NHG is the Regional Health System for Central Singapore. TRANSFORMING POPULATION HEALTH. Bringing Quality Healthcare Closer to You.

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1 NHG is the Regional Health System for Central Singapore. TRANSFORMING POPULATION HEALTH Bringing Quality Healthcare Closer to You.

2 The vision of Health City Novena is to create a vibrant and sustainable integrated community of healthcare, medical education and translational research in the Central Region of Singapore. It aims to shape the future healthcare of Singapore; anchor the Regional Health System for Central Singapore; and, empower active and healthy living. ABOUT THE COVER CONTENTS 02 This is NHG 04 Chairman s Statement 07 Group CEO s Message 10 Board of Directors 14 Senior Management 16 Health City Novena 22 Clinical Care 32 Community Care 44 Research, Technology and Innovation 54 Education 62 Our People 72 Milestones 76 About NHG s Institutions 78 Statistics 88 Key Financial Information

3 NHG Transforming Population Health Bringing Quality Healthcare Closer April 2013 May 2013 June 2013 July 2013 August 2013 September 20

4 to You Financial Year April 2013 to 31 March October 2013 November 2013 December 2013 January 2014 February 2014 March 2014

5 Milestones 25 Years of Dermatology 25 Years of Geriatric Medicine 40 Years of Rehabilitation Medicine 85 Years of Mental Health

6 this is 2 NHG s vision is Adding Years of Healthy Life. This vision 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. NHG is a leader in public healthcare in Singapore, recognised at home and abroad for the quality of its medical expertise and facilities. Care is provided through an integrated network of primary healthcare polyclinics, acute care and tertiary hospitals, national specialty centres and business divisions. Together, they bring a rich legacy of medical expertise to our philosophy of integrated patient-centred care. With our focus on providing accessible, affordable and quality healthcare services, NHG strives to improve integrated care within the Regional Health System involving long-term collaborations with other healthcare and community partners. Our Vision Adding Years of Healthy Life Our Mission We will improve health and reduce illness through patient-centred quality healthcare that is accessible and seamless, comprehensive, appropriate and cost-effective; in an environment of continuous learning and relevant research.

7 NHG Our Values Collegiality We nurture success by promoting collaboration, participation and trust between individuals and other healthcare organisations within an environment of sharing and mutual respect. Compassion Our paramount concern is the welfare and well-being of our fellow human beings. We sympathise with those struck by illness and suffering, and will do our best to alleviate their conditions. Respect We treat everyone with honesty, decency and fairness. Integrity We are committed to the highest standards of ethical conduct. Social Responsibility We contribute positively to the well-being and welfare of the community. Professionalism We are committed to being the best in what we do, and to achieving the best possible outcomes for our patients. 4P7R These represent a collective mindset and proactive culture we are adopting to further raise our standards in transforming population health towards Our Shared Future of being the Regional Health System for Singapore s Central Region. The 4 Principles are: Patient-centred Care Systems Thinking Learning Organisation Staff Engagement The 7 Rules are: Healthcare originates from what patients need and value We care and protect patients and ourselves As a system with partners, it is the system s results that count We give ideas, learn, develop, and improve continuously Work within guidelines and standard procedures Solve the problem and take responsibility for handing over to the next step Feedback to the step before NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 3

8 CHaiRMan S STaTeMeNT As we face a rapidly ageing population and growing chronic disease burden, delivering affordable and accessible quality care is vital to NHG s role as a public healthcare service provider. This is in line with the Ministry of Health s aim of enabling Singaporeans to live long, live well and with peace of mind. Central to our vision of Adding Years of Healthy Life is the Regional Health System (RHS), which moves away from episodic care to integrated care of the patient within the community. NHG celebrates its 14th year and we recognise the strides made in establishing our RHS network for Central Singapore. By forging strong partnerships, we can develop a seamless, patient-centred ecosystem that will cater to our patients medical and psychosocial needs. Our vision of an integrated care approach is shared by many like-minded organisations in Novena, where our member institutions Tan Tock Seng Hospital and National Skin Centre, are based. Together with our partners, we have developed the Health City Novena Master Plan where complementary functions are sited together to optimise care. The 17-hectare modern, integrated hub will physically link multi-disciplinary medical service providers in the Novena area when it is completed in Beyond healthcare, Health City Novena encompasses a complete ecosystem which will offer facilities for health services, research and education, as well as commercial, leisure and communal spaces. This landmark project signifies an important step towards providing holistic care for the community. 4

9 While the physical infrastructure for our Health City Novena takes shape, NHG has continued to build on partnerships that will form the foundation of the integrated care network. We have established the Central Regional Health Advisory Council, chaired by my fellow Board Member, Ms Anita Fam, with representatives from NHG, the Ministry of Health, Agency for Integrated Care, Ministry of Social and Family Development, Health Promotion Board, People s Association and representatives from our medical, social and community partner organisations within the Central Region. The Advisory Council will facilitate robust discourse and views on improving the overall management of population health. NHG celebrates its 14th year and we recognise the strides made in establishing our RHS network for Central Singapore. By forging strong partnerships, we can develop a seamless, patient-centred ecosystem that will cater to our patients medical and psychosocial needs. Already our community care efforts are making an impact, with the pilot Virtual Hospital programme at Tan Tock Seng Hospital (TTSH) winning the PS21 ExCel Certificate of Recognition for Most Innovative Project. The award recognises innovative projects by public organisations which have made significant contributions to society. Under the programme, Health Managers who are registered nurses with at least five years of clinical experience provide followup reviews and assessments for patients who need support through scheduled home visits and regular telephone calls. They also empower patients and caregivers through health education and practical advice on care. To provide patients with holistic care that includes social support, the Health Manager also works in tandem with primary care and community partners to address the needs of our patients. The transformation of healthcare must be embraced by the next generation of healthcare professionals. As the primary clinical training partner for the Lee Kong Chian School of Medicine (LKCMedicine), NHG has leveraged on its expertise in team-based, patient-centred care to develop an innovative curriculum that is into its second year. To further develop doctors who are skilled and passionate about healthcare in the community, NHG together with LKCMedicine have also jointly opened the Family Medicine Academy at Bukit Batok Polyclinic Singapore s first purpose-built primary care teaching facility where medical undergraduates will receive more robust training in Family Medicine, and in turn help boost the primary care sector in Singapore. Medical students are able to observe the Family Medicine consultation process, learn communication and clinical examination skills, as well as understand first hand the role of primary care in its entire healthcare continuum. Beyond undergraduate training, the facility is also available for the training of existing clinicians within the primary care sector. Within the NHG family, we have also marked several milestones. In May this year, we commemorated the 10th year of the Healthcare Humanity Awards, which was established a year after the SARS outbreak in 2003, to recognise the extraordinary dedication and courage of healthcare workers from across the nation, towards their patients. A record 76 recipients from 26 public and private organisations were lauded, including eight inaugural Honourable Mention winners. Bringing Quality Healthcare Closer to You NHG Transforming Population Health 5

10 6 On the medical front, our flagship TTSH celebrated its 170th Anniversary on 25 July 2014, since its founding in From its humble beginnings as the Pauper s Hospital, TTSH has grown into a world-class acute hospital addressing the needs of a rapidly ageing population. Its Department of Geriatric Medicine celebrated its 25th Anniversary and its Department of Rehabilitation Medicine its 40th Anniversary last year. The Institute of Mental Health (IMH) also commemorated its 85th Anniversary transforming from custodial to rehabilitative provider of mental health treatment. As a national specialty centre, IMH can be proud of its progressive rehabilitation methods and dedicated mental health experts and professionals, who have helped patients with mental health illness work towards a new lease of life. IMH staff, volunteers and patients staged a public play titled 8 to 5, to promote awareness and reduce stigmatisation of mental illnesses. Public education is a key enabler to help the population maintain healthier lifestyles. NHG s bimonthly publication, Lifewise, has been delivering interesting and informative articles in an attractive and easily digestible fashion to readers. My congratulations to the magazine which won the Award for Excellence in the Customised Magazine, Journals & Tabloids category at the annual APEX Awards 2014 an international competition which recognises excellence in graphic design, editorial content and the success of the entry in communicating its message. The NHG Corporate Yearbook 2012/13 also won the Award for Excellence in the Annual Reports category. Our successes would not have been possible without the dedication and commitment of all our staff, Management and the NHG Board. I am grateful to the Board, our 13,000 colleagues across the NHG family for your dedication and invaluable contributions. I am confident that NHG will continue to strive in our efforts as the RHS for Central Singapore. I would like to welcome Adjunct Professor Er Lau Joo Ming who joined the Board in October I would like also to thank Professor Stephen Smith who stepped down from our Board in July last year. Finally, my sincere thanks for the support and collaboration afforded to NHG by our multiple stakeholders in the community who have made this journey fruitful and rewarding. MADAM KAY KUOK Chairman National Healthcare Group Chairman s Statement

11 GROUP CeO S MeSSaGe The National Healthcare Group (NHG) is the Regional Health System (RHS) for Central Singapore a role that has given us the privilege of caring for 1.4 million people, where more than 30% of the population are over 50 years of age. Within this group are the frail and elderly who suffer from multiple chronic diseases with little or no social support. Providing holistic care for such patients would therefore have to go beyond the medical, to include looking after their psychosocial needs with integrated care provided by NHG and our partners both public and private. A rapidly ageing population is one that is prone to more chronic diseases, and our long established acute care hospital system, which provides episodic treatment for younger patients is no longer sustainable. While we continue to enhance our clinical care services and facilities in our hospitals and clinics, there is a pressing need for us to evolve and to help meet the multi-faceted needs of our patients from their discharge from the hospitals to their placements back into the community and to keep them as well as possible. To provide more seamless holistic care across the healthcare continuum, it is therefore necessary for us to move away from a hospital-centric model of care. This transformation of care is only possible when acute hospitals, community hospitals, nursing homes, home care and day-rehabilitation providers, polyclinics, General Practitioners, as well as voluntary welfare organisations, work together to create a robust support network for patients, their caregivers and the community at large. This vision is best exemplified and will eventually be realised with the establishment of Health City Novena, a 17-hectare modern integrated healthcare hub of multi-disciplinary partners that will offer facilities for health services, education and research as well as commercial, leisure and communal spaces. It will be completed by NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 7

12 8 To complement the development of our RHS infrastructure of tomorrow, NHG has been busy transforming the way we deliver care, today. A key step forward in our community care efforts has been the expansion of the Virtual Hospital programme. Helmed by a multi-disciplinary care team with representatives from the acute, primary, social and community care sectors, the pilot programme aims to reduce hospital readmissions through more cohesive care. Our medical professionals have been working closely with social partners to develop integrated care plans that will help our patients who have returned to the community manage their conditions more effectively, and hopefully, reduce future disease progression to add years of healthy life. To facilitate our goal of providing seamless care, NHG has also embarked on its Care Transformation journey, which will see the development of a unified electronic medical record system that will provide coordinated healthcare with our NHG Divisions and our partners working together as One Team. This new system will be incorporated as part of the National Health IT Master Plan led by MOH Holdings and is a key driver in developing more comprehensive care integration across the Group. Achieving a successful RHS is only possible with a strong primary care sector as the foundation of a sustainable healthcare system. We have made major strides in improving the quality and accessibility of primary healthcare with the launch of the Unity Family Medicine Clinic (FMC) together with NTUC To facilitate our goal of providing seamless care, NHG has also embarked on its Care Transformation journey, which will see the development of a unified electronic medical record system that will provide co-ordinated healthcare with our NHG Divisions and our partners working together as One Team. This new system will be incorporated as part of the National Health IT Masterplan led by MOH Holdings and is a key driver in developing more comprehensive care integration across the Group. Unity Healthcare in May Unity FMC leverages on NHG s clinical and administrative strengths through our primary care arm the National Healthcare Group Polyclinics. Doctors, nurses and a comprehensive team of allied health professionals are available to provide holistic care to patients. Patients from the Hougang and Ang Mo Kio Polyclinics also have the option of visiting the new Unity FMC for more personalised management of their conditions and treatments. This marks our second successful partnership between a public and private healthcare provider. The Ang Mo Kio Family Medicine Clinic (FMC) was the first FMC established in May last year and it is a partnership with Parkway Shenton. FMCs are part of the Government s plan to provide continuing care in the community and they support GPs in caring for our rapidly-ageing population. Leveraging on the benefits of collaboration in NHG s other strategic thrusts, we have also forged new alliances in the fields of education and research. We formalised our role as the primary clinical training partner for the new Lee Kong Chian School of Medicine (LKCMedicine) with an Affiliation Agreement signed in August We are very proud that some 100 of our top clinician educators are part of the faculty who are grooming our future doctors. We welcome the second cohort of LKCMedicine students who have begun their medical undergraduate training in August We have also made strides in our Graduate Medical Education with the NHG-AHPL (Alexandra Group CEO s Message

13 Health Private Limited) Residency completing its third phase of accreditation by the Accreditation Council for Graduate Medical Education International (ACGME-I). A total of 21 received this prestigious stamp of approval, which puts the Residency programmes on par with top medical schools in the USA. Under the umbrella of research, NHG s Domain Specific Review Board (DSRB) marked a major milestone in its 10th year with the signing of a Memorandum of Understanding with the SingHealth Centralised Institutional Review Board (CIRB) in May The agreement facilitates mutual recognition of multi-site studies by both Institutional Review Boards, eliminating the need for researchers to submit multiple applications and approvals as they conduct their research. To ensure a steady pipeline of clinician-scientists to fulfil our research goals, NHG introduced the Clinician-Scientist Career Scheme (CSCS) to equip our doctors to compete successfully for extramural grants and contribute to excellence in research innovations, improvement in patient care, delivery and outcomes. With the introduction of the CSCS (Senior) in January 2014, the scheme now caters holistically to developing clinicians from junior to senior levels. Dermatology research also received a $100 Million boost with the establishment of the Skin Research Institute of Singapore (SRIS) a joint collaboration between NHG through the National Skin Centre (NSC), Agency for Science Technology and Research (A*STAR), and Nanyang Technological University (NTU). SRIS will help foster high level collaborations in skin research, with the aim of developing better treatment outcomes for patients both here and in the region. Locally, the Institute of Mental Health (IMH) also embarked on a landmark two-year survey to understand mental health literacy in Singapore. The study will examine the impact of socio-demographic factors and determine society s perception and degree of acceptance towards people with mental illness. Understanding these gaps will help policymakers develop more targeted programmes to address mental health literacy, as well as help members in the community understand, cope and address mental illness more effectively. IMH also opened its Sunshine Wing with purpose-built rehabilitation wards for elderly patients with dementia. Exemplifying patient-centred care, the ward is equipped with elderly and dementia-friendly features, as well as unique facilities that aim to provide holistic care for better patient outcomes. Another prime example of how we continually improve infrastructure to better suit the needs of our patients is the opening of the Invasive Cardiac Laboratory at TTSH. The facility was relocated directly above the hospital s Emergency Department, and further reduces the time needed for emergency patients to receive urgent cardiac treatment. To deepen our common goal of delivering quality healthcare, NHG has continued to reinforce its culture-building 4 Principles 7 Rules (4P7R), which has culminated in the launch of a book Our Shared Stories Same Same Yet Different Our Shared Future a collective showcase of heartfelt reflections and stories from management and staff of NHG and its member institutions centred on encouraging a patient-centred care mindset, having a big picture systems thinking approach, inculcating a learning organisation and fostering staff engagement across all levels. As always, I am most grateful to our Chairman and the NHG Board for their continued leadership and guidance. I would also like to express my deepest appreciation to the 13,000 men and women across NHG and our institutions who labour tirelessly to help realise our vision of Adding Years of Healthy Life to our patients and to Singaporeans. My deep appreciation to Professor Roy Chan for his impeccable leadership and outstanding service as the Director of the National Skin Centre (NSC) for the last 10 years, and to Mr Leong Yew Meng for 15 years of collective dedicated service as CEO at IMH and NHGP. I wish their respective successors, Associate Professor Tan Suat Hoon and Associate Professor Chong Phui-Nah, the best in their new appointments. I would also like to welcome Mr Ho Khai Leng and Dr Eric Wong who have joined our Senior Management Team. PROFESSOR CHEE YAM CHENG Group Chief Executive Officer National Healthcare Group Bringing Quality Healthcare Closer to You NHG Transforming Population Health 9

14 BOaRd OF DIreCTorS Madam Kay Kuok Oon Kwong is a Barrister-at-Law from Gray s Inn, London, and works full-time in her family business, the Kuok Group of Companies, as Executive Chairman of Shangri-La Hotel Ltd, Singapore. She is serving and has served on several community service and statutory boards including the Singapore Tourism Board, National University of Singapore (NUS) Board of Trustees, South West Community Development Council (CDC), National Environment Agency, National Youth Achievement Award Council and the Wildlife Reserves Singapore Conservation Fund. Mdm Kuok was awarded the Public Service Medal in 1998 and the Public Service Star in MADAM KAY KUOK Chairman PROF CHEE YAM CHENG Professor Chee Yam Cheng graduated with MBBS from the University of Singapore in 1973, served National Service for two-and-a-half years (Best Cadet) after housemanship, and returned to the Ministry of Health (MOH) to train in Internal Medicine. He is a General Physician practising in the Department of General Medicine, Tan Tock Seng Hospital. He was the former Head of Department, and former Chairman of the Medical Board. From 1987 to 1998, he served in various administrative positions in the MOH concurrently with his clinical role. His responsibilities included the areas of manpower planning and deployment, and hospital administration. In 1995, he attended the Advanced Management Programme at Harvard Business School. In 2003, he was appointed the Assistant CEO (Clinical) of the National Healthcare Group, and in January 2011, became the CEO of the Group. He remains as Advisor and Senior Consultant to the office of the Director of Medical Services, MOH. He was Past Master of the Academy of Medicine Singapore ( ) and holds Fellowships at several medical colleges in USA, UK and Australia. He was awarded the Public Administration Medal Silver in 1991, Gold in 2006, and the Public Service Medal, also in He has been the Clinical Professor of Medicine at the Yong Loo Lin School of Medicine, National University of Singapore, since He also sits on the Pro-tem Governing Board of the Lee Kong Chian School of Medicine, which is a joint collaboration between the Imperial College London and Nanyang Technological University, with NHG as its primary clinical training partner. 10

15 Mrs Tan Ching Yee has been the Permanent Secretary of the Ministry of Health since April In addition to board memberships in public healthcare institutions, she is a Board Member of the National Research Foundation and the Singapore Totalisator Board. She joined the Singapore Civil Service in 1986 and has worked in the Ministry of Trade and Industry, the Ministry of Education, and the former Ministry of Information, Communications and the Arts. She returned to the Ministry of Education in 2005 before assuming her current post. MRS TAN CHING YEE MR R. SINNAKARUPPAN MS ANITA FAM MR SOH GIM TEIK Mr R. Sinnakaruppan is presently Chairman/CEO of Singapore Education Academy (AsiaPac) Pte Ltd, a holding company for a group of education companies involved in a wide range of products and services for children and adult education. He has served and continues to serve in statutory boards/community organisations/listed companies including HDB, CAAS, MDA, ITE, Singapore Polytechnic, Tan Tock Seng Hospital, SINDA Board of Trustees, Accel Frontline Ltd, SLF Leisure Pte Ltd and many more. He also served as a Member of Parliament from 1991 to He is a Foreign & Commonwealth Scholar and was educated at Harvard Business School, Loughborough University and Nanyang Technological University. Ms Anita Fam was formerly a Partner at Khattar Wong & Partners and thereafter Senior Legal Counsel, Enron Capital & Trade Resources before she retired 15 years ago to devote herself to her family. Since then, she has immersed herself in community work and is a full-time volunteer both at charity and national levels in the areas of disability, palliative care, family, marriage and international volunteerism. Ms Fam is Co-Chairman of the Community Silver Trust Evaluation Panel and Deputy Chairman of Assisi Hospice. She also chairs the Central Regional Health System Advisory Council and serves on the boards/committees of Caregiver Alliance Ltd, the Enabling Masterplan 2 Implementation Committee, Families For Life Council, Sembawang Family Service Centre, Singapore International Foundation and St Andrew s Autism Centre among others. Ms Fam was conferred the Public Service Medal in 2008 for her work in the community. She joined the NHG Board in Mr Soh Gim Teik advises corporations through his firm, Finix Corporate Advisory LLP, and has more than 35 years of experience in finance, corporate governance and strategic management. He was previously an Executive Director and CFO in a listed company and is currently serving as an independent director on the boards of several other listed companies. Mr Soh is a CA (Singapore) with the Institute of Singapore Chartered Accountants (ISCA) and a Fellow of the Singapore Institute of Directors (SID) where he is a Board member and Treasurer in the Governing Council. He was also previously a committee member in the Professional Accountants in Business Committee of the International Federation of Accountants (IFAC). He was named the Best CFO of the Year at the inaugural Singapore Corporate Awards in 2006 in the mid-cap category. He has a degree in Accountancy from the University of Singapore and is active in a number of non-profit organisations where he serves as a director and finance committee chairperson. NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 11

16 PROF JUDITH LEA SWAIN Professor Judith Lea Swain is a physician scientist and cardiovascular specialist, and is Executive Director of the Singapore Institute for Clinical Sciences (A*STAR), as well as the Lien Ying Chow Professor of Medicine, at the NUS Yong Loo Lin School of Medicine. Prof Swain previously served as Dean for Translational Medicine at University of California San Diego, Chair of Medicine at Stanford University and Chief of Cardiovascular Medicine at the University of Pennsylvania. She has worked in molecular cardiology and medical device development. She joined the NHG Board in Board of Directors MR PAUL CHAN Mr Paul Chan was appointed to the NHG Board in November He is also a Director of Integrated Health Information Systems Pte Ltd, and the Chairman of SP Services Ltd. Mr Chan had previously served on the boards of various companies including Singapore Airlines Engineering Company Ltd, Singapore Power Ltd, Singapore Telecommunications Ltd, the Singapore Economic Development Board, Verigy Ltd and the Advisory Board of the Lee Kong Chian School of Business at Singapore Management University. Formerly the Senior Vice President & Managing Director (Asia Pacific & Japan) of Hewlett-Packard Asia Pacific Pte Ltd and the Vice President & Managing Director (Asia Pacific) of Compaq Computer Asia Pacific Pte Ltd, his leadership and foresight contributed greatly to their business excellence. Mr Chan was awarded the Public Service Star in MRS LIM JOKE MUI Mrs Lim Joke Mui is an accountant by training. She had served as Group CFO in various corporate groups, including DBS Land Limited, CapitaLand Commercial Limited and Sembcorp Industries Limited. She retired from Sembcorp Industries on 30 June She oversaw various functions in the groups including corporate finance, accounting, tax, treasury, risk management, company secretarial and mergers & acquisitions. Besides being a director of several non-listed companies within various corporate groups, her past directorships included those of listed companies in Singapore, Australia and Malaysia such as Sembcorp Marine Limited, The Ascott Limited, The Insurance Corporation of Singapore, Australand Holdings Limited and United Malayan Berhad. She is currently a member of the Investment and Audit Committees of MOHH and a member of the Finance and HR Committee of the Singapore Cheshire Home. MR SEOW CHOKE MENG Mr Seow Choke Meng has been with Singapore Press Holdings Newspaper Group for the last 35 years. He has held various positions, including those of General Manager, Human Resource Operations, General Manager (Circulation) as well as General Manager of Chinese Newspapers Editorial Services Department. Mr Seow is currently the Executive Vice-President of Cultural Industry Promotion of Chinese Newspapers Division as well as that of Times Properties. He is also the Executive Director of Times Development Pte Ltd. Apart from serving in grassroots and community organisations, he also serves as the Chairman of the Promote Mandarin council and a Trustee of Chinese Development Assistance council. Mr Seow graduated from the University of Singapore with a Bachelor of Science (Honours) degree. 12

17 MRS YEE JEE HONG Mrs Yee Jee Hong was a member of the SWIFT Board from 1999 to 2012 representing 10 countries in Asia Pacific, including the ASEAN members, China, Taiwan, Korea and India. SWIFT is a cooperative based in Brussels and owned by banks with three data centres in three countries for high value financial transactions. Mrs Yee served at PSA, the former Port of Singapore Authority, for 13 years and was at DBS for 17 years before retiring. While at DBS, one of her most significant positions was as the Executive Vice President of all operational departments reporting to the Executive Chairman of the Board. Her scope of responsibilities included Human Resources, Finance, Administration, Risk Management, Legal, Communications and Technology. She joined the NHG Board in Mr Lionel Yeo has been the Chief Executive of Singapore Tourism Board since June He was formerly Dean and CEO of Singapore s Civil Service College, and Deputy Secretary (Development) in the Public Service Division of the Prime Minister s Office. A career civil servant, he has worked in the Ministries of Trade and Industry, Finance, Information and the Arts, and Community Development. Mr Yeo also serves on the Boards of the Urban Redevelopment Authority, Sentosa Development Corporation, Wildlife Reserves Singapore Pte Ltd and the Board of Governors of Raffles Institution. MR LIONEL YEO ADJ PROF ER LAU JOO MING Adjunct Professor Er Lau Joo Ming is the Senior Advisor of Housing & Development Board (HDB), Singapore. He drives the development of a strategic research plan for HDB, provides advice on technical issues, participates in technical reviews for HDB projects and guides HDB s young professionals. Prior to his position as Senior Advisor, he was the Managing Director of the HDB Building Research Institute (HDB BRI) from 2009 till HDB BRI is the research arm of HDB and envisions being the global leader in housing research, innovations and solutions for a sustainable living environment. In 2006, he was the Deputy Chief Executive Officer of the Building Group (BG) of HDB, managing four departments involved in the planning, procurement, project management, quality assurance and maintenance management of HDB estates. He was also the Chief Structural Engineer of the Housing & Development Board (HDB). He led a team of Architects and Engineers in driving the realisation of The Duxton project completed in The is an iconic housing project in Singapore s public housing history, with many unique features that set it apart from other HDB housing projects. It is the first 50-storey public housing project in Singapore, housing 1,848 apartments in seven towering blocks. This project was awarded the 2010 Best Tall Building Asia & Australasia by the Council on Tall Buildings and Urban Habitat. Besides HDB, he is the President of Professional Engineer Board and an Adjunct Professor at Nanyang Technological University where he lectures in the MSc class of the School of Civil Engineering. He is member of Development Projects Advisory Panel, set up by the Ministry of Finance to enhance the assessment and management of large and complex infrastructure projects. He is also the Advisor to the Ministry of Health Holdings Hospital Infrastructure Project Group. Our thanks to former NHG Board Member Prof Stephen Smith who stepped down in July Bringing Quality Healthcare Closer to You NHG Transforming Population Health 13

18 SeniOR MaNaGeMeNT PROF CHEE YAM CHENG Group Chief Executive Officer National Healthcare Group PROF PHILIP CHOO Deputy Group Chief Executive Officer (Regional Health) Natio nal Healthcare Group A/PROF LIM TOCK HAN Deputy Group Chief Executive Officer (Education and Research) National Healthcare Group A/PROF CHUA HONG CHOON Chief Executive Officer Institute of Mental Health/ Woodbridge Hospital A/PROF CHONG PHUI-NAH Chief Executive Officer National Healthcare Group Polyclinics Chief Executive Officer Tan Tock Seng Hospital A/PROF TAN SUAT HOON Director National Skin Centre A/PROF THOMAS LEW Chairman Medical Board Tan Tock Seng Hospital A/PROF DANIEL FUNG Chairman Medical Board Institute of Mental Health/ Woodbridge Hospital MS LIM YEE JUAN Group Chief Financial Officer National Healthcare Group MR LINUS THAM Group Chief Corporate Development Officer National Healthcare Group Chief Operating Officer Regional Health, NHG 14

19 MRS OLIVIA TAY Group Chief Human Resource Officer National Healthcare Group A/PROF NELLIE YEO Group Chief Quality Officer National Healthcare Group Executive Director National Healthcare Group College MS WONG FONG TZE Group Chief Corporate Communications Officer National Healthcare Group MR HO KHAI LENG Group Chief Information Officer National Healthcare Group DR ERIC WONG Group Chief Medical Information Officer National Healthcare Group DR EUGENE FIDELIS SOH Chief Operating Officer Tan Tock Seng Hospital MS GRACE CHIANG Chief Operating Officer National Healthcare Group Polyclinics MR LIM HOCK LENG Chief Operating Officer Institute of Mental Health/ Woodbridge Hospital DR LEW YII JEN Senior Director (Clinical Services) National Healthcare Group Polyclinics DR TYRONE GOH Executive Director National Healthcare Group Diagnostics NHG is the Regional Health System for Central Singapore MS CHAN SOO CHUNG Executive Director National Healthcare Group Pharmacy A/PROF TAI HWEI YEE Deputy Group Chief Quality Officer National Healthcare Group A/PROF NICHOLAS CHEW Designated Institutional Official National Healthcare Group MS LIM SOH HAR General Manager National Healthcare Group Diagnostics Our thanks to former Senior Management members Prof Roy Chan and Mr Leong Yew Meng. NHG Transforming Population Health 15

20 Health City Novena 1 16

21 Health City Novena s vision is to create an integrated community of healthcare, medical education and translational research in a vibrant and sustainable environment. It aims to shape the future healthcare of Singapore; anchor the Regional Health System for Central Singapore; and, empower active and healthy living Aerial perspective view of Health City Novena. 2 Vision + official launch (Lifewise Nov/Dec 2013). 3 Health City Day. 4 Singapore Institute for Landscape Architects (SILA) award (Lifewise Mar/Apr 2014). 17

22 Launch Of Health City Novena In August 2013, NHG and Tan Tock Seng Hospital (TTSH) officially launched Health City Novena a 17-hectare master plan for a modern integrated healthcare hub. The vision of Health City Novena is to become a precinct where Healthy Life is central, and will offer facilities for health services, research and education, as well as commercial, leisure and communal spaces. Eight new developments will be progressively added from now till 2030, with key expansions in the areas of healthcare, education and research. The Four Cs The Health City Novena Master Plan is built around four guiding principles, known as the four Cs Care, Continuous Learning and Innovation, Community, and Connectivity: Care Eight new buildings will help raise the level of specialist expertise in Singapore, and provide better care to our patients. The developments are: an HealtH City NoveNa integrated intermediate care hub; a national centre for infectious diseases; an expanded TTSH ambulatory centre; a medical education and training building; the Lee Kong Chian School of Medicine (LKCMedicine) headquarters and clinical sciences building; a future health sciences school; an extended National Skin Centre (NSC) and NHG headquarters, and a new national centre. Health City Novena will anchor the Regional Health System for the Central Region, and is a key component under MOH s capacity-building strategy to develop medical excellence and provide more accessible and quality care to Singaporeans. It also aims to enhance the collaboration among healthcare partners further. Mr Gan Kim Yong Health Minister, at the Health City Novena launch Continuous Learning and Innovation In addition to LKCMedicine, Health City Novena will also have two more developments dedicated to education the TTSH medical education and training building, as well as a proposed health sciences school. The hope is to create facilities that will leverage on the close proximity and synergise with one another to enable healthcare professionals to upgrade their skills. The integrated hub will also create opportunities for healthcare professionals to work in multi-disciplinary teams and gain hands-on experience in the acute, step-down and community care settings. Community Health City Novena will have welcoming architecture, green spaces, parks, plazas and exercise trails to 18

23 make it more conducive for communal activity. A park built around a conservation building will be used for community events and family activities. Feedback from residents and members of grassroots organisations was also sought during the development of the community areas. Connectivity Human traffic through TTSH is expected to double to some 30,000 people when Health City Novena is completed. To ensure smooth, safe human and vehicular traffic, all buildings will be linked at three levels above ground, at street level and via the basement. Some 4,000 parking lots are expected to be available. Healthcare buildings will also have sky bridges to facilitate direct movement of staff and inpatients, as well as provide the latter with greater privacy. The siting of specialist clinics closer to Novena MRT also translates into easier access for outpatients. Sheltered walkways will be built. This vision of an integrated care approach is shared by many like-minded organisations in Novena. Together, we have developed a healthcare master plan where buildings that perform complementary functions are sited together to optimise care, and are interlinked via sky bridges, pedestrian-friendly streets, leafy parks and underground car parks for safe, convenient and good access to care. Madam Kay Kuok Chairman, NHG Here are the eight new developments of Health City Novena: 1. Proposed Integrated Intermediate Care Hub This multi-purpose facility will cater to the intermediate care continuum with services for sub-acute, rehabilitative and palliative care. Dover Park Hospice and a proposed second community hospital will be housed here. The hub will be connected to TTSH and Ren Ci Hospital for seamless and coordinated patient care and transfers. The centre will also house specialist clinics catering to immediate care. 2. National Centre for Infectious Diseases This centre will boost specialisation in infectious disease research and prevention. It is set to be Singapore s first line of response in the fight against emerging infectious diseases and outbreaks, with isolation wards, intensive care units and support services such as laboratories and radiology facilities. NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 19

24 20 3. TTSH Medical Education and Training Building The project will provide students with a strong foundation in clinical training across different healthcare settings. It will have facilities such as an auditorium, multi-purpose hall and library. This building will also be central in raising the skill level of community care providers and will educate patients in healthy living via simulators, e-learning laboratories and training facilities. 4. LKCMedicine Headquarters and Clinical Sciences Building Singapore s newest medical school has auditoriums, learning studios, seminar rooms, teaching laboratories, libraries and many other immersive learning facilities. Its headquarters is housed in a conservation building, which historically was used by medical students and nurses. 5. New National Centre A new national centre will be built. 6. Proposed TTSH Ambulatory Centre Expansion The hospital will consolidate and expand the amount of space devoted to its day care and specialist outpatient facilities. 7. Future Health Sciences School The new school will train Allied Health Professionals to meet the healthcare needs of the community. It will also promote staff training and develop healthcare professionals through continuous learning. 8. Proposed Extended NSC Building and NHG Headquarters To help meet growing demand for dermatological healthcare, this development will house more outpatient and day treatment clinics, clinical laboratories, a pharmacy, patient education rooms, a research wing and training facilities. It will also house NHG s future headquarters. Community Celebrates Inaugural Health City Day Celebrations for the inaugural Health City Day held a day after the development s official launch in August were attended by some 1,000 NHG staff, family and friends. The carnival kicked off with a 1.4-kilometre walk that took participants through the area s historical sites. Games and live performances added to the celebratory mood, while free eye screenings and medication reviews were also provided. Guest-of-Honour Parliamentary Secretary for Health and Transport, Associate Professor Muhammad Faishal Ibrahim, gamely took part in the activities and also opened TTSH s new Foot Care and Limb Design Centre. Health City Novena Wins SILA Health City Novena bagged the prestigious Gold Award in the Master Planning Category in the Singapore Landscape Architecture Awards (SILA). Designed by Surbana International Consultants Pte Ltd and Broadway Malyan Asian Pte Ltd, the 17-hectare Health City Novena

25 development has 600,000 square metres of floor space for healing, learning and research. The honour recognises the project s high level integration within a mixed development, as well as the clever use of space to create a beautiful, yet functional environment. The SILA judges citation noted that accessibility and circulation are facilitated by landscape design, with vegetation strategically employed to buffer the multiple functions that need to occur within the complex. Bringing Quality Healthcare Closer to You NHG Transforming Population Health 21

26 Clinical Care 1 22

27 At the National Healthcare Group, our vision of Adding Years of Healthy Life goes beyond merely healing the sick to the more difficult but rewarding task of preventing illness and preserving health and quality of life. As the Regional Health System for Central Singapore, we are privileged to be given the opportunity to care for the district s elderly population. 2 To meet the changing needs of the population, NHG will continually evolve how it delivers quality care to our patients. This means redesigning our processes, as well as developing new infrastructure that encompasses our goal of providing patient-centred care. We are constantly pushing the boundaries by re-defining how care is delivered. This is best exemplified through new purpose-built facilities including the Invasive Cardiac Laboratory at the Tan Tock Seng Hospital, and the Dementia Friendly Ward at the Institute of Mental Health. 1 The Invasive Cardiac Laboratory at Tan Tock Seng Hospital features facility and process enhancements to give patients faster access to potentially life-saving interventions and the delivery of safer care. 2 The Sunshine Wing at the Institute of Mental Health features dementia-friendly wards which provide a more conducive healing environment for patient rehabilitation. 23

28 CliniCal Care 24 TT S H Opens New Invasive Cardiac Laboratory In November 2013, the Invasive Cardiac Laboratory (ICL) at Tan Tock Seng Hospital (TTSH) was officially opened by NHG Chairman Madam Kay Kuok. Relocated from the Medical Centre to the third floor of the Emergency Block, heart attack patients can now be transferred more quickly from the Emergency Department to ICL for more timely cardiac interventions. The new ICL features facility and process enhancements, such as the new hybrid laboratory and all-in-one disposable catheterisation set. These improvements will allow critically ill cardiac patients faster access to potentially life-saving interventions and the delivery of safer care. The advanced facility will also be used for training. In March 2014, TTSH signed an agreement with the Department of Health under Myanmar s Ministry of Health to further enhance the acute management of heart attacks at two of the country s largest public hospitals, Yangon General Hospital and Mandalay General Hospital. Under this collaboration, TTSH will be exchanging knowledge and best practices with their counterparts in Myanmar. Nurses and radiographers from the two hospitals will also undergo training and attachment stints at ICL. With strong funding support from the Temasek Foundation, the programme aims to establish primary angioplasty services in the two hospitals as a default treatment for acute heart attacks and immediate post procedure care in the coronary care units. The Invasive Cardiac Laboratory at TTSH will also be used to train healthcare professionals for Myanmar, under a Memorandum of Understanding signed with the country s Ministry of Health to further enhance the acute management of heart attacks.

29 Balance Clinic to Reduce by two qualified optometrists Falls Risk who under the Dizziness is a common sign of supervision of dysfunction in the sensory system eye specialists that controls one s balance. For elderly will treat patients patients, this translates into a higher with less serious risk of falls which can lead to major eye conditions complications. In April 2012, a new including dry multi-disciplinary balance clinic was eyes, early stage set up to manage the complex cases of cataracts and patients with dizziness problems. spots. This allows ophthalmologists Initiated by the Ear, Nose to provide more and Throat (ENT) department, the timely and clinic is run by a multi-disciplinary intensive care team comprising an ENT doctor, to treat patients physiotherapist and audiologist, who A patient undergoes therapy at the Balance Clinic at TTSH. with critical eye attend to each patient simultaneously. conditions. These joint assessments facilitate the formulation of the best treatment plan for patients as well as allow e-wound System for Better Care the healthcare team to provide more comprehensive Wound treatment a common ailment affecting advice and education. The one-stop service also patients, including diabetics is now safer and better offers patients better coordinated care and reduces for TTSH patients with the ewound Clinical Decision the need for multiple clinic visits. In addition, suitable Support System. The system was introduced in patients can undergo Vestibular Rehabilitation, an July 2013 and empowers nurses to treat complex exercise-based programme to help improve patients wound cases more effectively. Available in all the balancing, sensitivity to hospital s inpatient wards, movements and gaze stability. the computer programme Other treatments include generates appropriate medication management and diagnosis and treatment referrals to audiologists for methods, after a nurse vestibular testing and hearing inserts parameters like aid evaluations. Since its wound size and appearance. inception, the clinic has seen The algorithm also over 140 patients. provides a comprehensive electronic reference library Stable Eye Condition of appropriate wound Clinic to Treat Less treatments. With the new Serious Conditions system, nurses are able to provide timely and To create a more sustainable effective treatment to system for eye treatments, complex wound patients, TTSH launched the Stable Eye without a wound specialist Condition Clinic in October present, while also The clinic, which is reducing the incidence of housed at the hospital s NHG infection, deterioration and Eye Institute, will be staffed complications. Bringing Quality Healthcare Closer to You NHG Transforming Population Health 25

30 26 Launch of Singapore s First Palliative Care Handbook The demand for quality palliative care is increasing, against a backdrop of a rapidly ageing population and growing disease burden. To help healthcare professionals in the field, the TTSH Palliative Medicine Department developed and published a resource handbook. The 220-page Bedside Palliative Medicine Handbook, edited by Drs Allyn Hum and Mervyn Koh, was launched in October It marks the first such handbook for end-of-life care and taps on the expertise of healthcare professionals across the hospital. The handbook provides comprehensive information on improving pain, symptom management and enhancing the quality of life at the final stage. It also covers a selection of common clinical conditions in palliative care, and how to manage them. Going beyond the clinical, the handbook also covers practical issues such as how to facilitate a terminal patient s discharge from hospital, TTSH launched the Bedside Palliative Medicine Handbook which is the first dedicated resource of its kind for end-of-life care. As we embrace the transformation of Singapore into a first-world society, achieving a good death is increasingly recognised as a medical goal and core competency for the medical profession and its practitioners. Good palliative care goes beyond medical treatment; it also includes the psychosocial and ethical aspects of care. Associate Professor Chin Jing Jih, Divisional Chairman of Integrative and Community Care, TTSH where to find community hospices, as well as fulfilling the patients and families preferences. Copies of the books have been distributed to hospices, polyclinics, nursing homes and medical schools, and are sold in selected stores at $23.54 (inclusive of GST) each. Interested buyers can also call Armour Publishing at Scar-Free Way to Remove Stomach Cancer TTSH doctors can now remove cancer cells from the stomach without leaving a scar. During the operation, a long-tube with an encased needlelike blade is inserted via the patient s mouth, into the stomach. Surgeons then carefully cut part of the stomach s inner lining, which is where gastric cancer usually starts. The procedure leaves patients with an ulcer which usually heals in three months. It is also used to remove intestinal polyps which can cause colon cancer. Some 30 patients have been treated with the new endoscopic submucosal dissection method, which TTSH doctors learnt in Japan. The treatment is most effective when performed at an early stage. TTSH has screened more patients for early detection of gastric and colon cancer. TTSH Receives Ancc Pathway to Excellence Accreditation TTSH became the first institution outside the United States to receive the Pathway to Excellence designation, conferred by the American Nurses Credentialing Center (ANCC). The accreditation recognises healthcare organisations that promote Clinical Care

31 Our nurses have worked hard over the years to build a culture in which they are able to derive job satisfaction, enjoy opportunities for personal growth and development, as well as receive respect and appreciation. Mr Yong Keng Kwang Director of Nursing, TTSH nursing excellence. Organisations must meet 12 practice standards including having a safe and healthy work environment, access to professional development opportunities, a balanced and healthy lifestyle, and a nursing quality programme to ensure the use of evidence-based practice. TTSH Nursing Service submitted more than 1,000 pages of documentation and evidence detailing the hospital s high practice standards. Over 2,000 nurses also took part in a confidential survey by the ANCC, with many giving favourable responses. Mobile Billing Reduces Wait Times Inspired by airport self check-in kiosks and dim sum trolleys, staff from the TTSH Cardiology Clinic 3B developed a mobile billing service, which reduces the need for patients to queue for payment, and has cut average waiting time at billing counters from 34 to 11 minutes. The service is run by team of Patient Service Associates who, armed with mobile billing trolleys, approach patients to collect fees and make follow-up appointments where necessary. The service has since been rolled out at other TTSH clinics including 2A, B2B and 5A. NHG is the Regional Health System for Central Singapore NHG Pharmacy staff work collaboratively as part of a multi-disciplinary team to manage patients with chronic illnesses. NHGP s mobile smartphone application helps reduce waiting times at clinics. NHG Transforming Population Health 27

32 28 IMH ANCC Reaccreditation Extended The Institute of Mental Health (IMH) also received the American Nurse Credentialing Center s (ANCC) Accreditation with Distinction in 2012, the highest accolade from the accrediting body. In FY2013, IMH was awarded two more years of accreditation until 31 July 2016, in recognition of IMH s commitment to a high standard of mental health education for its nurses and also its position as a tertiary centre of excellence and global leader in mental healthcare. IMH is the only mental health institution outside the USA to receive this recognition. IMH Opens Dementia-Friendly Wards IMH officially opened two dementia-friendly wards in February 2014 the Dementia-friendly wards at IMH are designed to appear more homely; this encourages patients to pursue normal activities of daily living. only dedicated inpatient facilities in Singapore which treat dementia patients with severe Behavioural and Psychological Symptoms of dementia. The refurbished wards offer 25 beds each for male and female patients, and provide a more conducive healing environment for patient rehabilitation, with the intention of returning patients back to the community. Design features include a purpose-built therapeutic garden, where dementia patients can leisurely wander to enjoy the tranquil natural surroundings. The ward also features a Reminiscence Room where antique objects and materials are displayed to help patients evoke past memories and reminisce as part of their therapy. Various activity spaces including a gym and sensory room also provide holistic rehabilitation for patients. The ward environment has also been designed to appear more homely, which encourages patients to pursue normal activities of daily living. Thoughtful design and colours have also been used throughout the space to reduce patient agitation and aggression. The needs of caregivers are also looked after in the ward. IMH conducts psycho-education sessions and workshops to help caregivers understand issues relating to caring for patients with dementia. A Caregivers Resource Corner also provides additional information, emotional support and guidance. Clinical Care

33 The opening of IMH s Dementia-Friendly Wards marks an important milestone in IMH s vision to be a tertiary centre of excellence and global leader in mental healthcare. With these new facilities, we will be able to improve the quality of care for our elderly patients, in an environment that is specially tailored for their needs. Acupuncture Clinic to Combat Addiction Withdrawal symptoms are a major hurdle to overcoming addiction. To help addicts ease the symptoms of withdrawal, the National Addictions Management Service (NAMS) of IMH introduced an acupuncture service to complement its suite of addictions treatment options. Acupuncture is known to stimulate the body to release chemicals called endorphins, which promote a feeling of wellness. This in turn helps addiction recovery by countering anxiety, cravings and other associated withdrawal symptoms. The service accepts adult patients referred from polyclinics, private specialist clinics or other restructured hospitals. Patients are assessed by an addictions acupuncturist at NAMS. Those deemed suitable for acupuncture treatment usually undergo a minimum of 10 half-hour sessions over a six-week period. IMH Opens Memory Clinic To help patients with dementia and the elderly cope better with memory loss, IMH introduced the Memory Clinic in June A multi-disciplinary team conducts a series of structured interviews, as well as detailed assessments to diagnose a patient s condition. Depending on the outcome of these assessments, the doctor may refer the patient for a neuropsychological assessment by the psychologist, order blood investigations or a brain scan. The doctor may also start the patient on dementia medication. Patients with signs or symptoms of cognitive impairment, such as memory problems or personality change are referred to the clinic from various sources including acute hospital, primary and community care settings. There is no age limit for referral. IMH s Memory Clinic functions on a multidisciplinary model. The team includes a psychiatrist, memory clinic nurse, psychologist, occupational therapist and medical social worker. To date, the clinic has seen more than 40 patients. Revamped Sayang Wellness The Blossom Wing of Sayang Wellness Centre, IMH s private ward, underwent renovations in December 2013 to provide a more comfortable stay for patients. The ward was modernised with a fresh coat of paint, laminated cabinets, and wall-mounted writing tables and televisions. In April 2014, the designs for pillow cases, bed sheets, quilt covers and curtains were also changed. Patients have already given feedback that the ward looks more cheerful and cosy. Care of Complex Chronic Patients at NHGP The National Healthcare Group Polyclinics (NHGP) is seeing a growing number of patients with chronic conditions and co-morbidities. In FY2013, NHGP saw some 412,000 patients with chronic diseases, Associate Professor Chua Hong Choon CEO, Institute of Mental Health Bringing Quality Healthcare Closer to You NHG Transforming Population Health 29

34 compared to 406,000 in FY2012. Diabetes, hypertensive disease and hyperlipidaemia remained as the top three chronic conditions. Since April 2012, NHGP has been identifying patients with complex and multiple care needs, as well as matching them to a multi-disciplinary care team which includes care managers, pharmacists, dietitians, psychologists, and medical social workers. The team supports patients by helping them better manage their condition. As of June 2013, close to 700 NHGP patients have benefited from such support. NHGP has shown good results in managing its complex chronic patients. Diabetic patients with elevated glycated haemoglobin (HbA1c) markers showed 9% to 10% drop in low density lipoprotein-c and HbA1c levels, respectively. A third of patients successfully reduced their HbA1c from 9%. There was also a 6% increase in patients who achieved optimal diabetic control. NHGP Telecare Programme NHGP and Integrated Health Information Systems (IHiS) launched the Telecare Programme in February 2013 for patients who have good control of their chronic diseases such as diabetes, hypertension or lipid disorder. Patients measure and submit their home monitoring readings of glucose (if diabetic), blood pressure and weight through which is a web-based portal. Online prompts are available to guide the patients on action plans to take based on the home monitoring readings. Care managers review the information and guide the patients on their management of their diseases via scheduled teleconsultations. Patients who show good progress and are in stable conditions can reduce their number of visits to our clinics. The care managers will also alert the doctor and pharmacy for medication refills, which the patient can then collect at his or her convenience. Towards A Culture of Health and Safety NHGP has embarked on several initiatives to advocate infection control practices among its stakeholders staff, patients and the community at large to keep the population well. NHGP regularly reminds its staff to practise good hand hygiene through quarterly roadshows. Best practices are also shared with the wider community. It does this by conducting outreach programmes on personal health and cleanliness to preschoolers at kindergartens and nurses in nursing homes. NHGP updated its Infection Control Surveillance System (ICSS) in 2013; a discussion forum was added to this web-based surveillance system to encourage the sharing of best practices on infection control best practices. In addition, NHGP organised workshops for multi-disciplinary teams to learn and share about infection control practices across the polyclinics and professions. A culture of safety is fostered through monthly Safety Leadership Walkabouts. In July 2013, a Patient Safety Foundation workshop was started to enhance the knowledge of NHGP s doctors, nurses, health attendants and patient service associates on patient safety. NHGP launched its first patient safety newsletter in April The newsletter Clinical Care 30

35 focuses on raising the awareness about patient safety amongst staff, sharing on JCI safety standards and safety improvement initiatives. NHGP Cuts Waiting Time for Limb Fracture X-rays Waiting times for X-rays of limb fractures at NHGP has been cut by nearly half, thanks to a nurse-led triage process. Using a detailed medical questionnaire, nurses, instead of doctors, are able to check if patients require an X-ray for their injuries. Those who meet the criteria have their injuries immobilised before being directed to radiology. As a result, waiting time for patients with limb injuries has reduced from some 186 to 100 minutes, on average. Since the pilot in 2011, some 12,000 patients have benefited from the service. NSC Achieves JCI Re-Accreditation The National Skin Centre (NSC) successfully achieved re-accreditation by the Joint Commission International after a two-day survey in November JCI is an American-based accreditation body which recognises institutions for their compliance to international healthcare quality standards. Thanks to JCI accreditation exercises over the past three years, NSC has generated increased levels of patient comfort and satisfaction, improved staff performance, improved safety as well as better care policies and guidelines. Formulary Management Guidebook In April 2014, the NHG Pharmacy and Therapeutics office published a 156-page book to support formulary management the practice of managing medication lists in public healthcare institutions. The book titled, Formulary Management A Practical Guide, guides healthcare professionals to assess and select medication that is safe, effective and offers the best value for money. Information has been sought from all NHG institutions, as well as the National University Hospital. Improving Medication Management National Healthcare Group Pharmacy and IHiS rolled out the Multi-Dose Medication Management (MMM) system at 16 nursing homes and four long-stay wards in the Institute of Mental Health, benefiting over 3,400 patients. The solution was also rolled out to all nine polyclinics under NHGP in June The MMM system, also known as ConviDose, involves organising and pre-packing all the medicines to be taken at a prescribed time, into a single sachet. This innovative approach improves medication adherence and safety for thousands of elderly chronic disease patients taking their medicines at home, or in nursing homes across the island. The system also frees up nurses time previously used to prepare medication, so that they can spend more time on direct patient care. Automated packaging machines also substantially increase the productivity of pharmacy staff, enabling them to prepare medication for 200-bed nursing homes in 1.5 man-days instead of 20 man-days before. The MMM System clinched the regional CIO Asia Award 2013, and Singapore Infocomm Technology Federation (STF) bronze award in NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 31

36 COMMUNITY Care 1 32

37 As the Regional Health System for Central Singapore, NHG is responsible for the health of 1.4 million people. We aim to transform population health by empowering patients to age in place. To achieve this, we must first realign our services and care delivery models to be more patient-centric, holistic and cost-effective. The model of care is shifting from the current episodic treatment towards more comprehensive, continuing care delivered by an integrated team of providers The needs of our patients are evolving to include more than just medical help. Often, psychosocial and economic issues can manifest as clinical problems. Clinical care must go hand in hand with social and financial support. Our focus today includes developing a holistic care network which provides integrated healthcare and social services at the ground level. We have embarked on major health programmes working with various agencies to try and address the needs of the population, and are working closely with primary care and social partners to help patients get timely and appropriate care. 1 Ms Anita Fam, Chairman of the Central Regional Health Advisory Council, speaking to a patient at NHG s annual Chinese New Year lohei celebrations with community partners. 2 Mr Lim Swee Say, NTUC Secretary-General and Minister in the Prime Minister s Office, having his eyes checked at the Unity Family Medicine Clinic. The FMC is a joint collaboration between the National Healthcare Group and NTUC Unity Healthcare. 3 Mental healthcare professionals often conduct home visits to patients and their caregivers to provide support where they need it in the community. 4 The Virtual Hospital team from TTSH won the PS21 ExCel Certificate of Recognition for Most Innovative Project. 33

38 COMMUnity Care NHG Forms Central RHS Advisory Council NHG, in its capacity as the RHS for Central Singapore, formed the Central Regional Health System Advisory Council. The multi-agency group was established in September 2013 and comprises members of the Ministry of Health, Agency for Integrated Care, Ministry of Social and Family Development, Peoples Association (PA) and various social and community organisations within the Central region who are our active care partners. The formation of the Council allows for greater discourse and more well-rounded views on various issues and matters concerning the population in the Central region. These include the enhancement of integration of care services, promoting health and health literacy and improving access to care. The Council is chaired by Ms Anita Fam, who is also a Board member of NHG. The NHG Care Transformation Journey Begins As NHG continues its journey to develop patientcentred care in the community, infrastructure must also be in place to facilitate a new model of care. In 2013, NHG began its Care Transformation journey to create an improved, integrated healthcare system supported by a new Electronic Health Record system. This new Electronic Health Record system will enhance our efficacy as the RHS for Central Singapore by establishing a unified system, which will be in line with the National Health IT Master Plan, led by MOH Holdings. Between March and April 2014, a multi-disciplinary team examined 20 focus areas to understand improvements and requirements needed for each department and institution across NHG. The project is expected to be implemented from Representatives from across NHG marked the start of our Care Transformation journey to develop a unified electronic medical record system.

39 Bringing Care Closer to Home More seniors prefer to be cared for in their own homes rather than in a healthcare institution. NHG is helping to make this easier by bringing healthcare closer to them. TTSH has put in place programmes such as Post-Acute Care at Home (PACH) and Virtual Hospital (VH) to help patients move from acute care to home and community care after they are discharged from the hospitals. In addition, suitable patients who are currently visiting Specialist Outpatient Clinics in TTSH but can be cared for by GPs near their home vicinity may also be referred to the latter for continuing care. Further recognising that some patients would need to be placed in a nursing home, TTSH has also initiated Project CARE which serves to train and supervise nursing home staff in performing Advanced Care Planning and providing End-Of-Life care. Our spectrum of programmes is described in greater details in the following segments. Post Acute Care at Home In line with NHG s aim of providing seamless, integrated care to patients in the community, TTSH introduced PACH which aims to stabilise and rehabilitate patients in the sub-acute phase of illnesses. A multi-disciplinary team comprising doctors, nurses and therapists provides appropriate home care support to promote better self-care. The programme also aims to help caregivers better manage homebound patients so as to reduce the need for institutionalised care. In FY2013, PACH helped provide better home care support for over 800 patients who were discharged from the hospital. For continuity of care, coordination will be done for appropriate PACH patients who are discharged from the programme to receive step-down medical care from our network of community healthcare service providers. Virtual Hospital The Virtual Hospital service has been proactively caring for TTSH patients who are at-risk of repeated non-elective admissions to the hospital. This is achieved by a multi-disciplinary care team which provides home visits to the patients for clinical management and medication reconciliations where necessary. The team also links patients to relevant social and community support to further aid recovery and maintenance of their health at home. This helps to reduce re-hospitalisations and improve their quality of life. With the provision of health and social care for our patients through a one patient, one care plan principle, the team strives to bring about holistic and integrated care to our patients. For its innovative hospital without walls concept, the Virtual Hospital programme was awarded the Certificate of Recognition for Most Innovative Project PS21 Excel Awards. The prestigious annual awards recognise excellence in public service. The programme has serviced some 200 patients to date. Community Right Siting Programme for Stable SOC Patients General Practitioners (GPs) remain the main primary care services seeing 81% of primary attendance in Singapore. Leveraging on the expertise and accessibility of GPs in the community, TTSH developed the Community Right Siting Programme (CRiSP). The programme is a collaboration between TTSH and GP partners, where stable chronic patients from the hospital s Participants at a Falls Prevention community workshop. Bringing Quality Healthcare Closer to You NHG Transforming Population Health 35

40 36 Specialist Outpatient Clinics (SOCs) are referred to and managed in a primary care environment. The programme currently has 22 GP partners who help ensure assessable, affordable and good quality care for right sited patients. These GPs are granted access to patients clinical notes under the National Electronic Health Record to provide continuous care more effectively and seamlessly. Under the programme, National Healthcare Group Diagnostics also provides relevant subsidised radiology and laboratory services to patients at partner GPs to ensure that bill sizes remain affordable for patients. Under CRiSP, TTSH right-sited 106 patients to GPs in FY2013 and will develop more clinical tracks where GPs can help manage more chronic conditions. Project Care Palliative care has become increasingly vital as the number of frail elderly in nursing homes grows. To help improve the quality of care provided to nursing home patients, TTSH introduced Project CARE (Care At the end of life for Residents of Elderly Homes). Under the programme, the hospital deploys a multi-disciplinary team to care for patients in six participating nursing homes, namely the Lions Home for the Elders, Ling Kwang Home for Senior Citizens, Ren Ci Nursing Home, Ren Ci Long Term Care, Society for the Aged Sick and Singapore Christian Home. A specialist outreach team comprising doctors, nurses and medical social workers, is deployed to train and supervise nursing home staff in performing Advanced Care Planning and providing End-Of-Life care. Nursing home staff are also able to contact the team should they need assistance in managing such patients. With improved palliative care services at nursing homes, patients are given the dignity of spending their final days in their preferred environment and treatment. Some 110 patients were recruited to the programme in FY2013. Boosting Community Health Empowering patients and the elderly to care independently for themselves is a key strategy towards achieving our goal of Adding Years of Healthy Life. NHG and TTSH, through the Department of Continuing and Community Care, works with our RHS partners on several initiatives to boost population health: Community Health Engagement Programme (CHEP) CHEP comprises Stepping Out into Active Life, Engage In Life, and Chronic Disease Self- Management Programme which help seniors take charge of their health. Together with a network of community partners in the Central RHS, CHEP aims to equip the seniors with the skills needed for an independent and healthier life. This is achieved through regular community-based educational workshops and talks as well as exercise classes conducted by a multi-disciplinary team of doctors, nurses and therapists. In FY2013, CHEP received participation from over 1,300 people. A patient receiving help from a staff at the Unity Family Medicine Clinic, a joint collaboration between NHG and NTUC Unity Healthcare. Community Case Finding Programme NHG is responsible for the health of 1.4 million citizens in the Central Region of Singapore, of which some 320,000 are already cared for by NHG institutions. Past research work by our Health Services and Outcomes Research (HSOR) team and early phases of our CHEP programme have shown that those living in rental flats may remain Community Care

41 NHGP works with community partners to conduct health screenings, as well as workshops which provide residents with tips on healthy living. unknown to the public healthcare system until their conditions become severe. Adopting a proactive approach to engage and meet the needs of this population segment, NHG embarked on a pilot programme to assess the health and social needs of residents in the central region. Co-organised by NHG and the Central Singapore Community Development Council (CDC), the programme aims to reach out to over 4,400 rental flat units in Toa Payoh in its first phase. Nursing students and health promotion post-graduate students from the Ngee Ann Polytechnic and Republic Polytechnic, together with NHG staff, will conduct door-to-door interviews followed by health screening for eligible individuals. The data is then collated and analysed for close follow-up by a network of medical and social care providers. Second Family Medicine Clinic Opens NHG, in collaboration with NTUC Unity Healthcare, launched the Unity Family Medicine Clinic (FMC) in May The FMC is a publicprivate partnership that leverages on the respective strengths of NHG and NTUC Unity Healthcare to meet the growing demand for chronic disease care in the community. Located at the Braddell Heights Community Hub in Serangoon Central, the clinic is a one-stop family clinic for patients with stable chronic diseases including diabetes. NHG works through National Healthcare Group Polyclinics (NHGP) to provide clinical and administrative support to the partnership and to ensure integrated, comprehensive care for patients in the community. Patients from TTSH, IMH and Hougang Polyclinic can also be referred to Unity FMC if they are deemed suitable for follow-up care in the community. Patients who are subsidised under the Community Health Assist Scheme (CHAS) or Public Assistance Scheme will be able to use these benefits at the clinic. Unity FMC complements NHG s first FMC in Ang Mo Kio, which opened in May We ve designed cars that come with four gears. It s a combination of gear one to four that makes your journey smooth and speed-time cost effective. Healthcare is the same. If you try to run a healthcare system with only one gear, that is hospitals, the system will be under a lot of stress. More importantly, it will not be cost effective for members of the public. So under the leadership of the Ministry of Health, we are strengthening the healthcare system of Singapore to ensure that each of the four gears will be more comprehensive, working together in harmony. Mr Lim Swee Say NTUC Secretary-General, Guest-of-Honour at the official opening of Unity FMC NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 37

42 Community Care 38 TTSH held the first Singapore Patient Conference in October 2013 for healthcare staff, patients, caregivers, volunteers and members of the public. Beyond good outcomes and safe care, being attentive to patients and their loved ones needs, feelings and relationships is imperative in healthcare delivery today. Professor Philip Choo Deputy Group CEO (Regional Health), NHG and CEO, TTSH TTSH Hosts Inaugural Patient Conference TTSH held the first Singapore Patient Conference in October 2013 which attracted over 300 healthcare staff, patients, caregivers, volunteers and members of the public. The conference was launched by Associate Professor Muhammad Faishal Ibrahim, Parliamentary Secretary for the Ministry of Health and the Ministry of Transport. The one-day conference highlighted the contributions of volunteers who have provided support to patients. It also underlined the need to foster a culture of collaboration between healthcare institutions and families to improve safety and quality of care for patients. Participants had the opportunity to exchange ideas with healthcare providers. In conjunction with the conference, TTSH also opened CareConnect a new centre dedicated to improving patient experience and healthcare delivery. CareConnect is a one-stop information hub that provides patients, their families and caregivers access to resources within and beyond the hospital. Food for Health TTSH Complementary Integrative Medicine s Cookbook, Herbs for Health, Food for Life was officially launched in September 2013 at the Singapore Health & Biomedical Congress. Group CEO of National Healthcare Group, Prof Chee Yam Cheng, graced the event. Retailing at $20 (including GST), the bilingual cookbook features 18 recipes that promote a healthier diet. The book is sold at the TTSH Complementary Integrative Medicine Clinic (Clinic 6B) and at all major bookstores.

43 Mental Health Integrated Network for Central Singapore Mental health is a fundamental and indispensable component of an individual s overall health and wellbeing. In addition to its role as the national centre for mental health, the Institute of Mental Health (IMH) also oversees the Group s implementation and integration of community mental health programmes through the NHG Central Region Mental Health Integrated Network (NHG MHIN) since April 2012 in support of MOH s Community Mental Health Masterplan (FY2012 to FY2016). Key clinical and administrative leadership from NHG, IMH, TTSH and National Healthcare Group Polyclinics (NHGP) worked together to identify community mental health partners and match training needs to roles, as well as boost competencies for service delivery for the subsequent roll-out of community mental health initiatives in the Central region. The team works closely with community mental health partners including GPs, Family Physicians, Family Service Centres, Senior Activity Centres, grassroots organisations and constituencies, town councils, and voluntary welfare organisations to strengthen capability in providing quality mental Under the ASCAT programme, a multi-disciplinary team works with family physicians to manage patients with chronic diseases and mental health conditions. health care based on service development and mental healthcare needs in the community. With NHG MHIN s implementation of community mental health programmes, patients now have more access to healthcare with reduced waiting times and less stigmatisation, coupled with evidence-based medicine and co-management of both physical and mental health needs. In the ASCAT (Assessment and Shared Care Team) model for example, 50% of patients with both chronic and mental diseases can have their conditions managed concurrently at the primary care level. Boosting Primary Care and Community Capabilities in Mental Health Strong community support for mental health services has helped to improve accessibility of care for patients and their families. IMH has been working with its partners in the primary and community care sector to develop a robust safety net for patients outside of the acute hospital setting. These on-going partnerships in the Central region have enabled risk stratification and right-siting of patients at the appropriate level of care. A more coordinated referral workflow also helps patients navigate the system more easily. In addition, this seamless flow of healthcare services for patients across primary to tertiary care settings facilitates the initial interfacing of physical and mental healthcare with social services. ASCAT IMH s multidisciplinary team provides regular training, supervision and case discussion with the multidisciplinary team including Family Physicians, Psychologists, Medical Social Workers and nurses running the clinical service at NHGP Ang Mo Kio Polyclinic. This enables family physicians to provide more holistic care Bringing Quality Healthcare Closer to You NHG Transforming Population Health 39

44 40 for patients with mild to moderate mental health conditions through psychiatric assessment and follow-up treatment. The programme has helped more than 500 new mental health patients in the primary care setting since October Enabling GPs To provide more effective mental health treatment in the community, IMH links GPs with a Community Mental Health Intervention Team (COMIT) managed by a volunteer welfare organisation in the Central region. GPs offer psychiatric assessment, medication and comanaged patients with run by O Joy Care Services, which provides mental health counselling and case management. IMH s capability building efforts comprises multi disciplinary team case discussion and training sessions which have enabled GP-COMIT partners to see more than 100 patients in the community since the beginning of CREST Community Resources Engagement and Support Team (CREST) is a community-based programme which provides a community safety net for elderly in the community who are at risk of, or living with mental illness. There are three formed by Cluster Senior Activity Centres in the central region Thye Hua Kwan (Beo Crescent), Ang Mo Kio Family Service Centre and Care Corner SAC Cluster Support Toa Payoh. The programme aims to increase public awareness on mental illness through community outreach and education; to promote early recognition of conditions; and, to provide integrated care, information and support for patients and caregivers. This is done by developing a robust network of partners to help support patients in the community. IMH has been providing training sessions, resource sharing, monthly case discussion with experts, as well as working level meetings to build capabilities of staff at the three Supporting Community Efforts IMH also supported other community partners such as Silver Ribbon Singapore, Community Rehabilitation Support and Services (CRSS), Community Support Team (CST) and Singapore Anglican Community Services (SACS) on various collaborative and networking platforms to integrate processes, facilitate client flow, share best practices and success stories for continuous improvement as well as outreach, mental health awareness and training for community support networks. Mental Health Helpline The NHG MHIN also builds on existing mental health services such as IMH s Mental Health Helpline which serves as a support link for persons or partner agencies that need assistance for precrisis situations or basic clinical advice. It supports IMH and non-imh patients, or undiagnosed persons suspected of mental illness. Staff also attend to pre-crisis or crisis requests for clinical advice, and carry out onsite assessments, if needed. Mental Health Helpline connects and works closely with community partners and constituencies to understand their needs in the community and also builds capability via mental health training and interactive workshops with IMH specialists. Expanding Reach In FY2013, IMH s REACH (Response, Early intervention, Assessment in Community Mental Health) started combined training for school counsellors, VWOs and Special Education (SPED) schools, thereby enhancing collaboration between community services. The sixyear-old programme was first implemented to identify and provide early intervention for children with or at risk of developing mental health disorders. REACH provides specialised training and clinical expertise, as well as mental health services to all 20 SPED schools in Singapore. This is in addition to mainstream schools. The programme also organised a training workshop for GPs. To date, REACH has recruited a total of 31 GP partners to manage childhood mental health illnesses in the community. In May 2013, REACH implemented charges for its services, in line with Singapore s healthcare system where consumers co-pay part of the medical expenses incurred, following the end of the pilot programme. Community Care

45 Empowering Patients Against Addictions IMH s National Addictions Management Service (NAMS) rolled out several new initiatives to help raise awareness of how to combat addictions and it provides avenues where people can get help. NAMS Launches Second Satellite Clinic To better serve patients in the Central-Eastern part of Singapore, NAMS expanded its treatment services to IMH s Community Wellness Clinic (CWC) in Geylang from July Patients now have the option of seeking help at our outpatient clinics in Buangkok Green Medical Park, CWC in Queenstown or Geylang. Some 20 addiction cases were seen at the clinic between July 2013 and March Library Outreach NAMS worked with the National Library Board (NLB) for the first time to launch an addictions outreach programme in the regional libraries. Besides exhibiting selected art pieces from the Voices through Art exhibition a project undertaken by NAMS inpatients to express their thoughts in battling with addictions and to share their hopes for recovery; two interactive workshops on addictions were also conducted by students from the Diploma in Applied Drama and Psychology faculty of the Singapore Polytechnic for library goers. Training of Addiction Ambassadors As part of the collaboration between NAMS and the South West CDC, a new programme was launched to equip grassroots leaders (GRLs) and volunteers with better knowledge of how to reach out to and help residents with addictions in a timely manner. A pocket-sized resource toolkit was co-developed by NAMS and South West CDC to help learners recognise the signs and symptoms of addictions, as well as advise and assist at-risk residents by directing them to help resources in the community. Through workshops, GRLs and volunteers are taught practical tips on approaching and motivating residents who may be hesitant to seek help. The new programme equips community volunteers with relevant, practical and applicable tips to help residents who are at risk of gambling and alcohol addictions. Dropping Labels of Stigma Students at the National University of Singapore, together with the Community Health Assessment Team (CHAT) developed the Drop That Label! campaign to help fellow tertiary students destigmatise and improve their understanding of mental health issues. The campaign which started in June 2013 had students display badges pledging their support to destigmatise those with a mental illness. An online hashtag competition encouraging students to take creative photos with their badges. The initiative culminated in the premiere of the campaign video. IMH Launches Minding the Gaps Minding the Gaps Parenting a Child with Learning Disorders was written by IMH s Chairman Medical Board and REACH Programme Director, A/Prof Daniel Fung, together with REACH South Team Leader Ms Joycelyn Neo, and clinicians from IMH s Department of Child and Adolescent Psychiatry, Principal Educational Psychologist Kheng Joo Lian and Senior Special Education Teacher, Serena Lim. The book serves as an aid for parents with children who have learning disorders. It contains practical recommendations and other useful information parents may need to support their children. NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 41

46 Engaging community partners is a key objective in our role as the RHS for Central Singapore. year, we began actively connecting with various organisations such as the Thye Hua Kwan Moral Charities (THKMC), NTUC Eldercare and Lion s Befrienders so that our patients are able to receive community resources, care and support. Correspondingly, in the Intermediate Long Term Care (ILTC) sector, NHGP is also working with selected welfare and nursing homes management and resident physicians, to provide chronic care on site, so that their residents can be cared for, without the necessity for them to be transported to the polyclinics for their regular chronic care. Community Care 42 Working with the Community to Better Care for Our Patients Improvement and sustenance of good health is a massive and collective responsibility. NHGP or any other healthcare providers cannot work in isolation, as health is an outcome of multiple complex biological, psychological, and social factors. With its nine polyclinics across Singapore, NHGP has the opportunity to work with several partners and various RHSes to bring better care directly to the community. NHGP has started working with community partners and the various RHSes to provide integrated community care by empowering our patients with complex conditions and their caregivers to better manage their health. NHGP established the Patient Empowerment and Community Engagement Department (PEACE) in October 2012 in recognition of the need to integrate services across the continuum and establish inter-sectorial partnerships. Since last Under PEACE, NHGP engages CHAS-certified GPs to develop a robust support network for lower income patients with chronic diseases. Supporting Right Siting of Patients and Enhancing Primary Care Capacity NHGP has been making strong inroads into right-siting care for patients within the community. This is aimed at giving patients the convenience to seek care near their homes so as to improve their continuity of care and access to care. As of May 2014, about 4,300 NHGP patients have taken up the option to be seen at Family Medicine Clinics (FMCs). This includes 3,600 patients who have moved to Ang Mo Kio FMC, NHG s first FMC set up in 2013.

47 NHGP proactively engages other GPs near its polyclinics; working closely with them on enrolment into Community Health Assist Scheme (CHAS) which is one of the Ministry of Health s programmes to provide quality, accessible and affordable care to Singaporeans as well as engaging the CHASaccredited GPs to partner NHGP and facilitate the transfer of care and management of stable chronic patients who are on CHAS. About 1,650 patients have moved from NHGP to GPs since NHGP continues to work with 180 CHAS-active GPs to collaborate on care. provider in primary healthcare for one-stop imaging and laboratory services. These services are available through a comprehensive network of 25 static imaging and laboratory centres, six professional service centres and seven mobile centres around Singapore. Mobile services include general X-ray, mammogram, ultrasound and bone mineral densitometry. NHG Diagnostics mobile fleet also supports community health events organised by grassroots groups, companies and schools. By making diagnostic services more accessible, NHG Diagnostics minimises the need for patients to visit acute hospitals, saving them time and travel costs. Since the launch of CHAS, NHGP has been working closely with MOH and AIC to raise awareness about the scheme among its patients. From FY2012 to FY2013, CHAS uptake among NHGP patients has grown to some 230,000. Providing Accessible Diagnostics Care in the Community Accessible diagnostic services are a crucial element in providing seamless care in the community. The National Healthcare Group Diagnostics, a business unit of NHG, is a leading Bringing Quality Healthcare Closer to You NHG Transforming Population Health 43

48 RESEARCH, TECHNOLOGY and INNOVATION 1 44

49 Research is one of three key pillars that underpins NHG s work. Leveraging from the synergy of partnerships, we have had the privilege of collaborating with world-class organisations to boost research. By collaborating with experts and working with a multi-disciplinary teams, we seek to continuously improve and enhance care delivery to our patients. Technology also features strongly in helping to improve patient outcomes and contribute to Adding Years of Healthy Life. 2 1 The Skin Research Institute of Singapore is a $100 Million joint collaboration between the Agency for Science, Technology and Research, Nanyang Technological University and National Skin Centre. 2 Dr Amy Khor, Senior Minister State for Health and Manpower, speaking at the opening ceremony of the inaugural Singapore Mental Health Conference, held in conjunction with the Singapore Health and Biomedical Congress

50 ReSeaRCH, technology and INNovaTIoN NHG and SingHealth Ink Milestone Agreement Two of Singapore s largest healthcare clusters marked a major milestone in medical research in May 2014 with the signing of a Memorandum of Understanding (MOU) between SingHealth Centralised Institutional Review Board (CIRB) and the NHG Domain Specific It s a big celebration today as it signifies our two clusters coming together for a single mission and purpose. Professor Ivy Ng Group CEO, SingHealth 46 We hope that this change will further facilitate collaborative research for the good of biomedical research in Singapore through improved efficiency and more time and cost savings. Professor Chee Yam Cheng Group CEO, NHG Review Board (DSRB), which govern research ethics standards in their respective clusters. The MOU facilitates the mutual recognition of multi-site studies reviewed by both Boards. Mutual recognition means that researchers can conduct their studies across both clusters sites and institutions, without having to seek additional approval from the other review board. For example, a research study approved at one site governed by SingHealth CIRB will now also be recognised by NHG DSRB, and vice versa. The MOU will also facilitate knowledge sharing, which will in turn generate higher research standards in clinical studies involving human subjects. The MOU was signed by Professor Chee Yam Cheng, Group CEO, NHG and Professor Ivy Ng, Group CEO, SingHealth.

51 DSRB Celebrates 10 Years In addition to signing a milestone agreement with SingHealth CIRB, NHG DSRB also celebrated its 10th anniversary. Since its establishment in 2004, the Board has expanded to cover six domains, from four previously. The key achievements of NHG DSRB include receiving Full Accreditation by the U.S. Association for the Accreditation of Human Research Protections Program (AAHRPP) in 2007 and 2010, establishing a sixth research domain in October 2012 to support a more specialised and efficient review of population health research, and the launch of an integrated platform, Research Online Administration and Management or ROAM portal, in 2011 that streamlines the submission and review of ethics applications. Understanding the Population Health through Research Singapore s rapidly ageing population has resulted with a growing pool of individuals with multiple co-morbidities. To understand the complex needs of the population, NHG s Health Services & Outcomes Research (HSOR) used data analytics and visualisation tools and techniques to transform the deluge of information in simple interactive visuals. Studies focusing on population health and chronic diseases have given policy makers a better understanding of patients needs to enable the design of relevant and holistic programmes. HSOR was set up in 2005 to improve the quality of healthcare by providing the best available evidence for decision making and knowledge translation, building capacity and advancing knowledge in health services research. The multi-disciplinary team works closely with clinical heads and managers on the ground to formulate relevant questions and translate scientific qualitative and/or quantitative evidence into decisions and practice. Boosting Research Partnerships In 2013, several initiatives were introduced to promote research collaborations between NHG and its partners including Nanyang Technological University (NTU) and the Agency for Science Technology and Research (A*STAR). Two thematic grants were introduced. The $2 Million Ageing Research Grant with NTU helps drive collaborative projects in Ageing research, while the $4.75 Million Skin Research Grant with NHG, NSC, NTU and A*STAR helps in the area of skin research in support of the SRIS. NHG-NTU/LKCMedicine Research Seminars NHG is the primary clinical training partner for the Lee Kong Chian School of Medicine (LKCMedicine). Since November 2013, NHG and the school have launched a series of bimonthly thematic research seminars aimed at demonstrating the relevance and potential integration of basic and translational scientific research by both institutions in the clinical settings. The seminars also serve to introduce the new medical school to the healthcare and scientific communities in Singapore through talks given by the clinicianscientists of NHG institutions and LKCMedicine faculty members. Developing Clinician-Scientists and Investigators To develop research capabilities of clinicians, NHG introduced the Clinician-Scientist Career Scheme (CSCS) to equip our doctors to compete successfully for extramural grants and contribute to excellence in research innovations, improvement in patient care, delivery and outcomes. With the introduction of the CSCS (Senior) in January 2014, the scheme now caters to holistically developing clinicians from junior to senior levels. In addition, the inaugural Clinician Investigator (CI) Scheme was launched in May This unique scheme aims to promote a culture of collaborative research among established clinicians so as to generate better research outcomes, and develop them as international key opinion leaders in their respective fields. NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 47

52 48 A Leader in Research Ethics The 3rd Asia Pacific Research Ethics Conference (APREC 2014) was successfully held at the Grand Copthorne Waterfront Hotel in March Co-sponsored by NHG s U.S. partner, Public Responsibility in Medicine & Research (PRIM&R), the conference was called Research Ethics: Harmonising Global Principles with Asia Pacific Practices. Over 340 participants from 20 countries in the Asia Pacific, Europe, Africa, Middle East and the U.S., attended the two-day event. Some 50 local and international speakers presented and facilitated in-depth discussion on various topics that included challenges faced by Institutional Review Boards; quality risk management strategies; ethical and legal considerations in human research; and hot topics such as research involving vulnerable population and managing financial conflicts of interest. First Online Course for Good Clinical Practice With effect from August 2014, the Singapore Guidelines for Good Clinical Practice (SGGCP) has become a new Minimum Training Requirement for Principal Investigators (PIs), including site PIs in NHG and partner institutions. NHG is a key provider of the SGGCP course that equips participants with the basic knowledge of conducting clinical trials according to internationally acceptable ethical and scientific standards. NHG successfully launched the SGGCP Online Course at the 3rd APREC in March This is the first certified SGGCP training available online, and will help meet the demands of growing volumes of research activity. Easy accessibility to the course will also help more researchers to be trained in a shorter time, further facilitating the growth of clinical research here. Facilitating Dialogue for Research Staff and the Public As research continues to gain momentum across NHG, the Research & Development Office hosted several research forums and initiatives to promote knowledge exchange and education. CRCS-CRP Forums Three educational forums for the Clinical Research Coordinator Society and Clinical Research Professionals (CRCS-CRP) were held in Each boasted an interesting mix of speakers, presentation topics and audience representation from institutions and the industry alike. The myriad topics featured included quality assurance, compliance, institutional board reviews, regulatory updates and research misconduct. Attendance from the research community was consistently remarkable, with the audience capacity subscribed to the maximum for the forums. As population centres grow, the distribution of healthcare services needs to be able to cope with higher demands, especially when it comes to creating a comprehensive system of healthcare for the elderly. Professor Lord Ara Warkes Darzi Paul Hamlyn Chair of Surgery at Imperial College Hospital, London, during his keynote address at SHBC 2013 Research, Technology and Innovation

53 NHG Public Forum 2013 In July 2013, the NHG Office of Human Research Protection Programme (OHRPP) organised a public forum to educate the community about research. The theme was Research and You What You Need to Know about Participating in Research. Four experienced research ethics experts and subject advocates shared on how the general public could best make informed decisions before engaging in research activities. SHBC 2013 Breaks New Ground Over 3,000 delegates attended the Singapore Health and Biomedical Congress (SHBC) 2013, organised by NHG, in September at the Singapore Expo. The turnout was the largest in the conference s 11-year history, and was also the largest healthcare gathering in Singapore. Healthcare professionals from Singapore and the region gathered to discuss challenges and ideas in building a more affordable, accessible and quality healthcare system. Key to achieving this goal was the need for greater synergy amongst healthcare professional groups, which was why SHBC 2013 also SHBC 2013 Organising Chairman, Associate Professor Steven Thng, with Mrs Tan Ching Yee, Permanent Secretary for Health, before the start of the Health Leadership Summit. The high level dialogue was held in conjunction with SHBC included forums on nursing, primary care, health services and rehabilitative medicine among others. For the first time, three satellite conferences were held the Primary Care Forum 2013, the Singapore Mental Health Conference and the National Skin Centre Dermatology and Venereology Update. There was also a dedicated Research Ethics Track which provided clinical researchers with greater insight on local data protection laws and its impact on research. Guest-of-Honour Health Minister Gan Kim Yong presented the prestigious Singapore Clinician Investigator Award to five winners as part of the annual Scientific Competition. Another 47 Gold, Silver and Bronze awards were also given out. This year s Scientific Competition received a record 436 submissions from doctors, nurses, allied healthcare professionals and researchers from Singapore and the region. Bringing Quality Healthcare Closer to You NHG Transforming Population Health 49

54 50 We need to change the negative perception towards people with mental health issues in order to improve the situation for them. Mdm Halimah Yacob Speaker of Parliament, during her plenary speech at SMHC Singapore Mental Health Conference and World Health Summit On the sidelines of SHBC 2013 was the Singapore Mental Health Conference (SMHC), organised by the Institute of Mental Health (IMH). Guest-of-Honour, Dr Amy Khor, Senior Minister of State for Health and Manpower, stressed the need to reassess the mental health landscape in Singapore and overseas, and to identify how mental health capabilities can be further enhanced to cope with the changing needs of patients. The SMHC was organised as a national and regional platform for mental healthcare stakeholders to share their views and experiences. The conference covered topics like behavioural addictions, including Internet gaming and sex addictions. Forum Explores Changing Role of Primary Care Advancing Primary Care: Adapting for the Future was the theme of the Primary Care Forum Organised by the Primary Care Academy, the forum examined the changing scope and role of primary care, and how the sector needed to evolve to meet future healthcare needs. Some 1,000 healthcare practitioners and administrators from the public and private sectors attended the event. Many discussions centred on team-based care and how this would help create a more efficient healthcare system. The annual event was held in conjunction with the Singapore Health and Biomedical Congress 2013 and featured two keynote speakers: Professor Chris Van Weel, past president of WONCA (World Organisation of Family Doctors) and Emeritus Professor of General Practice in the Department of Primary and Community Care, Radboud University Speaker of Parliament, Madam Halimah Yacob, giving the plenary speech at the inaugural Singapore Mental Health Conference. Nijmegan Medical Centre, Netherlands, and Dr Andrew Lee Ellner, Co-Director of Harvard Medical School Centre for Primary Care. Automatic Vital Signs Recording Wins Award In October 2013, TTSH and Integrated Health Information Systems (IHiS), the Health Ministry s IT arm, clinched the prestigious HIMSS Elsevier award for the hospital s innovative SmartSense system. The automated system uses a radio-frequency identification (RFID) tag to record a patient s pulse, blood pressure and temperature remotely, and wirelessly uploads them to the hospital s medical records. This enables healthcare staff to instantly view the patient s latest vital signs to provide timely Research, Technology and Innovation

55 treatment, while freeing staff to provide more direct patient care. The RFID tag also tracks patients locations, allowing staff to better manage infection control during pandemics a vital tool for TTSH s Communicable Disease Centre, which plays a key role in Singapore s infectious disease control. Since its implementation, the system has benefited over 1,400 patients daily. Surgical Simulator for Eye Surgeons Ophthalmology residents at TTSH can now hone their surgical skills using a life-like simulator. The Eyesi ophthalmic surgical simulator comprises a hyperrealistic mechanical eye, suspended within a human head model. Students practise various procedures including cataract surgeries by inserting mock instruments through openings in the mechanical eye. Through Eyesi, computer generated three-dimensional images of the virtual surgical instruments are created, and they correspond with the trainee s movements. A separate flat-panel monitor projects the images, allowing others to observe the training. The simulator complements existing training using actual surgical instruments on animal eyes. These risk-free practice sessions allow trainee doctors to gain confidence and competence in their surgical skills, which in turn help ensure safer procedures for patients. IMH Hosts Mental Health Track The Institute of Mental Health (IMH) was invited to host the track on Mental Health at the World Health Summit, Regional Meeting in April This is the first time the summit was held in Singapore. The theme was Mental Health for the Population: Identifying Barriers and Creating Innovative Solutions to Address the Treatment Gap. The session was chaired by Associate Professor Chua Hong Choon, CEO IMH, and featured Associate Professor Chong Siow Ann, IMH Vice Chairman Medical Board (Research); Professor Parminder Raina, McMaster University; Professor Anthony Francis Jorm, University of Melbourne; and Dr Alan Ong, Ministry of Health, as speakers. Delegates gained insight into the National Mental Health Blueprint and the Community Mental Health Master Plan programmes, perspectives on funding therapies for dementia, and the positive impact of the Mental Health First Aid programme. National Mental Health Studies As the national specialty centre for mental health, IMH is at the forefront of mental health research. The Institute s Research Division continues to grow from strength to strength. In FY2013, IMH garnered some 81 peer-reviewed publications, 127 presentations, eight research-related awards, as well as two patents and copyrights. In addition, the Division also received S$11.7 million in extramural grants. IMH also spearheads several studies to better understand mental health in the local context. Mind Matters In its continuing campaign to promote better understanding of mental health conditions, IMH embarked on a nationwide survey to identify how well, or poorly, mental health is understood here. The two-year study is spearheaded by IMH s Research Unit, with support from the Sociology Division of the NTU. Funded by the Ministry of Health, the $1 Million study will take an in-depth look at how much locals understand different types of mental illnesses, their causes, treatment options and outcomes for common conditions. The study will also examine the impact of socio-demographic This important study will generate actionable findings that can be used to help identify and address misconceptions relating to mental illnesses and treatment. Associate Professor Chong Siow Ann Vice Chairman Medical Board (Research), IMH NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 51

56 52 factors and compare perceptions and degrees of acceptance towards people with mental illness. Understanding these gaps will help policy-makers create more targeted programmes to address mental health literacy, as well as help members of the community understand, cope and address mental illness more effectively. Research on Cyber Bullying in Singapore and Finland The Research Unit of IMH s Department of Child and Adolescent Psychiatry (DCAP), together with the Singapore Children s Society and Associate Professor Angeline Khoo from the National Institute of Education (NIE), are embarking on a study to investigate the prevalence of Internet addiction and cyberbullying, as well as to explore the various factors associated with these two phenomena among adolescents in Singapore. The research study is initiated by the University of Turku in Finland and led by Dr Ong Say How, Chief and Senior Consultant, DCAP. In addition to prevalence, the study also aims to explore possible crosscultural differences by means of data comparison with other countries in this research. Responses from 3,000 students aged between 13 to 17 years old from secondary schools, junior colleges, polytechnics and Institutes of Technical Education (ITEs) will be collected via an online questionnaire, and the results are expected by NHGP Implements New Systems for Improvements National Healthcare Group Polyclinics (NHGP) continually looks for ways to improve patient experience. Last year, it implemented several systems to help patients manage their time at the polyclinics and enhance patient care. NHGP Goes Mobile Now, making appointments at NHGP is literally, just a tap away. NHGP launched a mobile application in December 2013 that allows patients to book same-day slots for doctor consultations for acute conditions, as well as appointments for selected nursing services such as wound dressing. Patients can also make enquiries, give feedback and request refill of medication via the apps. NHGP s Contact Centre receives more than 15,000 calls monthly for same-day bookings. The mobile application provides another alternative to the hotline as well as empowers patients to better manage their time through scheduled medical consultations. The application is available on iphone and Android platforms, and has a simple user interface, requiring only three steps to make an appointment. To date, close to 2,000 patients have used the mobile application monthly for same-day slots. Leveraging Technology for Convenience to Patients Since June 2013, Missed Queue Number displays have reduced the anxiety of patients waiting at various service touchpoints such as registration and consult rooms. The electronic displays help alert patients who have not responded when their queue numbers are called. The patients who missed their queue numbers can now approach clinic staff for assistance so they can be attended to promptly. Since August 2013, NHGP also offers patients more convenient payment options through self-payment kiosks. The systems, available at all polyclinics, allow patients to pay bills via NETS, NETS Flashpay, NETS Cash Card and EZ-Link. The kiosks also allow patients to make payments using Medisave or through third-party payments, and financial assistance schemes like Medifund. They have helped reduce waiting times during payment. Research, Technology and Innovation

57 NHGP Healthcare and Wellness Kiosks NHGP, in partnership with A*STAR, developed the Healthcare And Wellness Kiosks known as HAWKS allowing patients to measure and record vital medical information before consultation. Patients can record symptoms relating to Upper Respiratory Tract Infections, while also getting their weight measured. The information is immediately transmitted to their personal medical records for use during their doctor s consultation. This one-stop solution reduces the need for multiple rounds of information gathering, as all presenting symptoms are captured at the kiosk after registration and before the patient sees the doctor. The pilot phase at Woodlands Polyclinic in May 2012 yielded positive results. A second phase with redesigned kiosks and multi-language capabilities was subsequently launched on 11 July $100 Million for Skin Research Institute of Singapore The need for dedicated skin research and improved treatments is growing. Studies have shown that one in three people worldwide suffers from a skin disorder, presenting a huge demand for innovative treatments and technologies. Evidence also suggests significant differences in how skin diseases present in Asian and Western populations, as well as how different ethnicities respond to treatment. The National Skin Centre, together with partners A*STAR, and NTU, established the Skin Research Institute of Singapore (SRIS). The institute will harness the expertise of scientists, clinicians as well as engineers to foster and conduct high impact, inter-disciplinary skin research design to translate into improved health outcomes and quality of life. NSC will provide clinical expertise which will help transform research findings into medical treatments. Together with the basic science and engineering expertise at A*STAR and NTU, respectively, SRIS is expected to produce novel innovations for skin treatment. The SRIS will leverage on NSC s diverse patient pool to better understand skin disease in Asian populations. Key research areas for SRIS will include eczema, allergy and inflammation, pigmentary disorders, wound healing, hair conditions and skin ageing. NSC is committed to building the SRIS. We have enhanced our programmes to train clinical researchers, recruit research manpower, and encourage clinicians to devote more time and energy in research. It is hoped that SRIS will yield new insights and discoveries that will lead to better therapies and improve the quality of life of patients afflicted by a variety of skin diseases. Professor Roy Chan Former Director, National Skin Centre Bringing Quality Healthcare Closer to You NHG Transforming Population Health 53

58 EDUCATION 1 54

59 Education, Clinical Care and Research are the key pillars that drive NHG s work as the Regional Health System of Central Singapore. As the primary clinical training partner for the Lee Kong Chian School of Medicine, we have the opportunity to shape an innovative curriculum and develop a new generation of doctors who will be well-versed in team-based care to deliver holistic, thoughtful and appropriate care to our patients. 2 3 Photo: LKCMedicine 4 As a learning organisation, NHG also believes in fostering a life-long passion for education. Learning and upgrading opportunities are extended to our clinical, nursing, allied health, administrative and ancillary staff, to develop their talents and contribute towards our shared vision of Adding Years of Healthy Life. 1 Students from the inaugural cohort at the Lee Kong Chian School of Medicine during their orientation at the Tan Tock Seng Hospital. 2 NHG is the primary clinical training partner of the Lee Kong Chian School of Medicine, Singapore s newest medical school. 3 Participants at the annual LKCMedicine Open House try their hand on the school s unique anatomage table which uses detailed imaging to illustrate human anatomy. 4 LKCMedicine students undergoing team-based learning, which will help them excel in multi-disciplinary care teams in the future. 55

60 EDUCATION Competent doctors must know the limits of their medical competency as it is not possible to know everything and do everything on your own. To cure sometimes, to heal often, to comfort always. Care is shown in the caring by attitude, words and actions. As you grow in clinical medicine, you will grow increasingly more competent and caring. Professor Chee Yam Cheng Group CEO, NHG, at the LKCMedicine White Coat Ceremony 56 LKCMedicine held two High Tea events for prospective students in May Some 110 students attended, where they met with faculty and doctors who shared their insights on the future of medicine in Singapore. Nhg is the Primary Clinical Training Partner for Lkcmedicine Singapore marked a key milestone in 2013 with the official opening of the Lee Kong Chian School of Medicine (LKCMedicine), a partnership between the Nanyang Technological University (NTU) and Imperial College London (ICL). NHG formalised its partnership with Singapore s newest medical school with an Affiliation Agreement signed in August As the primary clinical training partner for LKCMedicine, NHG is committed to playing a key NHG formalised its role as the primary clinical training partner for LKCMedicine with an Affiliation Agreement signed in August role in nurturing the doctors of tomorrow, who will meet the future needs of Singaporeans. Some 100 clinician educators from across NHG are playing an integral role in the development and implementation of LKCMedicine s innovative curriculum which stresses on team-based, patient-centred care. The school welcomes its second cohort of 78 students in August 2014.

61 LKCMedicine Inaugural White Coat Ceremony LKCMedicine students and faculty celebrated the school s first White Coat ceremony in August The timehonoured tradition sees medical students bestowed their white coats, marking their official step into the clinical profession. After receiving their white coats, students recited the Declaration of a New Medical Student which included the promise to practise medicine with integrity, humility, honesty and compassion. LKCMedicine Students Two-Week Orientation in the NHG Healthcare System A key objective of the innovative orientation sessions was for students to better understand the clinical journey through the eyes of patients and with the close guidance of their teachers. Students spent a week each in Tan Tock Seng Hospital (TTSH) and the Choa Chu Kang NHG staff, including those form TTSH, will play a vital role in training a new generation of doctors at LKCMedicine. Polyclinic, where they familiarised themselves with the healthcare system from the healthcare professionals and patients perspectives. Students Begin their Long-Term Patient Project As part of the LKCMedicine s innovative curriculum, students began a two-year project in November 2013 to interact and understand how patients cope in the community. Students connect with patients via various hospital programmes including the Post-Acute Care at Home and Home Ventilation & Respiratory Support Service at TTSH, as well as through community partners like the Tsao Foundation s Hua Mei Centre for Successful Ageing. The project is a key component of the curriculum where students get to better hone their communication skills while interacting with patients and their families. Pairs of students visited their assigned patient, wrote a journal of their visits and participated in NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 57

62 58 presentations and discussion with their peers and course tutors. The course was adapted from ICL s First Clinical Attachment Programme. Opening of the Toh Kian Chui Annex The Toh Kian Chui Annex, located at LKCMedicine s Novena campus near TTSH, was officially opened in October The three-storey building was named the Toh Kian Chui Annex in recognition of a generous $20 Million gift from the Toh Kian Chui Foundation, as part of an endowment that will amount to $50 million with matching funds from the Singapore Government. The distinctive glass building will serve as the School s education wing, housing a variety of teaching and learning facilities, including a 180-seat lecture theatre, 60-seat seminar room, and an interim library, among others. Mr Toh Kian Chui was a respected construction entrepreneur and philanthropist. The gift will go towards an endowment fund, for a Distinguished Professorship, a Gold Medal student award given to the top performing medical student from each cohort, and up to 25 scholarships annually, etc. Mentorship Programme for LKCMedicine Students To help new LKCMedicine undergraduate medical students better navigate the medical education system, NHG Residents launched the Medical Student Mentorship Programme in June Residents and junior doctors with good work aptitude, professional conduct and a passion for teaching were nominated as mentors to help guide their younger charges in their early years of medical school. Mentors and mentees meet up three to four times a year, to discuss challenges at school, as well as impart knowledge on how to cope with work demands. The mentorship programme is especially important for pioneering students of LKCMedicine as they do not yet have seniors to guide them through the medical education system, which can be challenging and complex. Residents from the NHG-AHPL Residency Programme have taken on a mentorship role to help LKCMedicine undergraduates navigate the complex medical education system. Family Medicine Academy to Boost Primary Care A robust primary care service is the bedrock of a strong public healthcare system. To provide a boost to primary healthcare training, NHG, National Healthcare Group Polyclinics (NHGP) and LKCMedicine jointly set up the Family Medicine Academy in September Ministry of Health Mrs Tan Ching Yee, Permanent Secretary for Health, at the official opening of the Family Medicine Academy. Permanent Secretary Mrs Tan Ching Yee was Education

63 the Guest-of-Honour at the Opening Ceremony. The Academy is the first dedicated training facility for family medicine and located at the Bukit Batok Polyclinic. The purpose-built facility houses specially-designed consultation rooms and a clinical skills laboratory where medical undergraduates and healthcare professionals can practise basic clinical procedures and hone their clinical consultation techniques. The Academy will also play an integral role in the delivery of primary care training as part of the curriculum at LKCMedicine, which exposes students to family medicine early in their learning journey. Residency Programme Completes Phase 2 Accreditation In 2013, the National Healthcare Group-Alexandra Health Pte Ltd (NHG-AHPL) Residency achieved initial accreditation for its nine medical subspecialities namely, Cardiology, Endocrinology, Gastroenterology, Geriatric Medicine, Infectious Diseases, Renal Medicine, Respiratory Medicine, Rheumatology and Medical Oncology. The quality of individual programmes is measured by the length of accreditation awarded, which determines when the next accreditation review occurs. NHG-AHPL Residency is proud that more than 50% of its residency programmes Anaesthesiology, Ophthalmology, Internal Medicine and Psychiatry achieved the maximum four-year cycle length. Accreditation is awarded by the US-based Accreditation Council for Graduate Medical Education International (ACGME-I). Accreditation ensures streamlining of the graduate medical framework for a greater emphasis on education and training of residents. It also provides an ongoing monitoring system to ensure a continual review of the residents learning process, as well as provide a structured training programme with competencies to be achieved at each clearly-defined stage. In addition, NHG Residency has been showcasing its innovations and best practices at various international platforms. Designated Institutional Official, Associate Professor Nicholas Chew and Ms We hope that early exposure to primary care will leave a deep imprint on students and encourage more to seriously consider making family medicine a career as they contribute to Singapore s healthcare system. Associate Professor Chong Phui-Nah Chief Executive Officer, National Healthcare Group Polyclinics Yvonne Ng, Director (Education), were invited to share at the ACGME-I Educational Symposium in Qatar. A/Prof Chew also led a delegation of 10 faculty members and residents to the ACGME conference in Washington, where the team gave poster and oral presentations, as well as conducted workshops to address various aspects of providing better and more structured training for residents. Pre-Professional Education Office to Boost Training NHG s Education Office set up Pre-Professional Education Offices (PPEOs) or equivalent across all NHG member institutions in FY2013, which focus on boosting pre-employment clinical training for healthcare professionals. The initiative which is funded by the Ministry of Health, allows for improved clinical training governance within the regional health system and healthcare institutions. The PPEOs plan, oversee, manage and support pre-employment clinical training activities among all NHG institutions. In addition to ensuring a steady manpower pipeline, the initiative also boosts quality and quantity of trained healthcare professionals to provide better patient care. NHG Provides Overseas Training Support In addition to improving healthcare services here, NHG and its members believe in sharing expertise with regional partners. Several programmes would not have been possible without the generous support of Temasek Foundation. Bringing Quality Healthcare Closer to You NHG Transforming Population Health 59

64 60 TTSH Signs MOU with Cambodian Hospital In January 2014, TTSH signed a Memorandum of Understanding (MOU) with the Calmette Hospital in Phnom Penh, Cambodia. The threeyear collaboration will promote and develop joint research, as well as training and education, in trauma care. TTSH will conduct the Skills in Trauma and Resuscitation (STAR) programme three times a year at Calmette. The programme brings medical staff through basic, intermediate and advanced training, equipping them with the necessary skills to manage patients suffering from multiple traumatic injuries. Thai Delegation Visits TTSH A group of 25 senior management members from King Chulalongkorn Memorial Hospital and Phra Mongkut Klao Hospital visited TTSH in January The group was keen to understand TTSH s learning journey in hospital management, and had an engaging session with TTSH management on best practices in infrastructure planning, human resource and finance. Host, Deputy Group CEO (Regional Health) and TTSH CEO Professor Philip Choo, explained how systems thinking helped our hospital maximise limited resources. In March, under the patronage of Royal Highness Princess Maha Chakri Sirindhorn, TTSH conducted two specialist programmes for nursing leaders in Bangkok. A total of 20 senior delegates from King Chulalongkorn Memorial Hospital and Thai Red Cross College of Nursing underwent programmes on Nursing Care and Management, to learn and exchange knowledge and best practices. TTSH also collaborated with the National Neuroscience Institute to provide specialist training for neurology nursing to 20 Thai delegates from Mahidol University and Siriraj Hospital. For 10 days, participants learnt and shared knowledge, skills and practices in the areas of Stroke, Parkinson s disease, Alzheimer s disease as well as other neurosurgical conditions. Both projects would not have been possible without the generous support from Temasek Foundation. TTSH signed a three-year Memorandum of Understanding with the Calmette Hospital in Phnom Penh, Cambodia, to develop joint research, training and education in trauma care. Nursing Delegation to Taiwan TTSH Nursing Department organised a four-day outreach programme to Taiwan in April The group consisting of Enrolled nurses to Senior Nursing Officers, visited both the Taipei Tzu Chi Hospital and Taipei Veterans General Hospital. In a visit to the former, our nurses were wowed by the culture of humanitarian work, the concept of a green hospital and how to build a sustainable network of community volunteers in providing care. They were also impressed by Taipei Veterans General Hospital s manpower reengineering programme, hospital based home care programme, staff development and clinical ladder system. Disaster Mental Health Programme for Communities in Asia Since 2012, clinical and Allied Health professionals from the Institute of Mental Health (IMH) have been engaged to provide consultancy services as well as share their skills in the regional training programme, Temasek Foundation Institute of Mental Health, Singapore: Disaster Mental Health Programme for Communities in Asia. Under this programme, IMH had signed collaborative agreements with Galya Rajanagarindra Institute, Thailand, West China Hospital, Sichuan University, China, and Rumah Sakit Dr Cipto Mangunkusumo, Indonesia, to boost recovery and preparedness of local communities affected by disasters. Education

65 The programme is based on a threelevel training model targeting various groups ranging from policy and healthcare leaders, mental health professionals and communitybased workers. In FY2013, the first milestone of the Programme was marked with the Asian Community Mental Health Leadership forum, held in September The forum engaged over 100 leaders and officials from the three partnering countries, as well as Singapore. This forum, designed to enhance leadership training, provided a platform for regional leaders to relate their experiences, challenges and strategies working with diverse communities in Asia. Problem Gambling Intervention Training and Certification Programme As the main national treatment centre in Singapore, the National Addictions Management Service (NAMS) at IMH was commissioned by the National Council on Problem Gambling (NCPG) to conduct a training programme leading to a certification for counsellors and caseworkers from various Family Service Centres. Into its fourth run, a total of 22 participants attended the training, which comprised a three-day workshop, followed by a three-month attachment at NAMS and a written examination. Successful candidates are awarded the NCPG-NAMS Problem Gambling Intervention Certificate. Third Batch of GPs Graduate from the Graduate Diploma in Mental Health 2014 IMH s third batch of general practitioners (GPs) graduated from the Graduate Diploma in Mental Health (GDMH) programme in a Graduation Ceremony held in April This year saw 25 physicians, including seven polyclinic doctors, graduating with the GDMH, marking a slight increase from the 24 GPs who graduated from the second cohort. Sixty-eight GPs successfully completed the programme since its inception in There are currently 18 GPs enrolled in the fourth cohort, and this group is expected to complete the programme by November In addition, seven of the 25 graduands met the Mental Health GP Partnership Programme admission criteria to become partners with the programme. They will help manage stabilised mental patients referred to them by IMH. IMH-MSF Intellectual Disability Clinical Consultancy Programme IMH has partnered with the Ministry of Social and Family Development to carry out a series of lectures and workshops under the IMH-MSF Intellectual Disability (ID) Clinical Consultancy Programme. The outreach programme seeks to support and build the capabilities of nine voluntary welfare organisations (VWOs) that are caring for those with an ID or Autism Spectrum Disorders, so that they can better help their clients with mental health issues and challenging behaviours. The training component of the Programme includes workshops, skills training modules in behaviour modification and sensory-based interventions, on-site supervision sessions, and case conferences. Over 200 participants attended the first workshop conducted by IMH in February A multi-disciplinary team of psychologists, occupational therapists and medical social workers shared their experiences and practical tips in helping patients. NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 61

66 Our People 1 62

67 NHG s vision of Adding Years of Healthy Life ties in with the Ministry of Health s Healthcare 2020 objective to make quality healthcare accessible and affordable to all Singaporeans. While we continue to develop infrastructure and programmes to fulfil our role as the Regional Health System for Central Singapore, it is only through the dedication and hard work of our people who will deliver good care to our patients Over the last year, NHG has invested in deepening our 4P7R culture as well as developing our talent pool as we move towards Our Shared Future. 1 Our Shared Stories Same Same Yet Different Our Shared Future is a 160- page book with a collection of inspirational stories, visuals and quotes from staff on what motivates them to exemplify the 4P7R. 2 NHG Senior Management sang for patients with piano accompaniment performed by Group CEO Prof Chee Yam Cheng at the launch of Our Shared Stories Same Same Yet Different Our Shared Future. 3 NHG talents across divisions and 4 NHG Diagnostics and support team. 63

68 OUR PeoPle 64 4P7R Symposium and Book Launch NHG s 4 Principles and 7 Rules (4P7R) were developed to inculcate a culture that would reinforce our vision of Adding Years of Healthy Life and strengthen our role as the Regional Health System for Central Singapore. Since its launch in 2012, the 4P7R movement has gained traction amongst staff through ongoing culture building initiatives. The inaugural 4P7R Symposium was launched in August 2013 as a key platform for the learning, sharing and application of culture building ideas. To help inspire staff to continue practising the 4P7R, NHG Group Corporate Communications produced the book Our Shared Stories Same Same Yet Different Our Shared Future. It was officially launched in March 2014 with a colourful display of song and dance performed by NHG staff. The 160-page book is a collection of inspirational stories, visuals and quotes on what motivates management and staff in delivering care (patient-centred care), working as a team and integrating macro and micro systems (systems thinking), relentlessly striving to do better (learning organisation) and each playing a role to help one another (staff engagement). The stories and reflections were contributed by the NHG Family. NHG College: Building Capability NHG College plays an instrumental role in facilitating training and continuous learning, as well as promoting systems improvement and developing healthcare leadership in NHG. It works with renowned institutions and industry partners to grow NHG s pipeline of leaders, educators, healthcare professionals and staff to help NHG carry out its role as the RHS for Central Singapore. To ensure sustainability and viability of NHG s growth plans, the NHG Leadership SEAL Programmes help equip its budding Managers, Directors and C-Suite leaders for their future expanded job roles and responsibilities in NHG. Participants are guided by Senior Management, mentors and subject experts across NHG institutions, as well as supported by their peers in this developmental journey. In partnership with Group Education, NHG College also offers Educator development programmes to build a strong pool of educators and teachers among the health professions. These programmes, which were co-created with Group Education s renowned global partner, the Harvard Macy Institute, have contributed tremendously in building NHG s expertise in health professions education, and have placed NHG education on the world map.

69 NHG Senior Management serving some 500 nurses in a buffet lunch during NHG Nurses Day NHG College s education and healthcare professional programmes are also customised with an inter-professional approach and include areas such as curriculum design, programme management, workplace-based assessment and evaluation as well as clinical incident management skills. In addition, NHG College continues to strengthen the competence of our medical, nursing and allied healthcare professionals in the areas of communication, open disclosure, risk management, patient safety and quality improvement to better manage the provider-patient interfaces. Our pharmacists are also given the opportunity to upgrade themselves through the Masters in Clinical Pharmacy Programme, a joint collaborative initiative between NHG College and the University of Southern Australia. Leadership Moments In 2013, NHG continued to create opportunities for staff to engage with Senior Management, network and learn from external thought leaders through the NHG Leadership Moments. Organised by NHG College and Group Talent Management, the sessions included a small scale visit to the Singapore Prisons Service (SPS), where staff gleaned insights from SPS on their successful transformation from their early role as prison custodians to helping offenders reintegrate back into society as productive individuals. A larger scale session of the Leadership Moments was organised in conjunction with the NHG and Health Manpower Development Plan (HMDP) Awards Ceremony in October The session was a unique platform for potential future leaders to dialogue with and gain insights from outstanding NHG staff. NHG Nurses Day 2013 Nurses Day is always a special event for NHG, as we recognise the tireless efforts of over 4,300 nurses from our member institutions and business units. NHG senior management donned personalised aprons decorated with thank you messages and showed their appreciation to some 500 nurses by serving them in a buffet lunch during the NHG Nurses Day Celebration in August In addition to a sumptuous spread, our nurses were treated to interactive games and song performances. NHG member institutions also celebrated Nurses Day in a big way. For example, Tan Tock Seng Hospital (TTSH) broke records and entered the Singapore Guinness Book of Records for the Most Number of People Dressed as Nurses. A total of 619 nurses stood together in the shape of an angel, holding glow-sticks to signify their solidarity through thick and thin to serve the community. The effort tripled the previous standing record of 201. Bringing Quality Healthcare Closer to You NHG Transforming Population Health 65

70 66 Our Awards and Accolades Our people continued to be recognised from within NHG as well as the community for their dedication and contributions to healthcare delivery. 10 NHG Recognition Awards Three NHG Distinguished Achievement Awards Six NHG Outstanding Citizenship Awards One NHG Distinguished Contributor Award 186 Development Awards 110 NHG Teaching Excellence Awards 17 Nurses Merit Awards 19 Healthcare Humanity Awards (HHA) President s Award for Nurses National Day Awards One Public Administration (Silver) Award One Public Administration (Bronze) Awards Seven Commendation Medals 11 Efficiency Medals 73 Long Service Medals Three PS21 Star Awards Asian Hospital Management Award Two Human Resource Management Awards 2014 Promising Social Worker Award Tan Chin Tuan Nursing Award Yellow Ribbon Award Content Marketing Awards: Honourable Mention (Best Healthcare/Medical Publication) Lifewise APEX 2013: Award of Excellence (One-of-a-Kind Health & Medical Publication) Lifewise Asian Hospital Management Award TTSH Clinic 2B clinched the Excellence Award in the Customer Service Project category at the Asian Hospital Management Awards in September Their innovative project titled Service Excellence through LEAN in multidisciplinary surgical clinic helped streamline and standardise work processes in the clinic. Using LEAN methodologies, the clinic has improved its service standards in care coordination. It has also promoted work efficiency using the least amount of resources. Since its implementation, patient satisfaction has been maintained consistently above the hospital s benchmark of 80%. The annual award recognises best practices of hospitals in Asia, and is one of the most prestigious hospital management accolades in the region. Ms Jasmine Kang received the President s Award for Nurses 2013, for her role as the first Advanced Practice Nurse trained in Geriatrics in Singapore. Human Resource Management Award TTSH bagged the Best Health & Well-Being Award and Human Resource Young Achiever Award at the annual Human Resource Management Awards 2014 in February this year. The awards are administered under the auspices of HRM Asia, a publisher of specialist industry news magazines headquartered in Sydney. Despite strong contention from other finalists in the public and private sectors, the hospital s HR Wellness department clinched the Best Health & Well-Being Award 2014 for their customised Health & Wellness programme, which aims to enhance retention and build a happy, healthy resilient workforce. TTSH HR Executive, Ms Koo Shun Ting, also stood out amongst 125 nominees and emerged as the winner of the HR Young Achiever Award for her passion and perseverance in seeing projects through, as well as ability to contribute new ideas and build good rapport with the departments. Our People

71 Tan Chin Tuan Nursing Award for Enrolled Nurses Ms Wilma Krishnan, a Principal Assistant Nurse at the Day Surgery Centre in TTSH, became the hospital s first nurse to rank in the Top 3 at the Tan Chin Tuan Nursing Award in November Winners received a cash prize and specially minted Florence Nightingale medallion. The national award recognises exemplary Enrolled Nurses who are committed to advancing the nursing profession. Ms Krishnan has over 29 years of experience, and has contributed selflessly to nursing care delivery, often going beyond her call of duty to help her patients. In addition, she also played an integral role in introducing and implementing many of the Day Surgery Centre s Clinical Practice Improvement Projects. Promising Social Worker Award Senior Medical Social Worker, Ms Carmen Wu, won the Promising Social Worker Award for her outstanding dedication and contribution to social work in TTSH. She started off as a Medical Social Worker (MSW) in the Geriatric Unit and has touched many lives since. She was instrumental in the setting up the MSW Clinic in the Memory Clinic, with the aim of providing more accessible medical social services and better psychosocial support to patients and their caregivers. Following her successful roll out of social services at the Memory Clinic, Ms Wu was asked to look into the development of social work services for palliative and critical care patients. While reviewing and developing the social work model for palliative care in the hospital, Ms Wu established the first Volunteer Programme in Palliative Care for TTSH known as the Life Enlightening Programme. The programme seeks to train and recruit volunteers to serve patients facing end-of-life issues. Health Minister Visits TTSH Mr Gan Kim Yong, Minister for Health, visited TTSH on the first day of the Chinese New Year in January 2014, to show his appreciation to the dedicated healthcare staff on duty during the festive period. Minister Gan used calligraphy to pen the Chinese character kang, which means good health in English. Health Minister Gan Kim Yong visited TTSH on the first day of Chinese New Year to show his appreciation to staff who continued to care for patients during the festive period. He also distributed pineapple tarts and oranges to the healthcare staff in the Emergency Department and other wards. NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 67

72 Patient Service Associates to Go Further To help raise the skill levels and employability of healthcare staff, TTSH announced a redesigned job scope for Patient Service Associates (PSAs) in June Co-designed by the PSAs, with strong Senior Management support, the new Career Framework aims at equipping staff to provide patient-centric care services and undertake leadership responsibilities. Through the job redesign, PSAs are able to upgrade their skills and render value-added services such as financial counselling, medication supply verification, and be patient ambassadors or Specialist Assistants. This enhances their productivity levels and job satisfaction. The hospital also re-designed the PSA uniform, with the PSAs having a hand in selecting the bright colours that reflect TTSH s rich Peranakan heritage. To better engage, foster and enhance bonding, trust and good working relationships amongst colleagues and superiors, TTSH also celebrated its inaugural PSA Day in June Dedicated to the hardworking PSAs, the event was a platform for the hospital to show appreciation to our well-deserving frontline staff. TTSH Value Festival 2013 TTSH launched its inaugural Value Festival in October The threeday festival aimed to promote the hospital s culture of being a Great Place for Working, Healing, Learning and Becoming the Best. Over 2,100 staff, community partners and healthcare professionals came together to share their insights on working together to create value for our patients and fellow colleagues. Among the highlights was a talk by Professor Clayton Our People 68 TTSH Charity Ride 2013 Over 80 cyclists took to Bintan Island for the Goodwill Ride in September 2013 after the cancellation of the ride earlier in the year due to the haze. The annual event raises funds for the TTSH Community Charity Fund which helps the hospital s financially-strapped patients gain access to proper treatment and care. Battling the blistering heat, participants in two categories pedalled distances of 30km and 60km, respectively and successfully raised more than $400,000.

73 NHG hosted a networking luncheon for members of the media during the Chinese New Year festive period, to recognise their continued support in public education on health matters. Christensen from the Harvard Business School. Prof Christensen is an internationally recognised expert on innovation and growth, who coined the term Professor Low Cheng Hock, Emeritus Consultant, TTSH, with NHG staff and medical students bringing festive cheer to patients during the Chinese New Year festive period. disruptive innovation. He gave his insights on dashboards and learning journeys, as well as conducted workshops on self-improvement and organisational development. Yellow Ribbon Award Senior Assistant Counsellor, Mr Reuben Narain, from the National Addictions Management Service (NAMS) at the Institute of Mental Health (IMH) received the Outstanding Achievement Award at the Yellow Ribbon Project s (YRP) Celebrating Second Chances (C2C) ceremony. Mr Narain, himself a former drug addict, now uses his experience to help people kick the habit. Despite his chequered past, Mr Narain has worked hard not to disappoint the people who took a chance to employ him. His efforts have paid off and he has been promoted three times in eight years. The annual C2C awards ceremony is held to recognise and celebrate the efforts of ex-offenders who have stayed crime and drug-free; and to celebrate organisations who have been supporters of YRP s cause. Some 140 awards were presented to exoffenders in October Bringing Quality Healthcare Closer to You At NHG s Dinner & Dance in February 2014, staff bonded and formed the letters NHG using multi-coloured light-sticks to demonstrate positive outcomes from teamwork and collaboration. NHG Transforming Population Health 69

74 70 Showcasing Talent on World Mental Health Day IMH, in collaboration with the Singapore Association for Mental Health, celebrated World Mental Health Day 2013 by showcasing artworks by persons recovering from mental illness. A collection of photographs, paintings, pottery, books and handicrafts demonstrated the untapped talents that former patients could harness with the right social support. The exhibition themed Towards Recovery: A Showcase of Talents was held at the LaSalle College of the Arts in October Over 500 participants from community agencies, their clients and caregivers attended, including Guest-of-Honour, Associate Professor Muhammad Faishal Ibrahim, Parliamentary Secretary, Ministry of Health and Ministry of Transport. A special workshop for caregivers titled How Can I Get Through to You? Effective Communication Workshop for Caregivers was also conducted for about 120 participants by Ms Ong Choon Ming, Head, SAMH Residential Services (Youth). IMH management and staff on World Mental Health Day. Persons with mental health issues often struggle to find social support, acceptance, employment and even accommodation on their road to recovery. Given adequate support and opportunities, they too can groom their talents and skills and fulfil their dreams and aspirations, just like anyone else. Associate Professor Daniel Fung Chairman Medical Board, IMH and President Singapore Association for Mental Health Challenging Mindsets for A Good Cause In November 2013, some 250 participants raced up 33 storeys of the Marina Bay Financial Centre Tower 1. The vertical marathon, dubbed the MINDSET Challenge 2013, was organised by MINDSET Care Limited and successfully raised $266,000 for the setting up of the MINDSET Rehabilitation Gymnasium at IMH. The 210-square metre Gym will consist of a sensory modulation gym for adult patients with intellectual disabilities and neurodevelopmental problems, including autistic spectrum disorders. A physical exercise gym will also help patients with psychiatric disorders engage in workouts to promote physical health and wellness. The gym, which was completed in August 2014, is expected to see some 140 attendances from patients each month. NHGP Inaugural Family Appreciation Day National Healthcare Group Polyclinics (NHGP) celebrated its inaugural Family Appreciation Day in November 2013 at Woodlands Polyclinic, attended by more than 30 families of staff. The event was organised as a show of appreciation to family members for their support at home that allowed the staff to excel at work. In recognition of this, 24 recipients were presented the Stand By Me Award by then NHGP Chief Executive Officer, Mr Leong Yew Meng. Our People

75 Among the highlights was the NHGP Book Prize. Through the generous contributions of NHGP s Senior Management and staff, children from 13 families received cash prize designed to encourage children of NHGP employees to do well in school. Going the Distance as A Team NHGP, together with NHG Diagnostics and Pharmacy formed a team for the Standard Chartered Marathon Corporate Distance Challenge The team was proud to finish 9th in the race, clocking in a total distance of 1,126km with over 100 staff from NHGP, NHG Diagnostics and Pharmacy participating in the event. NHGP Human Resource Director Mr Simon Tan, representing NHGP s CEO, received an award on behalf of the team at the award ceremony held at Conrad Centennial Singapore in January Beyond winning the award, participants fostered meaningful relationships by running together as a team. Tattoo Removal Programme To help ex-offenders wipe off their tattoos, National Skin Centre (NSC) supports the Tattoo Removal service by Singapore Anti-Narcotics Association (SANA). The service, implemented in August 2013, aims to provide laser treatment for tattoo removal for ex-offenders who are referred from SANA. Tattoo removal is conducted by professionals at the NSC and will help former offenders regain social acceptance and job reemployment. Partially funded by SANA, co-payment rates are made affordable. To meet the demand, NSC has ramped up service frequency from monthly to fortnightly since October Volunteering for World Psoriasis Day NSC doctors, nurses and pharmacists volunteered their time to mark World Psoriasis Day in October 2013 at the Nexus Auditorium in Cuppage Plaza. Staff entertained audiences with song and dance performances. Participation at this annual event is part of NSC s staff volunteers on-going efforts to show support for members of the association and to raise public awareness about this skin condition. Psoriasis is a non-contagious chronic inflammatory skin disease which affects about 2% of the local population. It is characterised by a rapid growth of the outer skin layer which leads to thick, silvery flakes of scale on raised pinkish red skin. Itching is often experienced in Singapore s hot and humid climate. NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 71

76 MIleSToNeS IMH Turns 85 IMH is the third oldest public hospital in Singapore, after the Singapore General Hospital and TTSH. Since its beginnings as a custodial care institution for patients with mental illness, IMH has evolved into a progressive therapeutic centre. Today, the hospital offers a comprehensive range of psychiatric, rehabilitative and counselling services for children, adolescents, adults and the The Institute of Mental Health has played a pivotal role in the development and roll out of mental healthcare services in Singapore over the last 85 years. As a tertiary centre, we will forge ahead to provide specialised services, conduct impactful research and train the next generation of mental health practitioners. We will expand our collaborations with partners locally and abroad to make mental healthcare more effective and accessible. elderly. To establish a robust support network for patients outside the hospitals, IMH has also made strides in developing community-based programmes. Among highlights of the year-long celebration was the inaugural Singapore Mental Health Conference which aimed to address evolving mental healthcare needs. Nearly 750 mental healthcare professionals and community service providers converged for the conference. IMH also inaugurated the Asian Community Mental Health Leadership Forum that was attended by over 80 leaders and officials from Thailand, Indonesia, China and Singapore. This was organised as part of the Disaster Mental Health Programme for Communities in Asia initiative that IMH and Temasek Foundation are jointly supporting with tertiary healthcare organisations in 72 Associate Professor Chua Hong Choon CEO, IMH

77 It has been a very eventful and challenging 40 years of rehabilitation medicine. The future is looking just as exciting as we continue to remain relevant, proactive and empathetic advocates for our patients and their families. We are focused on harnessing new technologies to achieve transformational outcomes for our patients, their families and our staff. Thailand, China and Indonesia. The objective is to develop a training programme to build the mental well-being and resilience of communities affected by disasters and crises. Staff, patients and volunteers staged a production called 8 to 5. The play illustrated how mental health issues affect ordinary people, and challenged the audience to see mental illness in a new light by demonstrating how persons with such illnesses are not so different from the rest of us. More than 700 people attended the two shows, held at the Lee Foundation Theatre in December Dr Chan Kay Fei Former Head of Department of Rehabilitation Medicine Bringing Quality Healthcare Closer to You 40 Years of Rehabilitation Medicine Rehabilitation Medicine at the Tan Tock Seng Hospital had its beginnings in 1973 with the opening of a Rehabilitation Centre. The facility s inpatient capacity grew steadily and the Department of Rehabilitation Medicine opened two years later. In 1994, the Centre moved to its current location in the Ang Mo Kio NHG Transforming Population Health 73

78 best exemplified with the opening of the Centre for Advanced Rehabilitation Therapeutics (CART) in CART provides outpatient neuro-rehabilitation services and uses innovative robotic and Virtual Reality technologies which help patients with stroke, brain or spinal cord injuries, in their recovery journey. Milestones 25 Years of Geriatric Medicine In 1988, Dr F. J. Jeyaratnam established Singapore s first Department of Geriatric Medicine. He mentored a pioneering group of geriatricians, among them, NHG Deputy Group CEO (Regional Health) and TTSH CEO, Professor Philip Choo. The TTSH Department of Geriatric Medicine now has the largest number of trained specialists who play a vital role in caring for a rapidly ageing population. To meet the growing needs of elderly patients, the Department established several 74 Thye Hua Kwan Community Hospital, which allowed patients to receive treatment closer to their homes. In addition to widening its reach, the Department also sought to deepen its expertise with the setting up of specialised diagnostic group-based teams to treat spinal injury, brain injury, stroke and musculoskeletal disorders. The Department is currently the largest rehabilitation medicine unit in the country. A key driver of its success has been its ability to use innovative technologies to improve patient outcomes and is

79 Holistic care goes beyond just managing the diseases that they have but to try to return our elderly patients to active life and to enhance their quality of life. We also want to support the caregivers whom we see as partners of care. Associate Professor Chin Jing Jih Divisional Chairman (Integrative & Community Care), Tan Tock Seng Hospital sub-specialty services namely the Geriatric Assessment Clinic, Falls and Balance Clinic, Continence Clinic, Elderly Chronic Pain Clinic, as well as Cognition and Memory Disorders Service. A decade after its establishment, the Department formed the Division of Integrative and Community Care (DICC) in response to the need to provide patients with more seamless care in the community. Key initiatives developed by the Division include the Post Acute Care at Home (PACH) programme, which provides postdischarge care by a multi-disciplinary team of doctors, nurses, and allied health professionals. PACH helps to stabilise and rehabilitate patients in the sub-acute phase of illness in their homes. It also helps to provide appropriate home care support and helps educate caregivers to manage patients more effectively. In 2012, NHG and DICC set up the Institute of Geriatrics and Active Ageing (IGA) to establish new directions for geriatric care in Singapore. The Institute will tap on the rich expertise of clinicians in TTSH, and aims to enable the delivery of holistic care to improve the health independence, safety and quality of life for older persons. IGA provides a structured platform for healthcare professionals to conduct research and work on technological innovation in the areas of clinical, epidemiological and health services, as well as less traditional fields of research including living environment and industrial design. The Centre for Geriatric Medicine at Tan Tock Seng Hospital that recently opened on 25 July Dr F. J. Jeyaratnam, founding father of Geriatric Medicine in Singapore. It will collaborate with medical professionals and partners in the community to promote ageing research and education to achieve our goal of Adding Years of Healthy Life. NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 75

80 about nhg s INSTITUTIoNS Tan Tock Seng Hospital 11 Jalan Tan Tock Seng, Singapore Tel: / Fax: Tan Tock Seng Hospital is one of Singapore s largest multidisciplinary hospitals with 170 years experience of pioneering medical care and development. The hospital has 36 clinical and allied health departments, 15 specialist centres and is powered by more than 7,000 healthcare staff. TTSH is accredited by the Joint Commission International (JCI) in recognition of its world-class patient care and the comprehensive range of high quality holistic healthcare services at its main hospital complex, the Communicable Disease Centre, TTSH Rehabilitation Centre and specialist clinics. Institute of Mental Health Buangkok Green Medical Park, 10 Buangkok View, Singapore Tel: / Fax: The Institute of Mental Health is a 2,000-bed acute tertiary psychiatric hospital. Set amidst 25 hectares of serene surroundings, IMH offers a comprehensive range of psychiatric, rehabilitative and counselling services for children, adolescents, adults and the elderly. IMH was the first mental health institution in Asia to receive the JCI accreditation in 2005, a prestigious global accreditation standard for healthcare organisations. National Skin Centre 1 Mandalay Road, Singapore Tel: / Fax: The National Skin Centre is an outpatient specialist dermatological centre with a team of expert dermatologists to treat a wide variety of skin problems. In addition to providing quality care to patients, NSC also aims to be a leader in skin research both here and in the region. National Healthcare Group Polyclinics Contact centre: National Healthcare Group Polyclinics forms the primary healthcare arm of NHG. Its nine polyclinics serve a significant proportion of the population in Central, Northern and Western Singapore. NHGP s focus is on health promotion and disease prevention, early and accurate diagnosis, disease management through physician-led team-based care, as well as enhancing the capability of Family Medicine through research and teaching. Ang Mo Kio Polyclinic 723 Ang Mo Kio Ave 8, # Fax: Bukit Batok Polyclinic 50 Bukit Batok West Ave 3. Fax: Choa Chu Kang Polyclinic 2 Teck Whye Crescent. Fax: Clementi Polyclinic 451 Clementi Ave 3, # Fax: Hougang Polyclinic 89 Hougang Ave 4. Fax: Jurong Polyclinic 190 Jurong East Ave 1. Fax: Toa Payoh Polyclinc 2003 Toa Payoh Lor 8. Fax: Woodlands Polyclinic 10 Woodlands St 31. Fax: Yishun Polyclinic 30A Yishun Central 1. Fax: Ang Mo Kio Family Medicine Clinic 4190 Ang Mo Kio Ave 6, # Fax: NTUC Unity Family Medicine Clinic 264 Serangoon Central, # Fax:

81 NHG College 3 Fusionopolis Link, #03-08 Singapore Tel: / Fax: NHG College complements the medical education efforts of NHG institutions through faculty and manpower development. NHG College partners renowned global institutions including Harvard University and Massachusetts General Hospital, to tailor training programmes that are designed to meet the needs of our professional workforce within the public healthcare setting, and to build a strong pool of high-value educators within NHG. NHG Diagnostics 3 Fusionopolis Link, #03-08 Singapore Call centre: (6-ASK-NHGD) / Fax: National Healthcare Group Diagnostics (NHGD) is a business division of National Healthcare Group. We are the leading provider in primary healthcare for one-stop imaging and laboratory services that are Accessible, Cost Effective, Seamless, Timely and Accurate. NHGD supports polyclinics, community hospitals, nursing homes, general practitioners and the community at large via our extensive network in Singapore, Indonesia and Vietnam. Our services are available in static and mobile centres. Our mobile services include general X-ray, mammogram, ultrasound, bone mineral densitometry, and medical courier. We also provide tele-radiology services, laboratory and radiology management, as well as professional consultancy services in setting up of imaging centres and clinical laboratories. NHG Pharmacy 3 Fusionopolis Link, #03-08 Singapore Tel: NHG Pharmacy manages the pharmacy services and retail pharmacies at all NHG polyclinics. Our pharmacists work collaboratively with other healthcare professionals to manage patients with chronic diseases, and to help them achieve the best results for their prescribed therapy, as well as promote safe and responsible use of medication. Primary Care Academy 3 Fusionopolis Link, #03-08 Singapore Tel: / Fax: The Primary Care Academy was set up to meet the professional training needs of primary healthcare professionals in Singapore and the region. PCA aims to be a platform for sharing of expertise and capacity-building among community healthcare leaders and practitioners in and around ASEAN. NHG Eye Institute Tel: The NHG Eye Institute was set up to meet the increasing demand for eye-care services. By combining the clinical expertise and facilities across NHG institutions, it is able to achieve greater synergy and provide quality eye care to patients. It also works with various organisations such as the Singapore Eye Research Institute, National University of Singapore and clinical research organisations to undertake clinical research programmes relevant to its patients. Institute of Geriatrics and Active Ageing Centre for Geriatric Medicine Tel: / Fax: The Institute of Geriatrics and Active Ageing was set up to establish new directions for geriatric care in Singapore. Through research innovations and continuous education, the Institute aims to enable the delivery of holistic care to improve the health, independence, safety and quality of life for the elderly. Johns Hopkins Singapore International Medical Centre 1 Jalan Tan Tock Seng Singapore Tel: / Fax: Johns Hopkins International Singapore Medical Centre is a licensed 30-bed medical oncology facility located in Singapore. It is a joint venture between NHG and Johns Hopkins International. It is the only fully-branded Johns Hopkins facility outside of USA, providing inpatient and outpatient medical oncology care, medical intensive care and laboratory services. Bringing Quality Healthcare Closer to You NHG Transforming Population Health 77

82 StatiStiCS Financial Year 2013 (1 April 2013 to 31 March 2014) Bed Complement by Hospital and Class of Bed as at 31 March ,800 TTSH TTSH-CDC IMH Johns Hopkins 1,757 1,600 1,400 1,200 1, No. of Beds Class A Class B1 Class B2 Class C Classless Class A Class B1 Class B2 Class C Classless FY 2013 FY 2012 Change Change % TTSH ,465 1,471 (6) 0% TTSH-CDC % IMH , ,010 2, % Johns Hopkins (5) -20% Total NHG , ,798 3,809 (11) 0% 78

83 StatiStiCS Average Bed Occupancy Rate by Hospital TTSH TTSH-CDC IMH Johns Hopkins 100% 90% 88% 89% 87% 89% 91% 88% 88% 90% 80% Average Percentage 70% 60% 50% 40% 30% 20% 10% 0% 65% 67% Apr 13 - Jun 13 51% 44% Jul 13 - Sep 13 55% 61% Oct 13 - Dec 13 67% 45% Jan 14 - Mar 14 NHG is the Regional Health System for Central Singapore Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 TTSH 88% 87% 91% 88% TTSH-CDC 65% 51% 55% 67% IMH 89% 89% 88% 90% Johns Hopkins 67% 44% 61% 45% NHG Transforming Population Health 79

84 StatiStiCS Trend in Inpatient Discharge TTSH TTSH-CDC IMH Johns Hopkins 14,000 13,186 13,248 13,421 12,687 12,000 10,000 8,000 6,000 No. of Inpatient Discharges 4,000 2, , , , , Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 FY 2013 FY 2012 Change Change % TTSH 13,186 13,248 13,421 12,687 52,542 52, % TTSH-CDC ,549 2, % IMH 2,045 2,053 2,109 2,149 8,356 8, % Johns Hopkins (43) -10% Total NHG 16,278 16,252 16,520 15,792 64,842 63, % 80

85 StatiStiCS Trend in Inpatient Day TTSH TTSH-CDC IMH Johns Hopkins 180, , , , , , , , , , , , ,000 80,000 No. of Inpatient Days 60,000 40,000 20, ,064 1,211 Apr 13 - Jun 13 8, Jul 13 - Sep 13 9,501 1,007 Oct 13 - Dec 13 11, Jan 14 - Mar 14 Bringing Quality Healthcare Closer to You Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 FY 2013 FY 2012 Change Change% TTSH 107, , , , , ,815 5,065 1% TTSH-CDC 10,064 8,770 9,501 11,156 39,491 38,206 1,285 3% IMH 160, , , , , ,617 9,899 2% Johns Hopkins 1, , ,823 4,882 (1,059) -22% Total NHG 279, , , ,409 1,109,710 1,094,520 15,190 1% NHG Transforming Population Health 81

86 StatiStiCS Average Length of Stay by Hospital and Class of Bed TTSH TTSH-CDC IMH Johns Hopkins No. of Days Class A Class B1 Class B2 Class C Class A Class B1 Class B2 Class C TTSH TTSH-CDC IMH (Short Stay) Johns Hopkins 9.7 IMH (Long Stay) 1 1, Note 1 : IMH (Long Stay) relates to the average length of stay of long-staying patients who were physically discharged during the year.

87 StatiStiCS Trend in Day Surgery TTSH 16,000 14,000 13,006 13,591 12,929 12,764 12,000 10,000 No. of Day Surgeries Performed 8,000 6,000 4,000 2,000 - Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 FY 2013 FY 2012 Change Change% TTSH 13,006 13,591 12,929 12,764 52,290 48,210 4,080 8% Total NHG 13,006 13,591 12,929 12,764 52,290 48,210 4,080 8% NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 83

88 StatiStiCS Trend in SOC Attendance 160, , ,004 TTSH TTSH-CDC IMH 149,612 NSC 152,407 Johns Hopkins 140, , ,000 84,157 86,281 86,886 85,139 80,000 60,000 No. of Attendances 40,000 20, ,978 39,271 1,955 13,086 39,412 2,238 12,707 38,564 2,222 11,555 39,133 1,819 Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 FY 2013 FY 2012 Change Change% TTSH 155, , , , , ,459 11,220 2% TTSH-CDC 12,978 13,086 12,707 11,555 50,326 50,920 (594) -1% IMH 39,271 39,412 38,564 39, , ,732 5,648 4% NSC 84,157 86,281 86,886 85, , ,437 7,026 2% Johns Hopkins 1,955 2,238 2,222 1,819 8,234 7, % Total NHG 294, , , ,053 1,174,082 1,150,192 23,890 2% 84

89 StatiStiCS Trend in A&E Attendance TTSH 60,000 50,000 40,000 44,315 41,179 42,261 40,132 30,000 No. of Attendances 20,000 10,000 0 Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 FY 2013 FY 2012 Change Change% TTSH 44,315 41,179 42,261 40, , ,827 3,060 2% Total NHG 44,315 41,179 42,261 40, , ,827 3,060 2% Bringing Quality Healthcare Closer to You NHG Transforming Population Health 85

90 StatiStiCS Trend in Polyclinics Attendance Acute Chronic Non-morbid 350, , , , , , , , , , , , , , , , ,000 No. of Attendances 100,000 50,000 0 Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 Apr 13 - Jun 13 Jul 13 - Sep 13 Oct 13 - Dec 13 Jan 14 - Mar 14 FY 2013 FY 2012 Change Change% Acute 244, , , , , ,276 10,913 1% Chronic 251, , , , , ,002 (4,007) 0% Non-morbid 242, , , , , ,399 45,135 5% Total NHG 738, , , ,052 2,912,718 2,860,677 52,041 2% 86

91 StatiStiCS Distribution of Staff as at 31 March 2014 (FY2013) 910 8% 1,435 13% Medical and Dental 2,621 23% 1,840 17% 4,388 39% Nursing Allied Health Ancillary Administration FY 2013 FY 2012 Medical and Dental Nursing 4,388 4,457 Allied Health 1,840 1,825 Ancillary 2,621 2,588 Administration 1,435 1,335 Total 11,194 11,117 NHG is the Regional Health System for Central Singapore NHG Transforming Population Health 87

92 KeY FINaNCIal information Financial Year 2013 FY2013 FY2012 S$ M S$ M Assets by Major Categories Properties, Plant and Equipment Trade and Other Receivables Cash and Cash Equivalents Other Assets Total Assets 1,238 1,176 Liabilities by Major Categories Trade and Other Payables Other Liabilities Total Liabilities Capital and Reserves by Major Categories Share Capital Reserves* Minority Interest 1 1 Total Capital and Reserves Revenue by Major Categories Patient and Patient Related Revenue Government Subvention Other revenue Total Revenue 1,722 1,573 Expenditure by Major Categories Staff Costs Medical Supplies and Consumables Depreciation and Amortisation Other Expenses Total Expenditure 1,703 1, * Reserves include accumulated surpluses and specific reserves ring-fenced for capital investment, medical research, Regional Health activities as well as innovation and productivity improvements in the future.

93 Healthcare is now delivered by many players, not just one. But we still think that we are the only ones that matter, so that mindset has to change. How do we work with community partners to deliver integrated care? As far as the patient is concerned, care must be seamless and provided by one integrated care team. Professor Philip Choo Deputy Group CEO (Regional Health) and CEO, TTSH Editors Wong Fong Tze Tania Tan Jason Chiew Contributors William Ng Jeraldine Koh Vera Soo Cindy Chew Sunanthar Lu Clara Lim Michelle Teo Sheryl Wang Produced by Group Corporate Communications, National Healthcare Group

94 National Healthcare Group 3 Fusionopolis Link #03-08 Singapore Tel: (65) or Fax: (65)

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