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Home > About TTSH > TTSH News > Ng Teng Fong Centre for healthcare innovation opens up Singapore's healthcare to the world

Largest purpose-built healthcare innovation centre (25,000 sqm ) features System Innovations, Living Labs, Expert Knowledge Networks and Tools to spur new ways to deliver care

Singapore, 9 May 2019 – A workforce of skilled healthcare professionals that embraces change while constantly adapting to bring about better care outcomes as well as keeping pace with the evolving healthcare system. This is the transformation that the newly-opened Ng Teng Fong Centre for Healthcare Innovation aims to bring about for Singapore healthcare. The Centre is one of nine new and exciting developments under the HealthCity Novena Master Plan 2030, launched by Minister for Health in 2013. It is home to the Centre for Healthcare Innovation or CHI hosted by Tan Tock Seng Hospital. Mr Gan Kim Yong, Minister for Health, officiated the opening of the Ng Teng Fong Centre for Healthcare Innovation today.

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"The Ng Teng Fong Centre for Healthcare Innovation aims to be the place for healthcare professionals and partners to bring their thoughts, their ideas and their passion, and together turn possibilities into real world solutions. At CHI, we take a systems-based approach to Healthcare Innovation through our CHI Innovation Cycle, starting with care redesign to optimise outcomes and value for patients; then applying technologies to enable the process; and redesigning better jobs for our workforce. This continuous innovation approach enables sustainable change in healthcare by testing future models of care, with the use of new technologies and the transformation of our workforce. Since 2016, CHI has grown into Singapore's largest co-learning healthcare innovation network of 37 local and overseas partners; an open innovation centre to empower healthcare professionals and our innovation partners to co-create the future of healthcare from ideation to innovation to implementation," said Adjunct Professor Eugene Fidelis Soh, Chairman, CHI Co-Learning Network, and CEO, Tan Tock Seng Hospital & Central Health.

Unveiled today at CHI Innovate 2019 are three innovation game changers to give our healthcare institutions the edge in care transformations:

SMART HOSPITAL: COMMAND, CONTROL & COMMUNICATIONS (C3) SYSTEM

The state-of-the-art Command, Control and Communications (C3) system, developed by TTSH and the Integrated Health Information Systems (IHiS) and supported by the Ministry of Health (MOH), is set to transform healthcare operations to manage resources efficiently, support operational decisions, optimise patient flow and respond effectively to ground situations. Much like an airport control tower, the C3 system will be the "brain" of the Smart Hospital. It:

  • Integrates multiple systems and sensors to provide real time visualisation of ground operations and resources;
  • Predicts and forecasts resource utilisation and choke points that may result in longer waiting times; and
  • Coordinates patient and supplies flows to optimise care for patients.

The C3 system is at pre-production stage at the newly-opened TTSH Operations Command Centre located at CHI. The first phase will start with streaming data from various operational systems to give a comprehensive overview of a hospital's operations in real-time, providing operational visibility. It will progressively use advanced analytics to generate actionable insights to provide situational sensing so that the hospital can better pre-empt and act in advance of situations before they occur. Developed using an agile approach, the C3 System is set to go live progressively from third quarter 2019 to support daily operations, making TTSH the first Smart Hospital enabled by C3.

The continuing development of the C3 System will enable real-time coordination with upstream pre-hospital care (e.g. ambulances) and downstream community partners (e.g. Community Hospitals) in our Regional Health System. The C3 System will be built on a common infrastructure and will eventually be scalable to other public hospitals for national capacity and emergency response management. (Refer to Annex A for more info.)

KNOWLEDGE MANAGEMENT - CHI LEARNING & DEVELOPMENT (CHILD) SYSTEM

To facilitate cross-organisation access to information and knowhow, CHI will host an open knowledge repository of healthcare best practices, project reports and learning experiences so that the search for knowledge can be across walls and borders. Funded by MOH and strongly backed by CHI's network of partners, which includes IHiS, healthcare clusters and overseas experts, this national knowledge management system will enable healthcare professionals and partners to research, initiate conversations and form communities of practice to actively ask, share, learn and build on the collective knowledge and experiences. Learning cycles can hence be shortened with these exchanges and duplication of work avoided. The linking of organisations, sectors, countries and cultures can contribute to better coordination and more collaborations in healthcare innovation and improvement to tackle challenges together. This portal will go live by end of 2019, featuring as a start some 500 curated innovation projects from different healthcare institutions and agencies. The full features of the platform will be fully stacked by mid-2020. (Refer to Annex B for more info).

LEARNING & EXPERIMENTAL ENABLING SPACES

The CHI Living Lab (CHILL) is an onsite facility that actively supports the translation of ideas into prototypes for testing. It is a space that innovates process, enhances patient care and experience through service design, as well as prototypes physical and digital products to support health and care. This makerspace will connect innovators with resources – there are designers, consultants, engineers, programmers, researchers and medical technologists to help work ideas out, and tools such as a 3D printer to develop prototypes and proof of concept. CHILL's core partners include TTSH's Kaizen Office for Prototyping and Service Design; NHG's Centre for Medical Technologies Innovation (CMTi) and TTSH's Clinical Research & Innovation Office for medtech development; and NHG-LKCMedicine's Games for Healthcare Innovations Centre and TTSH's Serious Games Unit for the development serious games in healthcare and clinical education. CHILL made recent headlines by collaborating with Nanyang Polytechnic and Phillips Healthcare on the FUSA Geriatric Chair that was showcased at Singapore Design Week 2019.

Beyond the living lab, new products and care solutions can be discussed, experimented with and improved on at the CHI Innospace (a co-creation space with video technology, configurable walls and layouts) and later refined at the high-fidelity SIMTAC (Simulation & Integrated Medical Training Advancement Centre) for test-bedding by users in simulated environments. The CHI Innocanvas is an experiential learning space for users to shift mindsets and experience first-hand future innovations in our health system by walking the journey from hospital to the community in the shoes of a patient, caregiver or healthcare provider.

CO-LEARNING TO INNOVATE HEALTHCARE & TRANSFORM THE WORKFORCE FOR THE FUTURE

Driving healthcare innovation at CHI is a thought leadership network committed to share and open up knowledge across organisations and borders. The CHI Co-Learning Network, hosted by TTSH, is a strategic alliance of 37 organisations, committed to be the ground-up think-tank for healthcare in Singapore, to drive the pursuit of value through innovation and workforce transformation. They include international and local healthcare partners, academic partners, strategic agencies, industry knowledge partners, and community partners. The CHI Innovate 2019 Conference is an annual commitment by the Network to promote open co-learning and to connect people in healthcare innovation. (Refer to Annex C for Fact Sheet on the CHI Co-Learning Network).

In conjunction with the CHI Innovate 2019 is the presentation of the 2019 National Healthcare Innovation and Productivity (NHIP) Medals. Supported by the Ministry of Health and managed by CHI, the third instalment of this award ceremony celebrates seven winners out of 51 projects which achieved excellence in Care Redesign, Automation, IT and Robotics Innovation, and Workforce Transformation. The NHIP Medals are sponsored by the Ng Teng Fong Healthcare Innovation Programme. (Refer to Annex D for Fact Sheet on NHIP).

On the side of the CHI Innovate 2019 on 10 May 2019, TTSH will also launch the Centre for Allied Health and Pharmacy Excellence (CAPE). CAPE marks the start of a new strategic journey in transforming the Allied Health and Pharmacy Professionals through innovation, training and health-social care integration. As our population ages, Allied Health Professionals and Pharmacists are increasingly required to work in a more integrated and collaborative style and deliver care beyond institutional walls into the community. The current model of care in the hospital where one patient can be attended to by an army of healthcare professionals would not be practical or sustainable for care in the community. In recognition of the need to change, CAPE is set up to collaborate, co-learn, and co-create with partners across health and social sectors, to build thought leadership and capabilities in three key areas for Allied Health and Pharmacy Professionals: Community Care (where care can be effectively delivered in homes and community), Trans-Disciplinary Care (where the different professions learn specific competencies of one another's disciplines to cross-care for patients reducing the need for multiple referrals), and Technology-Enabled Care (where staff and patients are empowered with innovative technologies to work and take ownership of their care more confidently and efficiently in the community).

Kick-starting this journey is a collaboration between CAPE, TTSH's Centre for Asian Nursing Studies (CANS), and the Singapore Institute of Technology (SIT) to co-develop courses to equip Community Healthcare workers to acquire transdisciplinary clinical skills competencies in holistic management of residents in the community across the care continuum.

The Ng Teng Fong Centre for Healthcare Innovation is proud to host CHI's collaborating centres: CAPE, CANS and Centre for Health Activation (CHA). CANS was established in 2016 to generate nursing thought leadership that is uniquely Asian focused. It spearheads nursing research, innovation and education across local and overseas healthcare institutions in the region. Launched in 2017, CHA serves to activate patients, caregivers and volunteers in care. The three collaborating centres add to the ecosystem at CHI to drive healthcare innovation and workforce transformation.

The Ng Teng Fong Centre for Healthcare Innovation is linked on one side to the Tan Tock Seng Hospital and on the other side to the Lee Kong Chian School of Medicine. Symbolically bridging the current and future healthcare workforce, this 9-storey purpose-built conference, learning and innovation building is the first in Singapore to be well-armed with comprehensive facilities and tools for innovation and more importantly, with the strategic connections for healthcare professionals to dare to think out of the box and experiment with new ways to deliver better care together.

About Centre for Healthcare Innovation

The Centre for Healthcare Innovation (CHI) is an open innovation centre that comprises three important levers:

  1. Co-Learning Lever: CHI Co-Learning Network of 37 innovation partners
  2. Financial Lever: $52-million Ng Teng Fong Healthcare Innovation Programme
  3. Physical Lever: 25,000sqm Ng Teng Fong Centre for Healthcare Innovation

The Centre for Healthcare Innovation (CHI) Co-Learning Network was launched in October 2016 and brings together diverse yet synergistic innovation partners. Hosted by Tan Tock Seng Hospital, the network has three strategic thrusts to drive healthcare innovation: Build Thought Leadership, Drive Workforce Transformation, Enable Healthcare Training. The Network is founded on the concept of Co-Learning – the idea that we learn better together as a Community of Practice. We are an open learning platform, an ecosystem of value-enabling alliances. Through our network, like-minded local and overseas innovation partners will co-learn and collaborate by co-building thought leadership in healthcare innovation, co-transforming the workforce for our future, and co-developing new training and andragogy. We will meet current and future healthcare challenges through innovative and value-driven care delivery to the populations we serve.

The CHI Co-Learning Network is enabled by our financial lever, the $52-million Ng Teng Fong Healthcare Innovation Programme that funds and supports healthcare innovation in collaboration with its partners through three tracks - Training, Innovation and Community Enabling. The programme is managed by the TTSH Community Fund and has to date funded 93 projects. The programme is the proud sponsor of the National Healthcare Innovation & Productivity (NHIP) Medals.

The Ng Teng Fong Centre for Healthcare Innovation (CHI) is an exciting 9-storey conference, training and innovation building that aims to transform our healthcare workforce to be future-ready. At 25,000 sqm, it is Singapore's largest purpose-built innovation centre with MICE facilities, simulation and innovation labs and engagement spaces.

​The C3 (Command, Control & Communications) system marks a new milestone in TTSH's journey towards innovation in hospital operations. Before 2008, bed allocation was a very manual process, which relied largely on coordination via pen, paper and phone. Since then, bed allocation in TTSH has evolved, first with the implementation of RFID tagging in TTSH, which allowed us to automate admission and discharge workflows, as well as identify the location of patients in real time.

In 2012, TTSH implemented an algorithm-based decision support bed allocation system, incorporating more than 350 clinical and optimisation rules to ensure that critically ill patients are admitted first, and that the right bed is allocated to the right patient the first time. This helped to reduce overflows, transfers and rework.

With C3, TTSH is now moving away from the segregated approach to command and control functions that have been evolving with the expansion of the hospital. It brings together all the key operational voices into a single command and control centre – the TTSH Operations Command Centre sited at the newly opened Ng Teng Fong Centre for Healthcare Innovation.

Developed by TTSH and the Integrated Health Information Systems (IHiS) and supported by the Ministry of Health (MOH), C3 enables the streaming of data from various operational systems to give a comprehensive overview of a hospital's operations in real-time, providing operational visibility. This will enhance the use of advanced analytics to generate actionable insights to provide situational sensing so that the hospital can better pre-empt and act in advance of situations before they occur.

Coupled with simulation capabilities of different scenarios and an AI-empowered decision support, the C3 System will allow TTSH to better manage patient flow and optimise hospital resources. It will significantly raise the hospital's ability to manage day-to-day operations and in times of outbreak or civil emergencies, manage the hospital's response.

The C3 System is currently in pre-production phase and will go live progressively from third quarter of 2019. It will be built on a base infrastructure and will be progressively scaled to the other public hospitals over the next few years. The C3 System will also be integrated within the Regional Health System to allow a more seamless care experience as patients move across care settings such as from the pre-hospital phase to the acute hospital to the community hospital.


​Healthcare delivery is complex – it involves multiple institutions with different roles, functions, agendas and decision-making processes; there is whole diverse network of interactions in an evolving environment, and multiple concurrent activities. Outcomes are hence unpredictable, from each institution and the system as a whole. We need to be able to embrace these complexities in healthcare, and one way by doing so, is to learn from one another's knowledge and experiences.

Today, institutions rely mainly on learning visits, meetings and local conferences for the diffusion of knowledge. This is much untapped knowledge residing in each institution. We need a better mode of doing, learning and sharing.

The CHI Learning and Development (CHILD) System is an online open co-learning platform that captures and enables the access, transfer and application of knowledge across healthcare institutions. It is guided by social learning strategies and features a live, central repository of information on best practice stories, ongoing projects, tools and event updates across healthcare institutions and professions. Healthcare professionals all over the world will be able to form and join communities of practice (COPs) on this portal and actively share and learn knowledge and experiences.

With CHILD, the exchange and creation of knowledge will accelerate across time and space. Hosted by CHI, this platform is funded by the Ministry of Health and strongly backed by CHI's network of 37 partners. CHILD will go live by end of 2019, featuring as a start some 500 curated innovation and improvement projects from different healthcare institutions and agencies. The full features of the platform will be fully stacked by mid-2020. A whole new world of doing, learning and sharing in healthcare will soon be opened to healthcare professionals and institutions to better embrace complexities together.


International Partners: 

  • Haelo, Salford Royal NHS Foundation Trust
  • Imperial College Healthcare NHS Trust
  • Oxford Centre for Triple Value Healthcare Ltd
  • Qulturum - Region Jönköping County, Sweden
  • Ribera Salud Group
  • Routine to Research (R2R) Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
  • South West Academic Health Science Network

Healthcare Partners: 

  • National Healthcare Group
  • National University Health System
  • Singapore Health Services

Academic Partners: 

  • Lee Kong Chian School of Medicine
  • Nanyang Polytechnic
  • Singapore Institute of Technology

Strategic Agencies: 

  • A*ccelerate
  • Agency for Integrated Care
  • Design Singapore Council
  • Enterprise Singapore
  • Integrated Health Information Systems (IHiS)
  • Institute of Adult Learning (SUSS)
  • MOH Holdings Healthcare Leadership College (HLC)
  • NTUC Learning Hub
  • Singapore Biodesign
  • Workforce Singapore (WSG)

Industry Knowledge Partners: 

  • Johnson & Johnson
  • NEC Laboratories
  • Philips Singapore
  • PWC
  • Workplace by Facebook

Community Partners: 

  • AWWA
  • Dover Park Hospice
  • Kwong Wai Shiu Hospital
  • NTUC Health
  • Ren Ci Community Hospital
  • St Luke's Eldercare
  • Thye Hua Kwan Moral Society
  • TOUCH Community Services
  • Tsao Foundation

WINNING PROJECTS:

AWARD NAME OF INSTITUTION PROJECT TITLE
Excellence Champion MedalNational Healthcare Group PolyclinicsNHGP Teamlet Care Model: A Redesign of Chronic Care Delivery
Automation, IT and Robotics Innovation (AIR) Best Practice MedalTan Tock Seng HospitalDisruption through Digitisation and 3D-Printing
Automation, IT and Robotics Innovation (AIR) Best Practice MedalTan Tock Seng Hospital & ST HealthcareBuilding a sustainable and resilient value-based supply chain through innovative supply chain models and technology advancements
Care Redesign (CR) Best Practice MedalTan Tock Seng Hospital Delivering Integrated Care for Hip Fracture Bundled Patients from Acute to Community Hospitals and Post-discharge Community Services, through Value Stream Mapping
Care Redesign (CR) Best Practice MedalNational University Cancer Institute, Singapore (NCIS)NCIS Nurse-Led De-escalation of Vital Signs Monitoring
Workforce Transformation Best Practice MedalSingapore General Hospital (SGH)Transforming SGH's Surgery Scheduling Process to Enhance Patient Satisfaction & Operations Efficiency
Workforce Transformation Best Practice MedalNational Healthcare Group Diagnostics (NHGD)Transformation of Primary Healthcare Laboratories using Technologies

Supported by the Ministry of Health, the annual National Healthcare Innovation and Productivity (HIP) Medals provide an opportunity for Healthcare and Community Care institutions to acknowledge, showcase and celebrate excellence in healthcare innovation and productivity.

The Medals recognise teams who achieved excellence in three award categories:

  • Care Redesign
  • Automation, IT and Robotics Innovation
  • Workforce Transformation

The National HIP Medals are sponsored by the Ng Teng Fong Healthcare Innovation Programme (NTF HIP) and managed by the Centre for Healthcare Innovation. The NTF HIP aims to drive healthcare innovation to benefit and enhance the health of patients and population through the sponsorship of innovation projects, training and development, and community enabling programmes.

The call for applications took place between 8 Nov 2018 to 9 Jan 2019.

Eligibility Criteria 

Applications were open to all Singapore-based Healthcare and Community Care providers. Team-based projects submitted must have demonstrated at least six months of improved productivity through time savings for staff, cost savings, cost avoidance, improved care outcomes, etc.

Project implementation and data collection with analysis must have taken place between 1 January 2016 and 30 June 2018.

EVALUATION

51 submissions from over 19 organisations were received. They were assessed by an evaluation committee whose members were:

  • Dr Benjamin Koh (Chair)
    Deputy Secretary (Development), Ministry of Health
  • A/Prof Low Cheng Ooi
    Chief Medical Informatics Officer, Ministry of Health and Chief Clinical Informatics Officer, IHiS
  • A/Prof Kenneth Mak
    Deputy DMS (Health Services Group), Ministry of Health
  • Mr Robert Chew
    Chairman, Silver Industry Standards Committee, Enterprise Singapore
  • Mr Ted Tan
    Deputy Chief Executive, Enterprise Singapore
  • Ms Susan Niam
    Chief Allied Health Officer, Ministry of Health
  • Ms Jeanne Liew
    Principal and Chief Executive, Nanyang Polytechnic

The submissions were assessed on the following criteria:

  • Problem definition
  • Project definition and scope
  • Quality of project idea/ concept
  • Innovation
  • Impact
  • Sustainability
  • Learning value
  • Presentation

Seven winning projects were selected – two Best Practice Medals from each category and an overall Excellence Champion Medal. The latter would need to have demonstrated exceptional innovation and productivity in more than one award category.

EXCELLENCE CHAMPION MEDAL
National Healthcare Group Polyclinics 
Project title - "NHGP Teamlet Care Model: A Redesign of Chronic Care Delivery"

Our primary healthcare system faces significant challenges from the growing prevalence of chronic diseases in Singapore. Increased disease complexity and growing patient numbers mean that there is higher demand on resources. One key problem faced previously was the episodic and reactive provision of chronic care which led to low care continuity. A redesign of how we managed patients with chronic conditions was therefore imperative for long-term sustainability.

The NHGP teamlet care model is anchored on relationship-based healthcare and is customised based on the patient's medical conditions. The care model leverages on technology, is sustainable and has been implemented in all NHG polyclinics. An IT dashboard was developed for teamlets to regularly track the outcomes of their patient panel, facilitating quality improvement. Patients with care needs were proactively identified and approached for health screening tests.

IMPACTS:

  • The first teamlet was piloted in Toa Payoh Polyclinic in 2015. The development and implementation of the care model took place over three years and has been implemented in all six NHG polyclinics, empanelling about 120,000 patients.
  • There was a significant reduction in the proportion of Teamlet patients who had poor control of diabetes (HbA1c <9%).
  • A significantly larger proportion of Teamlet patients underwent Diabetic Foot Screening and Diabetic Eye Screening. A significantly higher uptake was also seen for cancer screenings like Pap Smear and Mammogram.

Teamlet Care patients made significantly fewer doctor visits while having more Care Manager visits.

AUTOMATION, IT AND ROBOTICS INNOVATION (AIR) BEST PRACTICE MEDAL
Tan Tock Seng Hospital (TTSH) 
Project title - "Disruption through Digitisation and 3D-Printing"

As the only Prosthetics & Orthotics (P&O) Service in Singapore, the TTSH team was faced with limited resources to manage the current and immediate challenges ahead. There is an increasing national workload with increased incidence of lower extremity amputation and stroke needing customized prostheses and orthoses. Long wait times mean patient care was affected, impacting recovery and improvement rates.

One of the key strategic thrusts was to adopt new or emerging technologies to customise fabrication methods. By using available 3D scanners & Computer-Aided design software, the team was able to capture & manipulate a 3D image of a patient's body part. This has enabled them to digitize their otherwise conventional process of manually using plaster-of-paris casting and modifying it by hand. The digital image can be further optimized before it is 3D-printed using additive manufacturing. Overall, digitalisation solves challenges such as manpower and scalability.

IMPACT:

  • Digitisation process with 3D manipulation brings better value to patients as the design can be further augmented with complex architecture and geometry for greater comfort, and or varying thickness at different parts of the orthoses to improve strength and durability. This was not possible with the conventional methods.
  • Previously, 8 technicians were needed to fabricate 1024 jobs in a year. Now, 6 technicians can fabricate 1152 customized jobs in a year. With the savings in manpower, technicians were put through Job Redesign to up skill them to perform simple clinical tasks such as device repairs for walk-in cases and fitting off-the-shelf products.
  • This helped to shorten waiting time from 9-12 weeks to 1-4 weeks, improving clinical outcomes with earlier delivery of customized devices to patients.
  • Barriers of entry such as high costs of infrastructure and recruitment of specialised workforce have also been lowered for other hospitals to start their own P&O services.
AUTOMATION, IT AND ROBOTICS INNOVATION (AIR) BEST PRACTICE MEDAL
Tan Tock Seng Hospital & ST Healthcare  
Project title - "Building a sustainable and resilient value-based supply chain through innovative supply chain models and technology advancements"

With TTSH's upcoming expansion plans to Novena Health City in 2030, there is a need to ensure the Hospital has a sustainable and resilient value-based supply chain that can automate processes and transform the workforce.

The existing key challenges are a lack of storage space, congestions at the loading and unloading area and manpower issues such an ageing workforce, and supply chain spending most of their time on administration and routine purchases.

TTSH Material Management Department (MMD) engaged ST Healthcare (STHC) to conduct a preliminary site study in TTSH and initiated a proof-of-concept (POC) for six wards.

IMPACT:

  • It has proven that a vendor could support from an off-site facility for all of the medical consumables needs. It reduces ad-hoc orders from nurses, as well as manual transaction of orders and related errors by 80% and 100% respectively. There is also reduction from multiple invoices processed per month to a single invoice processed by Finance.
  • The total initial estimated projected man-hour savings from the use of technology is 3300 hours. The success results in a reduction in administrative work, and caters for surges and expansion.
  • Through standardization, inventory holdings can then be made using data. With vendors now delivering directly to ST Healthcare, there will be lesser vendors entering TTSH, therefore reducing potential threats to TTSH. With the use of Vertical Lift Module, an inventory storage system, warehouse staff can also be more efficient. It provides a reduction in warehouse footprint by 90.1% and a reduction of manpower by 50%.
CARE REDESIGN (CR) BEST PRACTICE MEDAL
Tan Tock Seng Hospital 
Project title - "Delivering Integrated Care for Hip Fracture Bundled Patients from Acute to Community Hospitals and Post-discharge Community Services, through Value Stream Mapping"

Holistic care of elderly patients with hip fractures require prompt diagnosis, early surgery, early mobilization, rehabilitation, falls prevention measures and osteoporosis treatment.

After early surgery, patients recovering from hip fracture require effective post-operative care and rehabilitation to regain pre-fracture mobility and function. The end-to-end care delivery involves a multidisciplinary team spanning across acute and community hospitals, and post-discharge community rehabilitation services. However, this care is often fragmented.

IMPACTS:

  • Over a 1-year period of interventions using Value Stream Mapping approach, the team saw improved patient outcomes with significant overall reduction in the average length of stay by 1 week. Readmission rates continue to be low at 8%.
  • These translate to cost savings to the hip fracture patients and the institutions.
  • The use of standardized workflow and discharge criteria allowed patients to be discharged based on standard assessment, which improved efficiency and reduced variability. New improved versions of the Hip Fracture Education booklet which provide information of patients' entire care journey from acute to community hospital also helped align patients' and caregivers' expectations.
CARE REDESIGN (CR) BEST PRACTICE MEDAL
National University Cancer Institute, Singapore (NCIS) 
Project Title - "NCIS Nurse-Led De-escalation of Vital Signs Monitoring"

Routine frequent vital signs monitoring (VSM) is often cited as an area which impacts time and resources for other aspects of patient care. It is also disruptive to patients, especially those requiring palliative care.

The project aimed to reduce VSM of Low Risk Haematology-Oncology patients in NCIS safely by 50% using a Nurse-led approach.

APPROACHES:

  1. Consensus Criteria were drawn up for Low Risk Patients via brainstorming sessions, survey of doctors and nurses, as well as a criteria review by stakeholders.
  2. Nurses were engaged at Role Calls and meetings for empowerment.
  3. De-escalation Protocol was formulated for VSM de-escalation of Low Risk Patients. Training sessions were then conducted for all ward nurses.
  4. Reminder to Nurses/Doctors to communicate VSM at daily ward rounds
  5. Regular review of recruitment and safety data, with interval audits and role modeling by senior nurses

IMPACTS:

  • Introduction of Low Risk Criteria and De-escalation Protocol reduced a third of patient admissions which requires traditional 4H monitoring, with no negative impact on patient care.
  • There was also a 50% reduction in measured outcomes. Over a 17-month intervention period involving a total of 1065 Low Risk patients, Nurse-led VSM De-escalation resulted in mean monthly savings of 948.4 Nursing Encounters and 2731.5 minutes for Nursing Encounters.
  • The time savings were then used to enhance other aspects of patient care such as patient and family education, nurse-patient interaction, patient safety (e.g. falls prevention), ward equipment checks and ward hygiene. Survey of doctors and nurses showed that majority were supportive of adopting Nurse-led VSM De-escalation as routine practice, with nurses highlighting that greater empowerment led to greater confidence, positive behavioural change and greater satisfaction.
WORKFORCE TRANSFORMATION BEST PRACTICE MEDAL
Singapore General Hospital (SGH) 
Project Title – "Transforming SGH's Surgery Scheduling Process to Enhance Patient Satisfaction & Operations Efficiency"

SGH embarked on a transformation project to redesign the process of scheduling surgery so that patients requiring elective surgery can receive surgery instructions from the comfort of their own home - reducing an average 45-minute wait time to see a nurse for a 10-minute session that would have conveyed the same information.

With this transformation, patients can now go home straight after consultation and receive information about surgery activities via SMS within the same day in the comfort of their home.

At SGH, surgery scheduling is performed by clinically-trained "Listing Nurses". Following confirmation of surgery with the surgeon, the patient will proceed to the listing room on the same day for surgery confirmation and to get pre-surgery instructions and cost estimates of their planned admission.

On average, it involves 45 minutes of waiting time before patients are called by the listing nurses for a 10 minute face-to-face contact time to confirm surgery activities.

Also, this transformation project leverages on a previous initiative where SGH's surgery order forms were digitised. These electronic surgery forms are referred to when scheduling surgery. As the electronic surgery order form is integrated with the hospital systems - all essential pre-admission tests are ordered and essential information indicated. These features greatly enhance patient care and safety.

This transformation project also looked into job re-designing for Patient Service Associates (PSAs) to undertake surgery scheduling so that listing nurses can focus on patient care.

IMPACTS:

  • 91% time saving experienced by patients
  • 40% manpower reduction for surgery scheduling
  • $1.62 million manpower savings per annum (done by PSAs instead of nurses)
  • 100% compliance to patient safety.
WORKFORCE TRANSFORMATION BEST PRACTICE MEDAL
National Healthcare Group Diagnostics (NHGD) 
Project Title - "Transformation of Primary Healthcare Laboratories using Technologies"

NHG Diagnostics processes more than 5 million tests per year in the primary healthcare laboratories. With an increasing number (average 5% year on year) of test loads, it is not sustainable to keep increasing manpower to run the tests.

In addition, manual processes are more prone to transcription error especially in results reporting. It is also open to human subjectivity and self-interpretation. Since 2009, NHG Diagnostics has started technologies adoption to software customisation to replace manual processes for better work efficiency and clinical outcomes, and to create continuous learning opportunities to up skill staff.

IMPACTS FROM YEAR 2016 TO 2018:

  • Automation has negated the need to transcribe results manually for more than 90,000 tests per year.
  • Patient management has improved. With more tests provided onsite, patients requiring immediate action can be attended to within an hour on the same day with no repeated technical visit. Having results available within same day also allows clinicians to be informed of critical results during office hours to better manage the patient.
  • By providing new learning opportunities for staff through new implementations, it has also created a platform for staff to up skill themselves and noticeable reduction in resignations from lack of learning opportunities.
  • Laboratory productivity has improved without compromising on turnaround time. Laboratories headcount can be maintained at 1-2 man operationally despite a 61% workload increase.
  • As for cost savings, there is a total of 3.31 FTE per year.












2019/05/09
Last Updated on