cured sometimes, relieved often and comfort always; My students become knowledgeable sometimes, diligent often and compassionate always; My colleagues and friends are joyful sometimes, appreciated often and safe always.

Dr Ng Chong Jin DEPUTY HEAD OF DEPARTMENT AND CONSULTANT, GERIATRIC MEDICINE

GROWING EXCELLENCE

What gives me joy in work? When patients are not irked, When I enjoy colleagues’ quirks. To see happy faces, And people going places. To see flowers bloom, Which chases away the gloom. These, give me joy in work.

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I am grateful and thankful to be in the HRD family. My lovely colleagues have been very helpful and supportive from the day I joined and I am still enjoying my work every day. The team spirit in the department keeps me going, we are never alone, always there for each other.

Ms Josey Koh

Ms Joylynn Peh Jia En

Many patients and their relatives are very anxious when they see a surgeon for an acute emergency. Watching the expression of relief on their faces after an operation well done, gives me joy in work.

Dr Anil Rao CONSULTANT, DEPT OF SURGERY

ADMIN ASSISTANT, HRD

PHYSIOTHERAPIST, REHABILITATION SERVICES

Joy at work When I see a smile A mate who goes an extra mile A nod of acknowledgement That makes it all worthwhile. When I am not alone And find meaning in what I do Restoring hope to those without A warm fuzzy feeling sizzles from within When work does not feel like work And rest comes with the setting sun The journey becomes light And filled with joy!

Ms Khoo Sue Anne

PRINCIPAL CLINICAL PSYCHOLOGIST, PSYCHOLOGY SERVICE ADJ. ASSOC. PROFESSOR, DEPARTMENT OF PSYCHOLOGY, NUS

Joining forces with various disciplines Offering comfort and care to the Young and Old, As a Team. Watching patients get better and Observing smiles Return to their faces also brings a Kilowatt grin to mine!

Ms Ong Zhi Lin Melissa ACUPUNCTURIST, SPORTS MEDICINE

The comfort and joy I bring to patients and their family when patients get better gives me joy and satisfaction. Having both a supporting family and great colleagues, I have never felt that it is a compromise to work in Singapore. This has allowed me to complete 10 years in nursing, sometimes as a “warrior” sometimes as an “angel” to our patients.

Ms Bhavana Panampully ENROLLED NURSE, WARD D48

Unity In Times of Crisis

In January 2020, YH campus was adorned with red ornaments in celebration of the upcoming Lunar New Year. As people rejoiced, worrying news emerged about an unidentified form of pneumonia in Wuhan, China. Having learnt the importance of crisis preparedness from the SARS epidemic in 2003, KTPH started implementing new safety measures while ensuring timely and efficient care for patients requiring critical attention. Many departments found themselves ramping up efforts and adopting expanded roles to manage the impact of COVID-19 while maintaining daily operations. True to the spirit of the institution, clinical and non-clinical teams united in the face of adversity to support the needs of our patients and community.

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CO L L A B O R AT I O N AT T H E FRONTLINES KTPH’s patient management capabilities in times of crisis rests on the hospital’s preparedness and ability to respond and adapt swiftly to change. Before the COVID-19 pandemic reached our shores, plans were already in place to ensure continuity in care provision. From critical care to community care, we aimed to ensure that no one falls through the cracks in our battle against an unseen enemy. “A month before Singapore had its first COVID-19 patient, CEO, Mrs Chew emphasised that we should keep close tabs on the situation and so we kick-started discussions on department responsibilities to raise vigilance,” Ms Yen recalled. YH quickly mobilised a cross-functional leadership team to form a Pandemic Task Force. The Task Force officially convened on 21 January, and Singapore identified its first COVID-19 case just two days later.

“It was fortuitous that preparations had already been proactively made to put together our pandemic plans and workflow,” said Ms Yen, who co-chaired the Taskforce with CMB A/Prof Pek. The team willingly sacrificed reunion dinners and customary visitations in the first few days of the Lunar New Year — putting the needs of the hospital first in the critical days of the pandemic. A few weeks later on 30 January, the World Health Organisation (WHO) declared the outbreak a Public Health Emergency of International Concern. “Our first priority was the safety of our frontliners. The second consideration was to configure the hospital to manage COVID-19,” A/Prof Pek, Chairman of the Task Force, explained. “This fine balance is essential to maintain business continuity. Our hospital operations cannot grind to a halt, because there are many other healthcare needs that must to be attended to.”

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The Task Force

From the first day, everyone at Yishun Health was very clear of our goals to strike a balance between caring for COVID-19 patients and those with acute conditions, as well as keeping every healthcare worker safe. We swiftly transformed our campus infrastructure and operations to respond to the evolving situation. I am humbled and proud of the strong commitment demonstrated. MRS CH EW KW EE TI A N G CH IE F E XE CUTIVE OF F ICER

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OUR FIGHT AGAINST COVID-19 21 January ■ Yishun Health holds its first Taskforce Meeting

5 February ■ Travel and contact history, and symptom screenings begin for patients and visitors in ambulatory care areas ■ Only one next-of-kin can accompany outpatients on appointments 7 February ■ MOH raises DORSCON level to Orange

MARCH

■

24 January ■ An Expanded Screening Wing (ESW) is set up outside the A&E in 48 hours ■ 2 wards are converted into negative-pressure isolation wards

7 April ■ Singapore’s Circuit Breaker takes effect ■ Cabin Crew join Yishun Health as Care Ambassadors ■ No visitors are allowed

MAY – JUNE

28 January ■ All staff working in clinical areas mandated to wear masks 31 January ■ Outpatient visitor and patient screening set up

22 February ■ Safe distancing measures take place across campus

10 February ■ Cross-campus staff movement is restricted

12 March ■ WHO declares COVID-19 a global pandemic

28 March ■ The first case from the dormitory cluster is diagnosed

18 March ■ Malaysia’s Movement Control Order takes effect

End March ■ Yishun Health starts planning for potential spike of cases from the dormitories

8 April ■ ESW expands and doubles in capacity ■ YCH begins its ward conversion to house COVID-positive patients 9 April ■ Holding Area (H1) begins operating to manage the cases from dormitories 10 April ■ A&E P3 shifts to Specialist Outpatient Clinic C31

6 May H5 begins operating at FutsalArena@ Yishun, Nee Soon ■ Sports Centre ■

25 January ■ Yishun Health’s Contact Tracing Team begins operating

19 February FEBRUARY ■ Business Continuity Plan team segregation kicks in

9 February KTPH admits its first COVID-19 patient

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4 March ■ National Stay-Home Notice and Leave of Absence begins

DECEMBER

18 February ■ KTPH discharges its first COVID-19 patient

All staff begin daily temperature recording at 8am and 4pm ESW officially begins operation

2 March ■ Yishun Health starts planning for the scenario that Malaysia would close its borders

3 April ■ Specialist Outpatient Clinics are closed

31 December The World Health Organization (WHO) is alerted by authorities in China of a string of pneumonia-like cases in Wuhan, a city of 11 million people

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23 January ■ Taskforce meets Yishun Health staff for a COVID-19 Townhall ■ Singapore confirms its first COVID-19 case at night

22 January ■ Acute & Emergency Care Centre (A&E) begins temperature JANUARY screening ■ MOH declares DORSCON Yellow

UNITY IN TIMES OF CRISIS

12 April ■ H2 begins its operations 13-17 April YCH patients are decanted to Ang Mo Kio-Thye Hua Kwan Hospital to create beds for Pneumonia APRIL Surveillance Negative patients

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17 April H3 begins operating

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19 April H4 begins operating

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12 May SafeEntry is implemented for visitors

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18 May ■ SafeEntry is implemented for all staff

2 June ■ Circuit Breaker ends ■

Healthcare services start resuming gradually

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GEARING UP FOR THE CHALLENGE Guided by the Task Force roadmap, the hospital was adapted to meet pandemic needs, such as infrastructure adjustments for infection control and triage, setting aside separate workflows for COVID-19 management, refreshing infection control training and gearing up capabilities. For Chief Nurse Ms Shirley Heng and her nursing team, their increasing and complex workload posed a daily challenge. One of the biggest difficulties they faced was in navigating the different areas in the hospital, some of which had been assigned as ‘hot zones’ or areas that have higher infection risk. “Because of changing capacity and containment demands, we’ve had to keep adding workflows and adapting spaces, all while dealing with capacity issues,” Ms Heng elaborated. Despite these challenges, the team remained resolute and worked through them. KTPH also took pre-emptive measures such as testing all pneumonia patients for COVID-19 — a move that increased workload, but reduced the risk of cross-contamination within the wards. “We were dealing with uncertainty over the virus, risk of infections, high workload and manpower shortage. I devised strategies for my department’s response based on current needs, demands and near-future predictions, so that we can adapt to any situation,” said Dr Matthew Yeo, Clinical Lead for Disaster and Pandemic Response, acknowledging the strain teams faced. In April, the pressure increased as Singapore faced a surge in outbreaks at foreign worker

dormitories, many of which were located in the north. KTPH received an influx of patients. Staff swiftly converted wards and set up holding areas to accommodate the numbers.

I am grateful to see many hands reaching out to help us — from Nursing Administration, Nurse Educators, Human Resource, Specialist Nurses, Ward Nurses, A&E Nurses, Clinics and Operations. I am very gratified to see the kampung spirit of Yishun Health with so many people coming together and supporting each other. M S FO O M E O W L I N G S E N I O R N URS E C L I N I C I A N I N F E CT I O N CO N T RO L

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HANDLIN G T H E CRISIS: IN N U M BE RS INCREASING OUR CAPACITY 109: the highest number of patient transfers to Community Care Facility (CCF) in a day more than 57,917 polymerase chain reaction (PCR) tests done more than 9,886 COVID-suspected cases swabbed more than 1,752 CCF transfers

more than 50% of YH converted to COVID-related wards 5 holding areas set up in total more than 30 temporary staff rostered to run screening stations at main lobby, satellite clinics, and AdMC more than 2,872 COVID-positive patients swabbed

TEAMWORK AND COMMITMENT

21 staff deployed outside Yishun Health

100 staff on standby as Standby Medical Response Team

35 departments shared in the task of contact tracing

343 staff crossdeployed within campus

more than 200 staff made the sacrifice to stay on in Singapore to battle the outbreak

96 staff trained in contact tracing

MANAGING A PANDEMIC 5,642 contacts risk-assessed

60 minutes: the average time for a contact tracing interview with a COVID-19 patient

Data stated is accurate as of June/August 2020

A L LROUNDED PREPAREDNESS The hospital’s spirit of collaboration was evident in how different departments strove to ensure the safety of patients and staff. The campus security team patrolled the grounds and conducted security checks. At the time of the circuit breaker, KTPH’s security personnel ensured that only essential personnel were allowed on campus, and took on the task of helping to transfer COVID-19 patients with mild symptoms to Community Care Facilities. Thus, manpower shortages in some areas were managed when staff from other departments courageously took on new roles to safeguard smooth operations. One of the most important members in this network was the Department of Laboratory Medicine, which had to develop a robust and accurate in-house test to achieve efficient and effective diagnosis. The team developed a test based on PCR (Polymerase Chain Reaction) methodology and, to meet the demand for testing, deployed staff from the Core Laboratory to work shifts. Ultimately, they were able to test approximately 800 samples daily. The Department’s Head, A/Prof Wong Moh Sim, worked closely with her team to ensure that the processes of specimen retrieval, test analysis and reporting of results were seamless and efficient. “Our team has risen to the occasion to learn new roles and take on new challenges without compromising quality,” A/Prof Wong Moh Sim affirmed. The A&E Department took extra steps to maintain clinical care standards. Mitigating risks involved

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Taken before masks were compulsory

segregating the department into eight zones across the YH campus, with minimum crossover of staff and patients. Staff assigned to these areas also had to adopt the respective protection levels in terms of PPE and infection control practices. “During this time, space was a required resource, which is why the department had to be expanded to the adjacent areas outside the hospital within the YH campus,” A/Prof Francis Lee, Senior Consultant, A&E, shared. This created manpower issues for the A&E team, but their colleagues in the surgical and dental departments stepped in to assist them, providing manpower to help with swabbing patients. Beyond the clinical, we are challenged to make the hospital’s work processes more flexible and adaptable, so that timely care can still be delivered in crucial times.

Our ability to tackle the challenges of this pandemic is a result of the unity and oneness present in KTPH. The trust in the institution to place its staff welfare and safety as top priority allows the team and system to function, thus protecting our patients and colleagues. D R CLEMENT CHIA CONSULTANT GENE RAL SURGE RY

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TRANSFORMING OUR HOSPITAL AS ONE To accommodate the surge in the number of COVID-19 patients from foreign worker dormitories, wards were swiftly converted and holding areas were set up in KTPH and YCH. The Inpatient Services and Nursing teams led this operation, supported by staff across the campus. Ms Kelly Tan, Assistant Director, Inpatient Services recalled that when the crisis first began, they were rushing to set up two COVID-19 wards. “By March, 70% of the hospital was converted. The stress level is no doubt high during these trying times, but knowing that we are doing everything we can for our patients and staff, it is all worth it,” she reflected. Heading the planning and decision-making processes for ward conversions was A/Prof Phoa Lee Lan. A key factor in her decision-making was the need to ensure that there were sufficient non-COVID-19 wards reserved for emergency cases. “This led us to converting YCH wards instead, as there was a cap to how many KTPH wards we can convert,” A/Prof Phoa elaborated. “We worked closely with YCH — Dr Lee Kok Keng, Medical Director, YCH, and his team had established a great deal of trust between both sides, and this enabled smooth transitions between the sister institutions. Like a family, we rallied and worked closely together.” In just three weeks, all seven YCH wards were transformed. In total, 290 beds from general wards across KTPH and YCH were successfully converted into COVID-ready wards. Within KTPH, steps had also been taken to anticipate emergency situations and ensure that the hospital would be equipped to handle them.

We all play a pivotal role during this current pandemic. Our individual actions, no matter how small they may seem, can affect the entire ward. M S R E B E CC A OYO G S E N I O R STA F F N URS E I CU 1 ( M E D I C A L )

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Yishun Health was quick to mobilise its resources, especially in activating emergency mechanisms. Taking the threat seriously right from the start, it has repurposed areas and personnel, setting quickly in motion contact tracing and testing capacities, and educating our community to protect themselves and practise personal hygiene. Their dedication and steadfastness have been very reassuring during these challenging times. A/PRO F MU H AMMA D FA I SH AL I BRA H I M MINISTE R OF STATE, MIN ISTR Y OF HOME AF FAIRS & M I N I ST RY O F N AT I O N A L D E V E LO PM E N T

Up to 40 non-ICU trained doctors underwent a course to learn the fundamentals of ICU management, intubation and ventilator setting and trouble-shooting. A multidisciplinary team helped to set up beds in Ward B46 and the Post-Anaesthesia Care Unit, raising the total number of beds from 22 to 90.

120 nurses from departments such as General Ward, Peri-Ops and SOC were mobilised to support the expansion of the ICU. They were also equipped by their ICU colleagues with patient management skills and knowledge in a new care setting. Clinical departments reorganised their work from eight- to 12-hour shifts to ensure sufficient medical support.

To prepare the hospital for a possible surge in the number of patients requiring critical care, a YH ICU surge plan was formed to manage the load.

Where ward conversions were not possible, the Hospital Planning team surveyed other areas in the hospital and provided fast information on retrofitting and conversions of different facilities in response to MOH’s Hospital Protected Vital Facilities

proposal. These demands were difficult, the team’s Assistant Director, Ms Esther Yap, acknowledged. “Despite the obstacles, we overcame the challenges with proactive and systematic implementation of specific actions”, she highlighted.

138

ELEVATING SERVICE WITH SOLID SUPPORT As the clinical, nursing and allied health teams tended to the medical needs of patients, the operations teams managed the logistical needs of the hospital, and the administration and ancillary teams worked vigorously to ensure that all processes ran like clockwork.

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139

BEYOND DUTY INTO THE COMMUNITY On the ground, YH’s MSS department set up a team to provide patients with psychosocial care. They worked closely with ward and logistics teams to identify and address patients’ practical needs, such as spare clothing, SIM cards and handphone chargers. Going above and beyond their duties, some members of the team purchased new sets of toiletries and gathered donated clothes for the patients. Many of the patients who were given psychosocial support were foreign workers facing employment and financial stress and loneliness due to prolonged isolation. MSS collaborated with inpatient ward teams and translators to engage and offer support to the patients in novel ways, including the use of videos. Although some medical services were scaled down during the days of the Circuit Breaker, the PHCT team expanded their efforts to reach out to the community. In response to the rising number of cases in nursing homes, PHCT partnered with various departments to send in swabbing teams. The teams, led by Dr Wong Sweet Fun, Deputy CMB, Population Health, and Dr Laurence Tan,

Consultant, Geriatric Medicine, also developed educational pictorial guides to improve awareness and recognition of infection control measures. Overall, more than 1,000 swab tests were conducted across three nursing homes. To ensure long-term sustainability of care for these residents, the team trained more than 70 nursing home staff across 11 homes to conduct swab tests independently. “This reflects PHCT’s ingrained mission to bring healthcare beyond the hospital, as well as to empower and educate those in the community to take care of one another,” said Dr Wong. To help address and manage the emotional and psychological challenges that the staff would undoubtedly face as a result of working during a crisis, a series of measures including counselling services and peer support programmes were rolled out. The PALS programme continued its trajectory of support — staff who face heightened levels of stress could approach a helpline or outreach groups, or learn wellness management from emails that were sent to them.

140

A FIRM ALLIANCE Even as the hospital tightened its workflows to better manage the pandemic, KTPH’s Allied Health Professionals (AHP) took on new roles to support their colleagues. “Our AHPs have responded to the needs of the COVID-19 patients in many settings, such as A&E, Holding Areas, wards, the ICU and Community Facilities,” Ms Teresa Foong shared. The Allied Health team innovatively implemented tele-rehab and tele-therapy. Rehab teams in YH demonstrated rehabilitative exercises to their patients from a “studio” within the hospital to ensure their holistic well-being. Patients could do these exercises from the

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comfort and safety of their own home. Further north at AdMC, pharmacy staff began delivering medication to their patients, conducting up to 70 deliveries per day. Ms Siew Yu Yao, Dietitian, N&D, attested, “It was daunting at first to take on roles and responsibilities different from what I was trained to do and keeping up with protocols that are changing daily. However, in challenging times like these, I am more than proud to be able to contribute in whatever way possible.” Support came from outside the healthcare industry as well. Assisting the hospital care teams were Care Ambassadors (CAs) comprising cabin crew from Singapore Airlines, SilkAir and Scoot. In April 2020, the pilot batch of CAs underwent a five-day training curriculum to learn basic medical terminology, care procedures, as well as safety and infection

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control measures. They utilised these skills to carry out duties such as basic caregiving procedures, nutritional care and patient service management. Cabin crew from Jetstar also joined us as Service Ambassadors (SAs). They performed supporting roles such as assisting visitors and patients to find their way around the hospital. During a time where hospital staff had been taking on longer shifts or more roles, the support of the CAs and SAs was paramount in helping to alleviate the workload and protect the well-being of KTPH staff. Balancing the needs of patients, staff and community during the COVID-19 pandemic was a demanding task that was eased by our staff’s unwavering focus and dedication.

OPPORTUNITIES AMIDST CHALLENGES On 20 August 2020, a Memorandum of Understanding (MOU) was signed between KTPH and Singapore Airlines (SIA), establishing a new collaboration between both institutions in the areas of service quality training and delivery; and the development of safer and improved working practices through the learning of SIA’s crew resource management training. SIA created the programme in collaboration with KTPH and tailored it for our requirements. This is the first time that SIA is extending its training and development services outside the organisation. In September, SIA commenced customer service training for KTPH’s new Patient Care Officers (PCOs) — a role that was inspired by the Care Ambassadors programme that KTPH and SIA jointly launched in April. The PCO is a new service professional role that works closely with doctors, nurses and allied health staff to provide quality care service, caregiving and end-to-end care coordination for patients in the ward. The PCOs undertake service-related work, allowing the nurses to focus on clinical care.

Heart-to-Heart, H a n d -I n - H a n d

We envision a future where communities take the lead in caring for themselves and supporting each other. We hope to facilitate self-organising ecosystems of care â&#x20AC;&#x201D; supported by community members and volunteers, community nurses, polyclinics, General Practitioners and community partners. We aim to be a trusted friend and neighbour in a community that pulses with health and vibrancy. We look forward to growing together and moving From Healthcare to Health, and From Hospital to Community.

2001

2000 ■

The Health For Life Clinic offered screening packages to aid the early detection of lifestyle-related diseases, ran health education and intervention programmes and connected the public to the healthcare resources and services they needed.

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P O P U L AT I O N AND CO M M U N I TY HEALTH IMPROVEMENT

AH developed the Community Outreach Programme, organising health talks on disease prevention and community health screenings Health for Older Persons (HOP) Programme was launched by AH’s Geriatric Centre to proactively equip seniors in the community with the skills to live confidently and independently, well into their later years Home for Independent Persons (HIP) Studio, a mock-up HDB flat enhanced with safe and enabling features, was launched to complement HOP and help ease the ageing transition

2004 ■

■

Able Studio, a collaboration between Pharmacy, Rehabilitation and Geriatric Departments (the 3rd generation HIP Studio) was launched in 2010

2011

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201 2

HIP expanded to the Homecare Solutions Centre at Jurong Medical Centre

The rejuvenated Yishun pond was designed to facilitate an active lifestyle with an open promenade, custom-designed running track, exercise corner and bicycle racks for staff Start of the Dyad Engagement & Enrichment Programme (DEEP) by KTPH’s dementia team The Ageing-In-Place pilot (AIP) commenced, aimed at providing medical and health-social care beyond the walls of the hospital, tapping on social support and community partners to keep discharged patients, especially Frequent Flyers, from having unnecessary readmissions. Setting up of Community Nurse Posts in the community in 2011, as part of AIP

CARITAS, or Comprehensive, Accessible, Responsive, Individualised, Transdisciplinary, Accountable and Seamless care, was initiated to improve care provision for frail older persons with dementia and support ageing-in-place.

201 3 ■

■

Mini Medical School (MMS) @ KTPH was introduced to make medical science education more accessible to the community, and increase their health literacy and self-efficacy Widespread community health screenings rolled out as part of the Population Health programme to understand the heath profile of the community in the north Opening of the CAMIE Ward (Care for the Mentally Infirm Elderly) in KTPH

2020 ■

2019 ■

2017 ■

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AIP-CCT started Medical Home Programme which offers intravenous antibiotics at home and provide, 24/7 phone support and daily home visits to patients with medical problems stabilised at A&E, who would typically have been admitted if not for this service.

Partnered NHG and Yio Chu Kang PA Active Wellness Programme to expand community screening initiatives in central Singapore Established the Coaching for Health Action and Management Programme (CHAMP), that brings together health coaching and peer support to drive sustained healthy lifestyle changes Started the Skills for Life! @ Community (SFLc), a behavioural health intervention programme that introduces residents to healthy food and physical activity in a hands-on manner

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Pandemic preparedness ❒ Supported residents with chronic disease by remaining accessible during COVID-19 ❒ Introduced safe community practices such as tele-consultations ❒ Conducted swab and serology tests for nursing home residents and staff ❒ Trained nursing home staff to swab ❒ Organised and led Standby Medical Response Teams for community responsiveness Launched Project Silver Screen, an affordable and accessible functional screening programme for Singaporeans aged 60 and above The Self-Managed Autonomous Regional Team (SMART) was introduced in 2017. Covering the Yishun, Woodlands and Sembawang zones, teams comprising community nurses and healthcare assistants proactively conduct home visits for residents referred by community partners.

2015 2016 ■ ■

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Official opening of YCH and launch of their new sub-acute palliative service, expansion of the A&E with a new EDTU In preparation for an ageing population, a Yishun-wide Dementia-Friendly Community campaign was initiated to improve education and awareness of dementia and provide dignified services for those afflicted.

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Three Wellness Kampungs were launched. These community spaces allow residents to inspire each other to adopt healthier lifestyles, in a close-knit kampung setting.

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2014 ■

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Collaboration with SMRT to run a preventive health screening and coaching programme for taxi drivers Started marketplace health screenings together with People’s Association (PA) Active Ageing Committees

Implemented Community Falls Prevention Programme at Community Nurse Posts Aimed at preventing or delaying frailty in the community, the first Share a Pot® session was held. At each session, seniors get a group workout and share conversations over a bowl of soup containing calcium and protein. AIP programme and Transitional Care (TC) service merged to form the AIP-CCT, extending the efficacy of care to the community

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INSPIRE

H E A R T- T O - H E A R T, HAND-IN-HAND

B U I L D I N G A H E A LT H -S AV V Y CO M M U N I TY

ur work involves a balancing act between service development and community building. Community building is a slow build. We work with residents to detect conditions early, manage their conditions, identify strengths and support systems, and work towards their goals and aspirations. At the same time, we recognise that there may be periods in a resident’s life when they need some additional support,” shared Dr Wong Sweet Fun, Chief Transformation Officer, Deputy CMB, Population Health, and Clinical Director, PHCT. Mr Liak, Dr Wong and Mr Lau Wing Chew, Chief Transformation Officer from 2010 to 2014, initiated our community health initiatives in 2001 in AH. They collaborated with community partners and social service organisations, organised many health talks on disease prevention and held community health screenings, focusing on the elderly and the poor. Prof Sum joined in the efforts and together with Mr Liak fronted the organising of diabetes screenings and talks in mosques, churches, and Buddhist and Hindu temples — bringing health education and chronic disease management services to the community. “The hospital must never become the centre; it should always be the side support. Our mindset should always be with the patients in their home, in their beds until they draw their last breath,” Mr Liak said.

In the first years at KTPH, the overwhelming demand for subsidised beds and inpatient admittance led the team to expand on community-based post-discharge care. The AIP programme began in 2011 to address patients’ unmet medical, social, behavioural and environmental needs, and rebuilt their capability and capacity to live independently. It was a two-pronged programme with visits to high consumers of hospital services and Community Nurse Posts (CNP) across 10 divisions in the Nee Soon and Sembawang Group Representation Constituencies (GRCs). Nurses took the lead in the AIP programme, supported by a lean multidisciplinary team of doctors and allied health professionals. They reviewed patients’ healthcare needs, developed care plans and were patients’ single point of contact to navigate the healthcare system. “We shifted the whole paradigm of healthcare by planting strong roots of self- and mutualcare within the community,” said Dr Wong.

Dr Wong Sweet Fun

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I N P U RS U I T O F A GOOD LIFE

r Bastari Irwan, Director of PHCT, and Ms Low Beng Hoi, Director, Nursing, PHCT, are firm advocates of self-managing communities. With the help of several other trailblazers such as Ms Teoh Zsin Woon, Deputy Secretary, Transformation, Prime Minister’s Office, they garnered the support from various associations and community organisations to collaborate on KTPH’s community projects.

“We start with what’s strong and not what’s wrong; playing the facilitator role,” Mr Bastari said. This allowed residents the space to lead and shape their communities, and assume responsibility for their health and well-being. Members of Parliament and the People’s Association (PA) were equally supportive when KTPH piloted all its Community Nurse Posts at their RCs, CCs and community spaces. Mr Bastari Irwan

Ms Low Beng Hoi

“Strength-based nursing is built on relationships and trust when partnering patients and families to promote autonomy, self-efficacy and empowerment. It focuses on the strengths of patients and families, what they can rather than cannot do. This de-medicalises care and, instead, looks at personhood rather than ‘patient-hood’,” Ms Low shared. The community partnerships led to collaborations with North West Community Development Council (CDC); and attracted student volunteers for TriGen. In 2016, a joint effort with PA and St Luke’s Eldercare gave rise to the Wellness Kampung — a network of three wellness and care centres in Chong Pang, Nee Soon Central and Nee Soon East. Residents are invited to contribute to the programming, building of the environment and operations, collectively building the space for themselves. They continue to develop guiding principles to regulate its use, and cultivate a shared responsibility for each other’s well-being. The efforts from the PHCT Team had a ripple effect on the population in the north. Residents, local merchants and hawkers started playing their part by contributing to health and recreational activities within the community through initiatives such as Share a Pot®. Neighbouring schools, Admiralty Primary and Woodlands Secondary, the Church of Our Lady Star of the Sea, and Covenant Evangelical Free Church, as well as the Sree Narayana Mission, and home care service provider, Home Nursing Foundation, also stepped forward to collaborate with the PHCT team.

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H E A R T- T O - H E A R T, HAND-IN-HAND MANAGING THE POPULATION IN THE NORTH

POPULATION STRATIFICATION

MAJOR CARE THRUST

Well Healthy

Well Unhealthy

Unwell Unhealthy (Early)

Unwell Unhealthy (Advanced)

Frail and Dying

People who take ownership of their health by exercising regularly and eating healthily

People who are unaware that their unhealthy lifestyles may put them at risk of developing chronic illnesses

People with medical exigencies and patients with existing chronic illnesses

Patients with multiple medical conditions that are poorly managed

Patients with multiple medical conditions who are usually bedridden and living out the last 1,000 days of their lives

Prevention, lifestyle change

Chronic disease management

End-of-life care

Acute episodic care

CARE SETTINGS

Community Nurse Posts

Homes, Nursing Homes

GPs, Polyclinics

Admiralty Medical Centre Khoo Teck Puat Hospital, Yishun Community Hospital, Woodlands Health Campus

PROGRAMMES

Community health programmes

Our longstanding population health efforts began in 2001. We equipped our neighbours and friends with tools, resources and platforms to take charge of their own health and make healthier choices. Today, we continue striving to help the elderly age well in their homes and neighbourhoods, and provide comfort and reassurance to those at the end of life. Through our extensive screening programmes, we now have a deeper understanding of our community,

Ageing- and Dying-In-Place

their health status, lifestyles and health needs. Around 21,600 residents in the north have had a health screening completed with us since September 2013. To better understand what good healthcare meant for residents, the healthcare innovation and research team conducted a special ethnographic study, â&#x20AC;&#x153;Project Orangeâ&#x20AC;?, in 2015. Findings indicated that residents still desired to participate, be valued and supported in their old age, relying on communal spaces to create opportunities for common roles and interests.

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Our programmes are guided by three underlying principles: PRINCIPLE #1: INDIVIDUALLY GOOD, STRONGER TOGETHER Having residents of different demographic groups gather for group activities builds a harmonious and supportive community. Youths introduce seniors to digital knowledge, while the seniors share stories rooted in traditions. Special interest groups like Repair Kaki give residents a platform to become assets of their community through contribution. Through the mutual bonds and trust built, we are able to encourage healthier lifestyle changes, reduce social isolation and prevent frailty. PRINCIPLE #2: FOCUS ON WHATâ&#x20AC;&#x2122;S STRONG, NOT WHATâ&#x20AC;&#x2122;S WRONG Building upon the assets within communities to support one another in place of costly and formal services nurtures a community that is self-reliant and mutually supportive, making it stronger and more sustainable in the long run.

PRINCIPLE #3: STEALTH HEALTH: SMALL CHANGES, BIG DIFFERENCES Stealth health presents itself in day-to-day activities like gardening. Instead of therapy and medication, residents exercise and get Vitamin D from the sunlight. Healthpromoting activities are designed to be simple and intuitive for seniors to pick up. Enjoyable activities are also organised in spaces such as the Wellness Kampungs to encourage bonding.

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H E A R T- T O - H E A R T, HAND-IN-HAND

CARING FOR OUR COMMUNITY

CARITAS: SIGNIFYING A UNIFIED COLLABORATION Launched in 2012, CARITAS aims to improve the care for frail older persons with dementia and support ageing in place. “CARITAS stands for Comprehensive, Accessible, Responsive, Individualised, Transdisciplinary, Accountable and Seamless care,” says A/Prof Philip Yap, Senior Consultant, Geriatric Medicine. Care continues after a patient is discharged and every patient is tended to. “This extends dementia care into the community,” explains A/Prof Yap. The transdisciplinary YH team, comprising dementia specialists, meets weekly with community partners to discuss methods of improving care. Today, CARITAS serves over 800 patients with dementia and differing levels of frailty and comorbidities in the north. Its individualised and person-centred care has improved patients’ behavioural problems, caregiver burdens and overall quality of dementia severities.

MINI MEDICAL SCHOOL@KTPH — LEARNING TO LIVE WELL Senior Consultant, Community Transformation Office, Dr Ong Chin Fung’s early approach with the MMS — a school that raises health literacy of the public to a level comparable to that of a second-year medical student — inspired the overall vision of more patient-centric and community-based healthcare. The school curriculum comprised topics such as Brain Health, Nutrition, Medication versus Poisons, Function and Frailty and Preventive Health. Since 2013, over 2,000 unique students have made 5,312 attendances over 16 runs. Enthusiasm for the school has shown that the community is ready to be responsible for their health and well-being, with the right guidance.

GROWING EXCELLENCE

SHARE A POT ® — BREWING COMPASSION, SIMPLY Share a Pot®, introduced in 2015, is a demedicalised model combining sharing nutritious bowls of soup with exercise to address frailty in the community. Good nutrition and exercise in a social setting strengthens seniors’ bones, muscles, cognitive function and interpersonal relationships. Since its pilot at St Luke’s Eldercare Centre in 2014, Share a Pot® has expanded to over 30 accessible community locations including the three Wellness Kampungs. The programme’s 12-week cycles encourage residents to improve their fitness level through daily step counts, group exercises and simple-to-

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do functional tests that they can perform for one another. Regular assessments of the participating seniors’ fitness levels track their progress. Any decline detected can be addressed. In 2019, about 180 volunteers ran 32 Share a Pot® sites with 34 weekly sessions for about 1,800 seniors. Mdm Sharon Yong is an avid Share a Pot® volunteer and active Wellness Kampung participant, known as the Wellness Kampung’s unofficial “Souper chef”. She prepares one soup a week from a menu of ten rotating recipes drawn from the volunteers’ contributions and assessed by YH’s dietitians as being rich in protein and calcium.

I take pleasure in seeing the satisfaction on people’s faces as they tuck into a bowl of hot soup, especially knowing they’re nourished well and are keeping physically and mentally healthy. MDM SHARO N YO N G VOLUNTE E R, SH AR E A P OT ®

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CHAMP — A PUSH IN THE RIGHT DIRECTION Coaching for Health Action and Management Programme (CHAMP) encourages every individual to take responsibility for their health, coaches them on goal-setting and selfmanagement, and motivates them to make lifestyle changes. CHAMP guides its participants towards sustained community health-promoting behaviours through four simple yet powerful health promoting actions. In 2018, 1,393 patients enrolled in CHAMP’s coaching sessions.

Many people know the consequences, but they could not be bothered. If there is someone to push and remind you, it makes a difference. M R TA N K E N G B O O N VO LUN T E E R, C H A M P

Once indifferent about his diabetes condition, Mr Tan Keng Boon changed his mindset and now champions the CHAMP programme. Previously, his wife, Mrs Tan, had grown concerned as his diabetes condition deteriorated and his medication dosage multiplied. Taking up Mrs Tan’s advice to participate in CHAMP was the nudge that Mr Tan needed to change his lifestyle. The simple changes introduced by the programme were structured clearly and could easily be integrated into his daily life. Within three months, his diabetes condition improved. Together with his new jogging routine and walks in the park with his wife, he returns home to a healthy meal. Simple steps such as consuming less free sugar and substituting white rice with brown rice even led Mr Tan to lose 4 kg. Mr Tan now shares his wellness journey with others by speaking at the CHAMPion League, inspiring them to make the lifestyle changes they need, just as he did.

In 2018, 127 Pre-/Diabetic residents who followed CHAMP’s diet and lifestyle intervention saw their HbA1C (a three-month average of blood glucose levels) improve from the sub-optimal to optimal range by an average of 0.5%. Residents who were supported by CHAMP Health coaches improved their LDL cholesterol levels. Average readings from 84 participants dropped from high to borderline range by an average of 14%.

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WELLNESS KAMPUNG® This network of three wellness centres located at the void decks of selected housing blocks provide health and social programmes, enabling residents to inspire each other to adopt healthier lifestyles in a close-knit kampung setting. This increased social interaction lowers residents’ and patients’ risk of cognitive decline while raising levels of psychosocial and physical health. The resident-led programmes enhances residents’ participation and ownership of health by incorporating healthy and active behaviours into their daily living. 2,214 residents visited Wellness Kampungs in 2018. Over 70% of the 175 activities conducted at the centres were led by local residents.

Dr Wong Sweet Fun

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AIP-CCT — FROM HOSPITAL TO HOME YH’s AIP-CCT is a post-discharge, nurse-led and team-based home-visit service that integrates the expertise of a transdisciplinary team and utilises close collaboration with community partners. The AIP-CCT team manages transitional care after a patient’s discharge, reducing visits to the ED, hospital admissions, and length of stay. Each care plan is individualised and holistic, based on assessments done by community nurses who assess patients at their homes. Since its pilot in 2011 till December 2019, the programme has benefited over 11,500 patients.

A. Community Nurse Post All Community Nurse Posts (CNP) are located close to residents’ homes alongside community partners. Community nurses provide preventive care services and personalised health coaching to help residents make lifestyle changes and manage their chronic diseases. By educating them on equipment use and self-management, the nurses enable residents to independently take measurements, record readings and report them on their next CNP visit. The nurses make an effort to know their residents’ strengths and needs, and connect them to community resources where necessary.

B. Community Nurse Home Visit Programme While AIP-CCT manages ‘hospital-down’ transitions, community nurses visit patients highlighted by ‘community-up’ referrals, from primary care or community partners and residents. The community nurses first build trusting relationships with patients and their caregivers in their homes, holistically assess their clinical, social and environmental needs, and co-develop individualised care plans for patients to keep them well at home. They become the patients’ single point of contact for care access and navigation of available assistance schemes and services. Since December 2017, around 450 residents have been visited by our community nurses at home.

Dr Ang Yan Hoon and Senior Nurse Manager Ms Jesbinder Kaur — pioneers in the implementation of community nursing in the early days.

Since 2011, about 6,000 residents have been seen by our community nurses across 19 Community Nurse Posts.

H E A R T- T O - H E A R T, HAND-IN-HAND

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C. ACTION Care Coordination Service The Aged Care Transition (ACTION) team helps patients transit from the hospital into their home or community through streamlining and coordinating care services, thereby optimising outcomes throughout and following an episode of illness. Trained care coordinators establish open communication lines among acute inpatient care teams, Agency for Integrated Care (AIC) headquarters and community services agencies to provide effective service coordination for patients upon discharge and identify service gaps and process improvement for both acute and community care settings.

I believe that through payingit-forward, and with everyone taking care of subsequent generations, we can build a sustainable healthcare system. D R WO NG S WEET FU N C HIE F TRANSFORM ATION OF F ICER

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TRIGEN The Tri-Generational HomeCare @ North West (TriGen) project is a partnership among the North West Community Development Council (NWCDC), YH and NUS. This studentled initiative involves university students from healthcare faculties leading secondary school students to visit seniors identified by the community nurses to need medical and psychosocial support at home. Into its fifth year in 2019, over 600 TriGen student volunteers supported about 250 seniors since inception of the project. Mentorship plays a huge role in the TriGen programme. Each team consists of at least two university student leaders, four to five secondary school students and a community nurse who provides them with support and advice. Mentors include geriatricians, nurses, medical social workers, pharmacists and rehabilitation therapists. The AIP-CCT team and the North West CDC team equip NUS students with skills in healthcare, caregiving and befriending to complement existing nurse home visits. This allows the younger generation to contribute to the future of healthcare in Singapore by nurturing them to develop a sense of responsibility and capability to care for the elderly. In 2019, TriGen expanded its scope to include:

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TriGen@NUHS — a collaboration with National University Health System (NUHS) Carehub to take care of elderly patients in the South West region, who face major social isolation besides medical and functional issues. TriGen@SGH — a new initiative spearheaded by the TriGen alumni working with SingHealth and Central CDC. Instead of involving healthcare undergraduates and secondary students, this project garners participation from SingHealth’s healthcare professionals and polytechnic/junior college students.

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CHESS — MAKING EYE CARE ACCESSIBLE FOR ALL KTPH’s Community & Home Eye Screening Services (CHESS) aims to make early detection and management of eye conditions more accessible and affordable for the seniors and less mobile residents living in the north. Headed by A/Prof Yip Chee Chew, this community-based programme facilitates the transdisciplinary collaboration between nurses and optometrists as physician-extenders, under the supervision of ophthalmologists. “By upscaling eye-screening, it reduces the need for patients to come to the hospital and allows specialists to focus on more acute cases,” said A/Prof Yip. For their contribution towards revolutionising eye care services for the community, the CHESS team were awarded the ExCEL Innovation Project Award at the 2018 Public Sector Transformation Awards. A/Prof Yip also received the Public Sector Transformation Award (Exemplary Innovator Award) in 2019 for his efforts in improving patient care and initiating quality improvement projects.

REPAIR KAKI At Repair Kaki, launched by the Wellness Kampung, residents with DIY skills assemble to fix appliances brought in by residents. Formed in 2017 by local residents who wanted to promote up-cycling at Wellness Kampung, Repair Kaki brings together local residents with interests and skills in mechanical and electrical repairs. Collectively, Repair Kaki has repaired over 220 items such as household appliances and wheelchairs for neighbours and community organisations. Research shows that better social networks and greater participation in social activities are associated with lower risks of cognitive decline and higher levels of psychological and physical health.

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GERICARE The GeriCare Team and programme was founded in Alexandra Hospital but began in KTPH in 2010, aiming to support nursing homes by providing clinical care, skills training and care-enhancing equipment or aids. Funded by the Healthcare Service Development Programme (HSDP) Fund, the programme adopted a hub-and-spoke model that leveraged on telemedicine to deliver care. In addition to clinical interventions such as telemedicine, the programme also offers training opportunities such as the TeleGeriatrics Nurse Training Course (TNTC). Nursing homes were further supported with medical equipment, educational materials and organised community-building activities. Recently, GeriCare has enhanced its palliative care services with the formation of the multidisciplinary GeriPall team, which guides and supports nursing homes in the care of terminally ill and dying residents. An LTC Inpatient Programme (LIP) was kickstarted in Ward D78 of KTPH to look after patients admitted from nursing homes and homes for the destitute. A direct admission programme was also started for residents

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who require admission to the acute care and community hospital. Care of the nursing home resident requires a holistic and compassionate approach. In collaboration with the nursing homes, the GeriCare team strives to ensure excellent care for the elderly as they age-in-place and spend their last days at the homes. The ACP programme seeks to allow residents to exercise their autonomy, even when they may have long lost their mental capacity. The GeriCare programme has proven to be a cost-effective and efficient way to provide care to large numbers of older people residing in nursing homes. Blending direct and remote care, it allows for increased and timely access to geriatric and palliative care for nursing homes. The programme reduces unnecessary ED transfers and hospital admissions through tele-triaging, and reduces resource-intensive nursing home resident visits to the hospital outpatient clinics for routine follow-up appointments. GeriCare lives up to its tagline of bringing care closer to nursing homes and strives to provide â&#x20AC;&#x2DC;high tech, high touchâ&#x20AC;&#x2122; care to nursing home residents, paving the way to future-ready eldercare for our rapidly ageing society.

The Future Starts Today

Research, education, care integration and health promotion efforts pave the way as we embark on addressing future healthcare needs. Using science, love and wisdom, we continuously adopt new clinical care methods and technologies, and develop tools and processes based on the needs of the population we serve. Our solid culture of embracing innovation drives us forward â&#x20AC;&#x201D; for us, the future starts today.

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F U T U R E - FA C I N G WITH RESEARCH A N D T E C H N O LO G Y

esearch is a wide enterprise. It can expand into innovation and education. Being a small hospital, that was where we got started,” said A/Prof Lim Su Chi, Senior Consultant, Diabetes Centre, AdMC, and Clinical Director, Clinical Research Unit. KTPH’s Clinical Research Unit (CRU) was established in the former AH, with start-up funding approved by our then-CMB, Prof C Rajasoorya. In 2007, Prof Pang, thenCMB, and AH senior management helped to secure research funds from our Endowment Board to continue the growth of our research roadmap. “Yishun Health embraces the tri-cycle model (clinical service, teaching and research) for excellence in healthcare. Involvement in research is a natural extension of care for our patients,” said A/Prof Lim. “Research gives us insights into how to improve, re-strategise and restructure our interventions,” said Ms Velusamy, who also leads research initiatives in the nursing department. KTPH’s work in the translational research field

A/Prof Tavintharan Subramaniam

A/Prof Sum Chee Fang

A/Prof Lim Su Chi

T H E F U T U R E STA RTS TODAY

turns laboratory discoveries into treatments that improve patient outcomes. In giving our clinician scientists the space and resources to test ideas, we have pursued relevant research that tackles some of the most common diseases and medical challenges. When A/Prof Sum Chee Fang, Senior Consultant, General Medicine, joined AH, he also initiated the NHG Joint Diabetes Collaborative which was responsible for developing the Chronic Disease Management Registry. The registry contains comprehensive records and clinical data of patients with diabetes mellitus within the cluster and has been an important source of data for many pieces of clinical and health services research. This data has contributed significantly to chronic disease management in NHG institutions. In 2003, the CRU built the cell-culture facility, with seed funding contributed by Mr Liak and Prof Pang. The facility, led by A/Prof Tavintharan, was then housed in a makeshift container. Eventually, the unit secured a sponsorship from Takasago Singapore Pte. Ltd., a cleanroom design and build project specialist, to convert the AH chapel into a clean room. The new facility became an enabler — the CRU executed the biggest longitudinal cohorts dedicated to diseases such as dementia, obesity and diabetes. We have also partnered other research institutions in Singapore to strengthen our ability to conduct more rigorous research. When used effectively, technology borne from research and innovation can bring medical professionals closer to patients and cater to their needs while patients remain in the comfort of their homes. “Diabetes care devices utilise technology such as glucose sensing monitors. Cloud technology enables patients who have these monitoring devices to share data with us remotely,” said A/Prof Tavintharan. KTPH continually champions novel ways to move care away from the hospital into the community and grant patients quicker and direct access to care.

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ASPIRE

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A DJ U ST , I M P R OV E , I N T E G R AT E

ontinuously improving on existing care models, adopting innovative ideas, building relationships and harnessing technologies pave the way for successful patient care.

Mr Ling Nee Ker

A/Prof Terence Tang

“We seek to harness technology to improve patient care, but we must first have the desire to change, the desire to do better for patients, before technology can make a real impact on how we deliver care,” said A/Prof Terence Tang, Chief Clinical Informatics Officer, Deputy CMB, Clinical Informatics, Innovation and Patient Engagement. A/Prof Tang is involved in building an effective data infrastructure at KTPH and leads the hospital in our implementation of the Next Generation Electronic Medical Record (NGEMR), adopted as part of efforts to monitor a patient’s entire care journey from admission to discharge, and determine their progress. NGEMR, an essential component of the One Care Plan, aims to improve the quality of healthcare by increasing administrative efficiencies and preventing medical errors. Clinical informatics have also benefited greatly from the adoption of information technology (IT), according to Dr Samuel Sim, Senior Manager, and Dr Joshua Hii , Assistant Director, Office of Clinical Informatics. Plans are underway to equip staff with the necessary IT know-how to uphold clinical quality standards amidst constantly changing IT systems. These include the broadcasting of relevant IT changes via SMS or email bulletins and targeted training of departments. At KTPH’s Customer Contact Centre, the team uses Customer Relationship

Dr Joshua Hii

Dr Samuel Sim

Management (CRM) and telephony systems to facilitate the triaging of information. KTPH adopts the concept of “One Piece Flow” where wearable medical devices follow a patient through different departments without having to be exchanged at every touchpoint — reducing discomfort and risk for the patient. Mr Ling Nee Ker, Assistant Director of Operations Administration, explained, “We need to sense, decide and actuate on data. This is enabled by new technology such as wearables, IoTs and contactless sensors, so that data can be collected effectively. Standardisation by using a common data model to make data collection seamless and cost-effective is the very beginning of this.” A Standardisation Framework has been implemented in KTPH to unify data across multiple applications and deployments, further streamlining processes.

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THE WAY AHEAD

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We are committed to providing holistic and patient-centred care, and working with community service providers in the north to meet the medical and psychosocial needs of residents. D R A N G YA N H O O N SE N I O R CO N S ULTA N T, G E RI AT RI C M E D I C I N E

The Integrated Medical Clinic

The healthcare system of the future focuses on three key areas — care integration, creating a more robust network of primary care providers (GPs and Polyclinics), and strengthening health promotion initiatives in the community. It comprises a network of healthcare professionals working in collaboration to deliver better value. Critical to this are adjusting and improving models of care, harnessing new technologies, being open to innovation and continuous training of healthcare professionals. THE INTEGRATED MEDICAL CLINIC (IMC) In an IMC (pictured above), patients with *complex medical conditions attending multiple SOCs have their care plans effectively coordinated by their primary physician, who serves as their principal point of contact. This relieves them of the hassle of consulting multiple specialists, and gains them focus and clarity on their medical conditions

and goals of care. “Certain departments, such as Geriatric Medicine, are more attuned to looking at patients holistically due to the nature of the work, keeping patients out of the hospital for a longer time, and enabling them to be aware of their own behaviours. The IMC also serves as an interface between hospital and community, directing patients to all the available services specific to their needs,” said A/Prof Tang. To ensure that no patients fall through the cracks, the IMCs accelerated the adoption of certain technologies during the COVID-19 pandemic. Suitable patients were identified for tele-consults, helping to reduce crowds at clinics and enabling safe distancing without compromising the quality of care. In addition, tele-consult also saves patients’ and caregivers’ time and cost from travelling and waiting.

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DIABETES MANAGEMENT IMC “The Diabetes Centre has constantly strived to work in a holistic manner and look after the patient as a whole. With the potential complexities of patient care officially articulated in the plans for the IMC, coupled with a good structure and resources, we are certainly able to implement holistic, patient-centric care on a larger scale,” A/Prof Tavintharan explained. He added that patients come with complex conditions and different complications, so medical care needs to be carefully calibrated to suit their individual needs — some need a care coordinator, while others need coordination between specialists. Augmenting care provision are instruments like glucose sensing monitors and cloud technology where data-sharing between patient and doctor enables regular monitoring and administration of care.

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TELEMEDICINE “The use of technology such as Telemedicine has added value to our team and our patients by complementing our existing care model — especially for repeated visits in chronic disease management,” said Adjunct Asst. Professor Ling Lee Fong, Senior Consultant Cardiologist. A/Prof Ling mentioned that patients engage in consultation via digital platforms — by phone or video. Investigation tests if needed are done prior to the actual tele-consults. Medication is given where required after the tele-consult and delivered directly to patients’ homes or workplaces. PHARMACY’S ROLE IN IMC Ms Low Suat Fern credits the strong Pharmacy Informatics team for improving the quality of the Patient Medication List (PML), where instructions for medication are simplified for patients’ comprehension to improve their medication health literacy. Patients are also interviewed to identify and rectify medical discrepancies, in order to ensure medication safety. By incorporating these steps in the dispensing of medication, patients are encouraged to be more involved in their health, thereby facilitating and fostering continuity of care beyond the hospital.

*Criteria for Complex Care Patient to be referred to the Integrated Medical Clinic Frail person with multiple chronic medical conditions who is: ■

Experiencing two or more acute hospital admissions in the past one year and have two or more medical-type SOC appointments; and/or

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Person flagged by the Ministry of Health’s predictive list to be at high risk of acute hospital admission in the next one year, and have two or more medical-type SOC appointments.

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SHAPING FUTURE-READY HEALTHCARE PROFESSIONALS YH’s Education Development Office (EDO) was set up in 2013 to oversee and coordinate the delivery of pre-employment clinical training and to equip our people with skills that will enable them to thrive in a healthcare role. Headed by A/Prof Yip Chee Chew, who became Education Director in 2018, it develops Healthcare Professional Training Programmes for students from the medical, nursing, pharmacy and allied health professions. With the integration of YH into the NHG cluster, EDO restructured to align itself with the NHG Education Office framework — comprising three units: the Graduate Medical Education (GME) unit, Pre-Professional Education (PPE) unit, and Education Development (ED) unit. In 2019, 254 residents were posted to YH and aggregated about 837 training months under the GME programme. Within the same year, EDO coordinated the training for up to 165 trainees. Prior to COVID-19, the PPE office coordinated and conducted 11 months of training with an aggregate of over 12,000, 22,000 and 1,500 student-days for medical, nursing and allied health respectively. EDO also hopes to inspire pre-professionals to undertake more initiatives involving service improvements and biomedical research. KTPH’s educators have been conferred cluster- and institutional-level awards for their contributions to teaching and education administration leadership. These include the NUS Medicine Dean’s Award for Teaching Excellence and the NUS Medicine Clinical Training Excellence Award. “If we just develop one person, we create a habit that may be lost with time. However when we train whole groups of people, we enable a culture — the impact is going to be exponential,” said A/Prof Yip.

Education is very important because it allows people to continuously grow and achieve more. It gives professionals, from all disciplines and specialties, the tools to work at the top of their licences. A/PROF YIP CHEE CHEW H E A D O F D E PA RT M E N T A N D S E N I O R CO N S ULTA N T O PH T H A L M O LO G Y & V I S UA L S C I E N C E S

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SPOTLIGHT ON

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HARNESSING THE POWER OF RESEARCH A N D I N N O V AT I O N

Keeping pace with scientific and technological advances enables KTPH to innovate the way we help our patients. Not only have we undertaken numerous research projects â&#x20AC;&#x201D; published in international journals and implemented in our institution, we have also created innovative technologies â&#x20AC;&#x201D; all for the benefit of patients both in KTPH and across the nation. Here is a spotlight on 10 research and innovation initiatives we are proud to call our own.

DIABETES AND METABOLISM RESEARCH Our research in diabetes and metabolism dates back to 2002 in Alexandra Hospital when the CRU was set up in a refurbished mortuary. Since then, defining moments in our clinical research journey include the initiation of longitudinal cohorts dedicated to diabetes, obesity and related metabolic disorders. Besides careful clinical profiling of our research volunteers, we also collected and cryopreserved their bio-specimens at baseline. Subsequently, the participants have been followed-up with virtually over more than a decade through linkages with their electronic health records. These incremental and concerted efforts over the years have given us a rich wealth of data that has enabled our own diabetes research as well as fuelled multiple valued collaborations. From starting out in a cell-culture facility housed in a converted make-shift container at

CRU at AH

A/Prof Tavintharan in front of the cell-culture facility at AH

AH to moving into a dedicated laboratory space in the basement of KTPH, our research team has seen many changes over the years. Since then, diabetes and metabolism research has become a niche area that we have become known for. Here is a look back at five of the most significant Diabetes and Metabolism initiatives that we have undertaken.

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THE INAUGURAL COHORT â&#x20AC;&#x201D; DIABETIC NEPHROPATHY In 2002, the longitudinal Diabetic Nephropathy (DN) cohort was kick-started along with the establishment of the CRU. It sought to understand the molecular epidemiology of how diabetes leads to major complications such as kidney damage. Over a period of 15 years, this cohort led to other major projects, and research opportunities for other areas such as understanding the metabolites-signature associated with progression of DN. The extensive dataset and bio-repository is managed by Dr Shao Yi-Ming, Centre Grant Manager.

BARIATRIC SURGERY TO MANAGE DIABETES â&#x20AC;&#x201D; A FIRST IN ASIA In 2007, Dr Anton Cheng Kui Sing, General Surgery, initiated research in Bariatric Surgery, with an interest in how gastrointestinal metabolic surgery can benefit diabetics. This study, the first of its kind in Asia, compared the effectiveness of bariatric surgery versus traditional medical treatments for patients with moderate obesity i.e. BMIs between 27 and 32. Working with Dr Cheng, Dr Angela Moh Mei Chung, Principal Scientific Officer, CRU, has developed a clinical-calculator to estimate the probability of achieving diabetes remission after bariatric surgery. This calculator will be very useful as a patient counselling tool in the clinics before surgery. These studies led to the publishing of important findings in the Singapore Medical Journal and Journal of Diabetes and Metabolism, and the presentation of findings at various local and international conferences.

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PERSONALISED MEDICINE THROUGH GENOMICS High cholesterol due to a single gene mutation, known as familial hypercholesterolemia (FH), is not uncommon in our population. The team led by A/Prof Tavintharan and Dr Sharon Pek, Principal Scientific Officer, CRU, have set up a national network to provide genetic testing for eligible individuals. This is followed by systematic screening of at-risk family members known as family-cascade screening. Coupled with effective cholesterol lowering treatment, this project is expected to prevent Ms Clara Tan premature coronary artery disease and stroke in our population. Separately, there are people with diabetes or obesity due to single gene mutation called monogenic diabetes and monogenic obesity respectively. The team led by A/Prof Lim Su Chi, Dr Sharon Pek Dr Ang Su Fen, Senior Scientific Officer, Ms Clara Tan, Scientific Officer, and Angela Moh Mei Chung have set up the relevant genetic testing capability to support the care of these patients.

Dr Anton Cheng Kui Seng

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SMART 2D — DATA IS POWER Through a series of highly competitive National Medical Research Council research grants, we set up the Singapore Study of MacroAnginopathy and Micro-vascular Reactivity in Type 2 Diabetes (SMART 2D) cohort in 2011, managed by Dr Keven Ang, Project Manager. The overall aim is to study the impact of diabetes on blood vessel function, major diabetes complications (diabetic foot syndrome, kidney disease & retinopathy) and several related conditions such as cognitive dysfunction and mood disorders. SMART 2D has recruited over 2000 participants with Type 2 Diabetes Mellitus (T2DM) and recalled them every three years for protocol-prescribed systematic reassessment. The cohort has thus far generated nearly 50 publications in international peer-reviewed journals. Several important discoveries have been made by our scientists — Dr Liu Jian Jun, Principal Scientific Officer; Dr Resham Lal Gurung, Senior Scientific Officer, Dr Wang Jiexun, Senior Biostatistician and Dr Serena Low, Consultant, CRU. These include ethnic disparity in the susceptibility to diabetic cardiovascular complications, novel biomarkers (e.g. urinary haptoglobin, plasma Leucine-rich a-glycoprotein, fibroblast-growth-factor 21 etc.) predictive of diabetic complications (e.g. lower limb amputations), body composition and cognitive impairment, weight gain and risk of diabetic kidney disease (DKD), propensity of

The SMART 2D team

young-onset diabetes to develop DKD and riskcalculator for DKD progression in the clinics etc. SMART 2D has established collaborations with high profile institutions, including the National University of Singapore (NUS), Genome Institute of Singapore (GIS), National Registry of Diseases Office (NRDO), the National Healthcare Group Polyclinics (NHGP) and the Wellcome Trust Centre for Human Genetics at Oxford, United Kingdom. Observations from SMART 2D have been published in renowned scientific journals (e.g. Nature Communications and Nature Genetics) and presented in conferences worldwide. In August 2019, the team won the prestigious Best Oral Presentation award at the 13th International Congress of the Asian Society Against Dementia and 6th Singapore International Neuro-Cognitive Symposium. Research teams: A/Prof Lim Su Chi (endothelial function and genetics), A/Prof Tavintharan Subramaniam (diabetic foot syndrome), Dr Allen Liu (nephropathy), A/Prof Sum Chee Fang (clinical epidemiology) and Dr Kumari Neelam (retinopathy).

DYNAMO — WORKING TOGETHER FOR KIDNEY HEALTH In 2017, recognising the increasing need for new approaches to Diabetic Nephropathy (DN), the National Medical Research Council awarded an Open Fund-Large Collaborative Grant (OFLCG) of nearly $25 million over five years to a multidisciplinary, multi-institutional team (including NUS and Duke-NUS) to conduct the Diabetes Study in Nephropathy and other Microvascular Complications (DYNAMO). DN is a devastating complication of diabetes that causes significant morbidity, mortality and human suffering. In Singapore, the incidence of DN as a cause of end-stage kidney disease is among the highest in the world. Nonetheless, its molecular pathogenesis is not well understood, and no new treatments have been introduced in nearly 20 years. Led by A/Prof Lim Su Chi, one of the DYNAMO theme Principal Investigators, the project aims to reduce diabetic kidney disease in Singapore by 30% within the next five years. It seeks to understand the disease and its complications better, so as to develop more effective methods for diabetes prevention and management.

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INNOVATION “There are three steps to building a smart hospital. Firstly, digitisation. Secondly, innovation, or giving an idea a new twist, adapting it to meet your needs, and thirdly, scaling it up so that your idea is accessible to all,” said Dr Daniel Chia, Director, Transformation Office.

Dr Daniel Chia

EPUSH — ENHANCING MANOEUVRABILITY OF HOSPITAL BEDS EPUSH controls the direction and speed of heavy hospital beds at the push of a button. The device facilitates mobility, making patient transfers hassle-free. This applies to Hill-Rom beds for YH and ArjoHuntleigh beds in the SingHealth and NUHS clusters. Project team: Ms Yen Tan, Ms Shirley Heng, Ms Low Beng Hoi, Ms Jolia Low, Mr Barcilla Aballe, Technical Officer, NTFGH, Sister Lye Siew Lin, Assistant Director, NTFGH, Mr Lim Tow Peng, Principal Engineer, NTFGH

APP-BASED OXIMETRY SYSTEM FOR PATIENTS WITH OR SUSPECTED OF OBSTRUCTIVE SLEEP APNEA (OSA) Enabled via an app, this take-home sleep test device saves patients the cost of an inpatient sleep test. The app is able to measure and transmit data to specialists, so that the specialists are able to monitor the patients without a physical meeting. Project team: A/Prof Edwin Seet Chuen Ping, Dr Cheryl Saw Jia Yu, Medical Officer, MOHH

A/Prof Edwin Seet, Head of Department, Anaesthesia, with the Anaesthesia Machine used in sleep apnea studies.

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MOBILE ADJUNCT TO PERIMETRY SYSTEM (MAPS) This mobile equipment allows the public to check their eyes for eye problems which may lead to deterioration or loss of vision. It is implemented for Glaucoma, Age-related Macular Degeneration (AMD), and Visual Acuity assessments at AdMC. Project team: A/Prof Yip Chee Chew, Dr Philemon Huang, Consultant, Visual Science and Ophthalmology Department

AEROSOL BOX FOR ENDOTRACHEAL INTUBATION AT A&E The aerosol box prevents the spread of potentially infectious droplets, protecting healthcare personnel from viruses and germs during the intubation process. Project team: A&E Department

THORACIC DRAINAGE CHAMBER STABILISERS As appropriate chest drainage is required to maintain respiratory function and haemodynamic stability, this system allows the draining of air and fluids from the lungs, and enables the expansion of the lungs, restoring negative pressure in the thoracic cavity. These stabilisers cater to seven types of hospital beds and trolley beds in YH. Project team: Sister Chin Guey Fong, Senior Nurse Clinician, Nursing Administration

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being implemented in three geographic zones of NHG including Yishun.

A BETTER TOMORROW

The UCM facilitates our implementation of the RoL. Designed to be the highest form of integrated care, the UCM guides YH and care partners in the implementation of integrated healthcare based on residents’ needs in each of the RoL’s five population segments. The model is a comprehensive map of our efforts to ensure that all residents have a One Care Plan that supports them in staying healthy for as long as possible while providing safe, dignified and valuedriven care when they need it. The UCM is a reflection of our shared vision: Adding Years of Healthy Life.

We cannot be mere witnesses to the evolution of healthcare — each of us must play an active role in shaping its future. We envision that residents, patients, families, caregivers and communities will collectively decide how healthcare will evolve and impact them. As healthcare experts, we are ready to support their needs and empower them on their journey of sustained good health and recovery.

Our journey of transforming healthcare and building a better health system in collaboration with members of our community and shared care partners has already begun. We are forging relationships with community care providers, social service organisations and grassroots organisations. On the academic front, we are partnering with local and international healthcare organisations and governments, as well as research institutes and institutions of higher learning.

The future of health and care in Yishun is centred on keeping our residents as well and healthy as possible. We will achieve this through the implementation of NHG’s RoL framework in Yishun, using YH’s UCM. The RoL framework is a master plan guiding the cluster’s holistic and dynamic approach to health. Comprising Five Segments of Care, the RoL is

Population Segments by Intensity

NHG River of Life - Yishun Health Unified Care Model One Care Plan Crisis & Complex Care

Community Care

“3 Campus Flows”

Prevention & Temp Acute Conditions

1. Acute Medical Flow

2. Living with Chronic Disease 1A.Living with Frailty & EOL (e.g. Integrated Medical Clinic, 24/7 Support)

Shared Care Partnership Office

3. Yishun Zone n = 316,210 Regional Health Teams = 6

e.g. Emergency Care & Initial Triage, Acute Medical Unit, Acute Stroke Unit

2. Acute Surgical Flow

e.g. Emergency Surgery & Trauma, Acute Hip Fracture Service

3. Elective Flow

@ Nursing Homes/Shelters 1B.Living Well (e.g. Gericare@North, Tele-G Services)

e.g. Total Knee Replacement

Episodic Care Segments

Lifelong Care Segments

Episodic Outcomes & Episodic Costs (e.g. up to 90 days) Annual Cycle of Outcomes & Annual Cycle of Costs EOL: End-of-Life Conditions

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UCM

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The provision of care that is coordinated, efficient and empowering is the ultimate solution for all shared care partnerships. In this ecosystem, a range of healthcare providers will collaborate and play a strong role in effecting appropriate care to patients, as well as empowering the population to embrace ownership of their health and play their part in preventing illness. M RS CH EW KWEE TI AN G C H IE F E XE CUTIVE OF F ICER

DIGITAL TRANSFORMATION OF OUR CARE ECOSYSTEM On 18 September 2020, YH signed an MOU with the Institute of Systems Science at National University of Singapore (NUS-ISS) to digitally transform our organisational processes and equip our staff with skills to meet the changing demands of healthcare. The collaboration is set to be the driving force behind YHâ&#x20AC;&#x2122;s move into digitally transforming its care delivery ecosystem. Here are the four digital initiatives in summary: 1. A Data-Driven Smart Health Programme A Digital Competency Training Roadmap will enable all staff to understand and appreciate the role of data, technology, and design in organisational and care model transformation. 2. Addressing and Supporting National Challenges Upskill and enable career transformation for jobseekers affected by COVID-19. 3. Pilot Projects Two pilot projects aim to identify opportunities and enhance the care journey for patients: The Artificial Intelligence (AI)

in the Customer Relationships Management project, and the Empathy and Value-Stream Mapping. 4. A Living Learning Laboratory Living Learning Laboratory will provide a platform for experimenting, developing joint research, prototypes and implementing new technology solutions â&#x20AC;&#x201D; encouraged through tailored advisory and mentorship by NUS-ISS lecturers and industry partners. It is our vision that this digital transformation will facilitate the implementation of the UCM in the long run.

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YISHUN HEALTH 2020 AND BEYOND We aspire to go beyond healthcare to health, putting people, their families and communities at the centre of their care. Residents living with multiple chronic illnesses often require long-term healthcare follow-up and regular adjustments to their care plans. Care partnerships may be coordinated by the resident’s GP or a SOC specialist, but care plans will nevertheless be co-created with the resident by all members in the partnership. This collaboration will contribute to improved outcomes valued by the resident. As teams work across conventional institutional boundaries to bring better care to patients, the Yishun Zone Registry will facilitate the sharing of residents’ updated care plan information, including medication information and caregiver support, with other members of the enlarged care team. The YH UCM will focus on building Shared Care Partnerships and One Care Plans along two major aspects of care: Lifelong Care and Crisis and Complex Care. Lifelong Care When lifelong care is done appropriately, residents are free to live their lives with passion; doing the

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things that are meaningful to them and their communities. Healthcare is minimally intrusive and fades into the background. Lifelong care begins when a person moves to the north. Residents will be grouped into five population segments — Living Well, Living with Illness, Crisis and Complex Care, Living with Frailty, and Leaving Well. They will be decisionmakers in their own wellness and care. Moving care upstream, we will expand the array of determinants of health to be addressed and study the interactions between them. Through timely health and care interventions, lifelong care will ensure residents live longer and healthier lives, minimising risks of chronic illnesses and health crises. For those already with illness or frailty, lifelong care aspires to help them live well in spite of it by early identification of potential physical health, mental health and social issues. Lifelong care is with and by people, families and partners in the community. Community-based initiatives such as Community Nurse Posts, Wellness Kampungs and Share a Pot® offer diverse health and care support to residents in the community. They aim to empower and increase the resilience of individuals and families to take ownership and manage their health.

GROWING EXCELLENCE

Crisis and Complex Care When people are suffering from the occasional healthcare crisis, or need episodic specialised care for complex medical conditions, they seek help from healthcare institutions and hospitals. We describe this as Crisis and Complex Care. We aspire to provide hassle-free care at all touchpoints. We define hassle-free care as “Doing things right for the patients and delivering value safely — from the time they enter, to the time they are discharged from the hospital.” A patient is conventionally “discharged” from the hospital when his medical crisis or complex care process is deemed complete. We will re-orientate this perspective to include recovery at home as part of the patient’s crisis or complex care process. He will not be “discharged” until he has recovered sufficient physical function and well-being to continue with his Lifelong One Care Plan. Shared care partnerships and care continuity are critical in helping people return to Living Well after a crisis. Our network of Shared Care Partnerships will support people through their transitions in and out of Crisis and Complex Care. Transitions back to Lifelong One Care Plans will focus on helping people live with their chronic illnesses without “medicalising” their lives.

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HARNESSING SCIENCE, LOVE AND WISDOM Harnessing the best of medical sciences, improvement science, innovation and new technologies, we will enhance health and care outcomes that are meaningful to people. We will continue to listen to our patients and meet their needs for a hassle-free experience that is delivered with love and wisdom; we will sustain our efforts in driving care standardisation and harnessing value-driven care methodologies to continuously improve crisis and complex care outcomes to match global standards, delivered at the best possible value to our patients and the nation. We will continue to develop new skills — from caring for patients in a hospital environment, to incorporating Asset Based Community Development and strength-based approaches, to enabling the formation of supportive social networks and health-giving ecosystems for residents to celebrate joy in life. The future of our health system springs from the foundations we have built over the past decade while continuously learning and adapting and improving. The relentless pursuit to become more peoplecentred, community-centred and better at what we do will help us to build on our foundations and drive us towards excellence.

Some members of the Yishun Health Senior Management team. From left: Mrs Chew Kwee Tiang, A/P Pek Wee Yang, Ms Yen Tan, Mr Donald Wai, Ms Cheong Choy Fong, A/P Phoa Lee Lan, A/P Tan Kok Yang, A/P Terence Tang, A/P Wong Moh Sim, Dr Wong Sweet Fun, Mr Roger Leong, Ms Shirley Heng

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A W A R D S 2012 2010 TO 2020

BCA Construction Excellence Award — Institutional Buildings Category Health Promotion Board — Singapore Health Award (Platinum)

2010 Singapore Institute of ArchitectsNational Parks Skyrise Greenery Awards — 1st Prize

2011 President’s Design Award — Design of the Year Singapore Institute of Architects Design Awards for Healthcare Facility Singapore Institute of Architects — Building of Year FutureGov Awards — Healthcare Organisation of the Year Landscape Industry Association (Singapore) ■ Gold Award and Best of Category, Implementation, Commercial ■ Silver Award (Turnkey) for Yishun Pond

2013 Global Centre for Healthy Workplaces — Global Healthy Workplace Award (Large Enterprise) Most Innovative Project / Policy Award (Gold) — PS21 Excel Awards & Convention, Ageing-In-Place (AIP) Programme

T H E F U T U R E STA RTS TODAY

2015 PUB Watermark Award

2016 National Healthcare and Productivity (HIP) Medal — Best Practice Medal in Workforce Transformation, Nurse-led Perioperative Care for Cataract Surgery under Topical Anaesthesia

National Parks Board’s Landscape Excellence Assessment Framework (LEAF) — Certificate of Recognition for Development Projects with Outstanding Greenery

2017

Taiwan Ministry of Health and Welfare (Health Promotion Administration)

Ministry of Environment and Water Resources — The President’s Award for the Environment

International EnvironmentFriendly Hospital Team Work Best Practice Award

United States Green Building Council (USGBC) and International Living Future Institute (ILFI) — Inaugural Stephen R. Kellert Biophilic Design Award Winner

2014

Ministry of Health — Singapore HEALTH Award iF Social Impact Prize — Share a Pot®

International Rooftop Landscaping Association — World Best Green Roof Award 2011

BCA Green Mark Award for Buildings — Platinum for Yishun Community Hospital (YCH) under Healthcare Facility Category

Ministry of Health, National Health IT Excellence Awards, IT Excellence: Beyond Hospital to Community, GeriCare (TeleGeriatrics)

Building and Construction Authority (BCA) Award — Universal Design Gold Award

Public Utilities Board (PUB) Water Efficient Building (Hospital Sector) — Gold Certificate

MIPIM Asia Awards 2011 — Silver

Ministry of Manpower — Work-Life Achiever Award

National Healthcare and Productivity (HIP) Medal ■ Best Practice Medal in Workforce Transformation, Community & Home Eye Screening Service (CHESS) ■ Best Practice Medal in Care Redesign, Integrated Hip Fracture Unit

Design & Health International Academy Award 2011 — International Health Project (over 40,000m2)

United Nations Public Service Award — Ageing-In-Place (AIP) Programme

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H I G H E ST ACCO L A D E S FO R O U R P E O P L E

2018 Singapore Environmental Council — Singapore Environmental Achievement Award (Public Sector)

2019 Seoul Design Foundation — Human City Design Award — PHCT Wellness Kampung Asian Hospital Management Award ■

■

Gold Award, Facility Management and Financial Improvement Project — A Health-Promoting Medical Facility, AdMC Bronze Award, Community Involvement Project — Community & Home Eye Screening Service (CHESS), Ophthalmology and Visual Sciences

Asian Elderly Care Awards (AECA) 2019 ■

■

Gold Award — Excellence in Brand Building and Marketing — Share a Pot® Gold Award — Most Creative Community Partnership — Intergenerational programmes Gold Award — Excellence in Day-Care / Home Care or Stay-in Services — Community Nursing in the North Gold Award — Best in Healthy and Active Ageing Services Excellence Award — Outstanding Innovations in Health Education — Mini Medical School

International, Regional and National Awards Received for Our Institution 2010 to 2020

The President’s Award for Nurses 2008 Mdm Chua Gek Choo Deputy Director, Nursing, Alexandra Hospital

■

The President’s Award for Nurses 2014 Nursing Administration ■ Ms Sim Lai Kiow, Nurse Clinician President’s Award for Nurses 2015 Nursing Administration ■ Ms Velusamy Poomkothammal, Assistant Director, Nursing National Medical Excellence Award (NMEA) 2016 National Outstanding Clinician Educator Award ■ A/Prof Pang Weng Sun, CMB Distinguished Senior Clinician Award (DSCA) 2016 ■ A/Prof Sum Chee Fang, Senior Consultant, Diabetes National Medical Excellence Award (NMEA) 2017 Distinguished Senior Clinician Award ■ Prof Wilfred Peh, Head and Senior Consultant, Diagnostic Radiology National Medical Research Council 2017 Clinician Scientist Award, Investigator Category ■ A/Prof Lim Su Chi, Clinical Director, CRU President’s Award for Nurses 2018 ■ Ms Shirley Heng, Deputy Chief Nurse, Nursing Administration Public Sector Transformation Awards 2018 Distinguished ExCEL Innovation Champion ■ A/Prof Philip Yap, Senior Consultant, Geriatric Medicine ExCEL Innovative Project Award ■ Community & Home Eye Screening Service (CHESS) National Medical Excellence Award (NMEA) 2018 National Outstanding Quality Outstanding Clinician Award ■ A/Prof Wong Moh Sim, Deputy CMB Public Sector Transformation Awards 2019 Exemplary Leader ■ Mdm Chua Gek Choo, Nursing Director, YCH Exemplary Innovator ■ A/Prof Yip Chee Chew, Head and Senior Consultant, OVS National Medical Excellence Award (NMEA) 2019 Distinguished Senior Clinician ■ A/Prof Chin Thaim Wai, Senior Consultant, Orthopaedic Surgery Public Sector Transformation Awards 2020 Exemplary Leader ■ Dr Wong Sweet Fun, Chief Transformation Officer & Deputy CMB Exemplary Innovator ■ Dr Daniel Chia, Director, Transformation Office (3 Jan 2012 to 30 Sep 2020), Director, CRU (1 Oct 2020) National Medical Excellence Award (NMEA) 2020 National Outstanding Clinician Award ■ A/Prof Sum Chee Fang, Senior Consultant, General Medicine

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T H E F U T U R E STA RTS TODAY

WITH AP PR E C I ATI O N We would like to extend our special thanks to the following individuals who went the extra mile to support us â&#x20AC;&#x201D; from pointing us to the right information to coordinating various production work. Your contributions made this book possible.

Alice Leong

Javier Po

Anuja Karve

Joycelyn Yip

Benjamin Yeo

Kendrick Tan

Bob Lee

Kong Ka Hei

Chok Se Ho Francis

Lee Meow Li

Citra Dianti Binte Sonarno

Lim Hui Yee

Cyndi Ho

Lim Siao Ee

A/Prof Edwin Seet

Mark Lim

Edwin Tan Ying De

Melinda Lee

Farhan Bin Amin

Mohammad Karyantoh Bin Osman

Florence Cher

Ng Su Yee

Florence Chng

Dr Ng Yeuk Fan

Izzah Inani binte Abd Rahim

Oon Thian Soon

James Ding

Rachel Tan

Jamilah Bte Hussin

Rohaizah Binte Md Derus Rosalind Wee Sim Ai Ling Stanley Oh Tan Lay Cheng Wong Li Ching Zabina Binti Musthafa

GROWING EXCELLENCE

RE F E R E N C E S A Healing Space: Creating biodiversity at Khoo Teck Puat Hospital. (2016). Singapore: Khoo Teck Puat Hospital, Alexandra Health. AHA Jan-Feb 2020. (2020). Retrieved April 1, 2020, from https://www.ktph.com.sg/uploads/aha/ documents/13031_AHA%20Jan-Feb%202020.PDF AHA Jul-Aug 2019. (2019). Retrieved December 1, 2019, from https://www.ktph.com.sg/uploads/aha/ documents/12888_AHA%20Jul-Aug%202019%20Nurses%20Day%20Special%20Edition.pdf AHA Jul-Aug 2020. (2020). Retrieved September 1, 2020, from https://www.ktph.com.sg//uploads/ aha/documents/13153_AHA%20Jul-Aug%202020.pdf AHA May-June 2018. (2018). Retrieved December 1, 2019, from https://www.ktph.com.sg/uploads/ aha/documents/12402_AHA%20May-Jun%202018.pdf AHA May-June 2019. (2019). Retrieved December 1, 2019, from https://www.ktph.com.sg/uploads/ aha/documents/12851_AHA%20May-Jun%202019.pdf AHA Sep-Oct 2018. (2018). Retrieved December 1, 2019, from https://www.ktph.com.sg/uploads/ aha/documents/12535_AHA%20Sept-Oct%202018.pdf Alexandra Health System, The Little Hospital That Could — The Transformation Story of Alexandra Hospital. Singapore: Alexandra Health System, 2017. Annual Report 2014-2015. (2015). Retrieved December 1, 2019, from https://www.ktph.com.sg// uploads/report/documents/11524_AHS_Annual_Report_2014-15.pdf Annual Report 2015-2016. (2016). Retrieved December 1, 2019, from https://www.ktph.com.sg// uploads/report/documents/11524_AHS_Annual_Report_2015-16.pdf Annual Report 2016-2017. (2017). Retrieved December 1, 2019, from https://www.ktph.com.sg// uploads/report/documents/11862_AHS%20Annual%20Report%20FY%202016-2017.pdf Annual Report 2017-2018. (2018). Retrieved December 1, 2019, from https://www.ktph.com.sg// uploads/report/documents/12683_Yishun%20Health%20AR2017-2018.pdf Annual Report 2018-2019. (2019). Retrieved December 1, 2019, from https://www.ktph.com.sg// uploads/report/documents/12996_Yishun_Health_Annual_Report_2018_2019.pdf Lau, J. (2019). Seeking Sustainability: The Khoo Teck Puat Hospital Experience. Singapore: Khoo Teck Puat Hospital. Liak Teng Lit, Medical Services in Singapore, Accession Number 003867, Reels 19-20 & 22-25 [Interview]. National Archives of Singapore. (2014, December 04). Retrieved June 15, 2020, from https://www.nas.gov.sg/archivesonline/oral_history_interviews/recorddetails/c268808e-ac1f11e4-859c-0050568939ad Liker, J. K. (2003). The Toyota Way. New York: McGraw-Hill. NHG Corporate Yearbook — Adding Years of Healthy Life. (2019). Retrieved December 1, 2019, from https://corp.nhg.com.sg/Lists/Corporate%20Year%20Book/Attachments/67/NHG%20 Yearbook%202019%20Lowres%20Single1.pdf The Five Pillars of Health. (2017). Singapore: Khoo Teck Puat Hospital.

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