Mr Chia Oh Chang doing simple leg exercises with the assistance of his helper, Ms Ihat Kuslihat. The 88-year-old was pleased at being able to receive care at home for cellulitis, a bacterial skin infection, said his son. PHOTO: LIANHE ZAOBAO
Team at hospital assesses and identifies those who can recover safely elsewhere
The Straits Times (7 February 2026)
A geriatric team at the
emergency department of Tan Tock Seng Hospital (TTSH) has helped 723 frail seniors avoid unnecessary acute hospital admissions in the past year, up from 191 seniors the year before.
These seniors received care either at home, in a short-stay ward or in a rehabilitation ward. A small number were deemed to be in a safe condition to be discharged back home, with support.
Dr Bao Minfang, the consultant leading the service known as Emergency Department Interventions for Frailty (EDIFY), said the 723 senior patients did not require readmission within 72 hours, which showed that they had been safely diverted to the right care. The seniors’ treatment also lasted for a shorter duration than if they had been admitted to an acute hospital ward.
They avoided an average of 1.6 to 8.5 days of hospitalisation with the service, which meant they collectively spent 4,000 fewer days in hospital in the past year, said Dr Bao.
She said this reduced their exposure to unfamiliar environments and hospitalisation-related risks such as delirium, functional decline and infections.
This is particularly significant, as more than 95 per cent of the patients the team helped under EDIFY were aged 85 and above. It has also helped to alleviate the strain on the busy public hospital’s limited bed capacity.
EDIFY is led by an
advanced practice nurse (APN), who works closely with geriatricians, emergency doctors, geriatric emergency management nurses, pharmacists and physiotherapists to care for the patients. If a patient can avoid admission, the APN will communicate that to him and his family members.
The EDIFY team links emergency care to alternative care outside acute ward stays. Traditionally, in the emergency department (ED), elderly patients are assessed by a doctor there, who will determine the need for geriatric admission. At TTSH, the EDIFY team intervenes after the senior is screened by a geriatric emergency medicine nurse for frailty and before he is warded. The APN then conducts a comprehensive geriatric assessment to identify those who can avoid routine ward admission and recover safely elsewhere.
The EDIFY service started in 2017 but was slow to take off, as awareness was low and the pathways were limited – patients could be sent either home with support or to rehabilitation care in the community.
The hospital-care-at-home option,
TTSH@Home, became more common in 2024, after it became part of Singapore’s mainstream healthcare landscape in April that year, with patients getting subsidies, insurance and MediSave coverage the same way they would if they were admitted to an acute ward.
And, in October 2025, TTSH added another option under EDIFY – a six-bed geriatric short-stay ward for seniors who require closer monitoring for up to 72 hours. As Singapore’s population ages, public hospitals’ EDs are seeing growing numbers of older adults presenting with falls and complex medical needs. TTSH, in particular, has one of the busiest EDs in Singapore, with one-third of its ED attendances comprising patients aged 65 and over.
Dr Bao said she saw the need for an emergency triage service to help seniors avoid unnecessary stays. But she noted that family members are often the ones who need convincing. “The traditional mindset is that ‘I am at the ED to seek help, of course I have to be warded’. The patients, and mostly the family members, feel that it is safer this way,” she said. She wants to change this mindset because hospital stays are not always the best for every senior who is ill, as seniors sometimes run the risk of becoming more ill there. For Mr Chia Oh Chang, who is 88 and has moderate dementia with behavioural disturbances, being able to receive care at home for cellulitis, a bacterial skin infection, was a godsend.
His son, Mr Chia Sok Chuan, 55, said his father was very pleased with the option, as he preferred the comforts of the home he now shares with only his Indonesian helper, after his wife died in 2025. When the senior Mr Chia was hospitalised for another issue in 2025, he wanted his helper to remain by his side round the clock. Ms Ihat Kuslihat, 43, said she slept there to accompany him. At home, she can cook the food he enjoys and help him with exercises that were taught by a physiotherapist, while a nurse comes by to administer his treatment. Dr Bao said TTSH is now developing an artificial intelligence screening tool in-house to help screen seniors at the ED.
The hospital has also shared its EDIFY model with other hospitals in the same health cluster, and Woodlands Hospital has put in place a similar care model.