FY2019 Annual Report FORGING AHEAD DELIVERING WORLD-CLASS PRIMARY CARE FORGING AHEAD The National Healthcare Group Polyclinics’ (NHGP) Annual Report FY2019, titled ‘Forging Ahead’, showcases our journey in delivering quality primary care. To provide care that is world-class, we must be prepared to challenge old ideas and break new ground.
The paper-cutting imagery on the cover and throughout the Annual Report depicts how NHGP has navigated through the intricacies and complexities of primary healthcare, forged ahead in the face of challenges, and found breakthroughs as part of this journey. On the cover, the burst of colours and the blooming petals portray the collaborative synergy of our staff and partners as well as our constant drive to meet the growing needs of Singapore’s population. This journey of constant growth and discovery has made NHGP a leader in advancing Family Medicine and transforming primary healthcare for the benefit of all Singaporeans. CONTENTS
OUR VISION To be the leading health-promoting institution that helps advance Family Medicine and transform 04 06 08 primary healthcare in Singapore. GROUP CEO’S MESSAGE CEO’S MESSAGE NHGP SENIOR MANAGEMENT OUR MISSION We will improve health and reduce illness through 10 18 24 patient-centred quality primary healthcare that is accessible, seamless, comprehensive, appropriate and cost-effective in an CHAPTER 1 CHAPTER 2 CHAPTER 3 environment of continuous learning and relevant research. Combatting a Developing Population Charting Our Way Global Pandemic Health Forward
OUR VALUES 32 36
People-Centredness Compassion CHAPTER 4 CHAPTER 5 We value diversity, respect each other We care with love, humility Advancing Towards a Enhancing Our and encourage joy in work. and empathy. New Norm of Care Capabilities
Integrity Stewardship 42 50 We commit ourselves to the highest We are responsible for the care of our standards of ethical conduct. people, patients and population. APPENDICES SNAPSHOTS OF PATIENTS ATTENDANCE AND WORKLOAD IN FY2019
02 Our Vision, Our Mission, Our Values Annual Report FY2019 03 GROUP CEO’S MESSAGE
I sincerely thank all I sincerely thank all NHGP staff for soldiering on I hope that marking this milestone spurs all staff to during this period, despite the long hours you put continue their efforts to reach even greater heights in NHGP staff for soldiering in and personal sacrifices you had to make. Such the next 20 years and beyond. I am confident of the on during this period, demonstrated commitment underscores the fact that journey ahead, guided by the foresight and experience — working as one NHG — we can and will overcome of Chairman, Madam Kay Kuok, the Board of Directors, despite the long hours any challenges we encounter. the Ministry of Health, and Associate Professor Chong you put in and personal Phui-Nah, CEO of NHGP & Primary Care. I look forward sacrifices you had to BEYOND 20 YEARS to working closely with all of you as we continue to Against this backdrop of an unprecedented healthcare transform care and achieve our vision of ‘Adding Years make. Such demonstrated crisis, NHGP commemorated its 20th Anniversary in 2020. of Healthy Life’. commitment underscores While circumstances derailed many planned activities, this milestone was no less momentous and memorable. the fact that — working as I wish to highlight some of the commendable milestones one NHG — we can and will that NHGP has achieved over its 20-year journey: overcome any challenges • Launching the first Family Physician Clinic at we encounter. Ang Mo Kio Polyclinic in 2005 • Establishing the Primary Care Academy in 2007 Professor Philip Choo Wee Jin TOGETHER, WE SHALL OVERCOME • Establishing the Family Medicine Academy in 2013 Group Chief Executive Officer Since the first case of COVID-19 was diagnosed in Singapore Beyond the polyclinic walls, NHGP has also played • Introducing the Teamlet Care Model in 2015 National Healthcare Group in late January 2020, the entire NHG Family — from acute a key role in NHG’s endeavours to support various to community care — has been hard at work helping to efforts at community facilities around Singapore. All of these have established a strong foundation manage the pandemic. Among those at the frontlines of this for primary care and enhanced our patients’ overall battle is the National Healthcare Group Polyclinics (NHGP). These included the setting up and managing of experience. Through continued innovations in care 14 Medical Posts at migrant worker dormitories, delivery, NHGP has not only made primary care more Standing shoulder to shoulder with General Practitioners running four Swab Isolation Facilities, and accessible and holistic, they have also shifted the in our Central-North Primary Care Network, NHGP has participating in close to 70 mass swabbing missions paradigm of care towards a patient-centric model that spared no effort in swiftly preventing and containing the across Singapore. All of this, done under challenging empowers patients to become active participants in outbreak within the polyclinics. conditions and in full Personal Protective Equipment. their health. This is truly worth celebrating!
04 Group CEO’s Message Annual Report FY2019 05 CEO’S MESSAGE
EMBRACING A NEW NORM OF CARE FORGING AHEAD The quiet resilience shown I am also pleased by how NHGP has risen to the These achievements spur us on in our on-going quest to occasion and turned the many obstacles faced during raise the level of primary care — even as we continue the by our NHGP family in this the COVID-19 crisis into opportunities for real-world battle against COVID-19 for the rest of FY2020. I would recent COVID-19 pandemic innovation. We are embracing new norms of care and like to take this opportunity to once again thank all leveraging technology to accelerate the implementation NHGP staff for their dedication and perseverance in what has been inspiring and of initiatives that enable us to connect safely with looks to be a long journey ahead of us. I am grateful for patients, continue essential services and yet reduce our valued partners in healthcare — NHG Central-North heartening. As healthcare the risk of infection transmission. These initiatives Primary Care Network General Practitioner (GP) partners, providers, all of us at NHGP include the launch of Video-Consultations (by doctors), community partners and other healthcare institutions – Tele-Dietetics, Tele-Psychology and more. for working closely with us through this eventful year. are cognisant of the risks associated with infectious CELEBRATING EXCELLENCE The year 2020 also marks NHGP’s 20th Anniversary — And while FY2019 will be remembered largely for our a two-decade journey that has been enriched by the disease. However, to support infection control and management efforts to counter tremendous support of various parties. On behalf of the Singapore’s battle against COVID-19, this year will also be commemorated for management team, I would like to thank the Ministry several important achievements. of Health, NHG’s Board of Directors, our GP partners COVID-19, many of our staff and NHGP’s senior management members and staff for have risen to the challenge. One of these is winning the overall Excellence Champion sharing our vision and supporting us. I am confident Medal at the annual National Healthcare Innovation and that whatever comes our way, we will draw from Productivity Award, held in May 2019. NHGP’s project, this collective strength and continue to make strides titled ‘NHGP Teamlet Care Model: A Redesign of Chronic towards transforming primary healthcare and advancing Care Delivery’, was selected for this top spot from more family medicine. COURAGE IN THE FACE OF ADVERSITY The quiet resilience shown by our NHGP family in this recent than 50 project submissions. Since the establishment of the National Healthcare COVID-19 pandemic has been inspiring and heartening. Group Polyclinics (NHGP) in 2000, our staff have As healthcare providers, all of us at NHGP are cognisant In September 2019, NHGP also received two Excellence served Singapore with dedication. This commitment is of the risks associated with infectious disease. However, Awards under the ‘Community Involvement’ and ‘Facility not only lived out in our daily efforts to deliver sound, to support Singapore’s battle against COVID-19, NHGP has Management and Financial Improvement’ categories at the patient-centred primary care, but also in the face of risen to the challenge. Many of our staff overcame their Asian Hospital Management Awards. This is a prestigious Associate Professor Chong Phui-Nah greater challenges, such as the SARS, H1N1 and Zika own personal fears to care for patients, toiling for long award that recognises and honours healthcare institutions Chief Executive Officer outbreaks in the past. hours across our six polyclinics and various community that take innovative and progressive approaches to National Healthcare Group Polyclinics facilities. This courage and resilience has done us proud! improve healthcare in the region. & Primary Care
06 CEO’s Message Annual Report FY2019 07 NHGP SENIOR MANAGEMENT NHGP SENIOR MANAGEMENT
Dr Simon Lee Associate Professor Chong Phui-Nah Dr Karen Ng Dr Tang Wern Ee Dr Kenneth Low Dr Darren Seah Dr Irwin Chung Chief Operating Officer and Chief Executive Officer, Director, Clinical Services Head, Clinical Research Unit Director, Dental Division Director, Family Medicine Development Director, Primary Care Academy Chief Clinical Informatics Officer NHGP & Primary Care
Ms Chen Yee Chui Mr David Kok Mr Shawn Phua Dr Mok Ying Jang Ms Chan Soo Chung Ms Lim Soh Har Dr Lim Chee Kong Chief Nurse, Nursing Services Director, Finance Director, Human Resources Deputy Chief Operating Officer Executive Director, NHG Pharmacy Executive Director, NHG Diagnostics Deputy Director, Clinical Services (Manpower)
Dr Christopher Chong Dr Jonathan Ting Dr Kong Jing Wen Dr David Ng Dr Gowri Doraisamy Dr Wee Wei Keong Dr Tung Yew Cheong Head, Ang Mo Kio Polyclinic Head, Geylang Polyclinic Head, Hougang Polyclinic Head, Toa Payoh Polyclinic Director, Care Integration Director, Health Promotion & Preventive Care Director, Quality and Patient Safety (until 31 Jan 2020)
Head, Special Projects, Primary Care (from 1 Feb 2020)
Dr Tan Khai Wei Dr Evan Sim Dr Kwan Pek Yee Dr Lim Ziliang Mr Donald Wai Ms Noraizah Zainal Abidin Ms Jaclyn Fam Head, Toa Payoh Polyclinic Head, Woodlands Polyclinic Head, Yishun Polyclinic Head, Yishun Polyclinic Director, Operations - Deputy Director, Corporate Communications Deputy Director, Corporate Planning (from 1 Feb 2020) (until 31 Jan 2020) (from 1 Feb 2020) Facility Development and Planning Office
08 NHGP Senior Management Annual Report FY2019 09
BATTLE AGAINST COVID-19 Cleaning and Disinfection Preventive Measures for Staff Special COVID-19 Issue of Plexus Being the first line of defence in the primary healthcare setting, NHGP played a critical role to minimise Processes To minimise exposure to the virus and The Primary Care Academy (PCA) produced For areas visited by a suspected or to reduce the risk of transmission for all a special COVID-19 issue of Plexus and reduce the risk of COVID-19 transmission nationwide. confirmed COVID-19 patient, thorough staff, NHGP promptly implemented strict on containment and infection control cleaning and disinfection were done. All processes in February 2020. Staff were measures, which was distributed to instruments and environmental surfaces, required to follow Personal Protective GP partners. In line with the ever-evolving In minimising the risk of COVID-19 from stethoscopes and thermometers Equipment (PPE) guidelines closely when health advisories and updates from the transmission, NHGP swiftly developed to telephones and keyboards, were in the clinic premises, adhere to strict government, a team of NHGP Family the following framework to tackle the also disinfected for safety. Routine safe distancing measures, and restrict Physicians addressed common queries challenges brought about by the pandemic: environmental cleaning procedures their movements across Public Healthcare from the frontlines in that issue. included disinfecting floors twice a Institutions (PHIs) and clinics. Containing risk of cross-contamination day and cleaning clinic common areas, Observing safe distancing including lifts and toilets, as well as Verifying infections quickly consult rooms within Red Zone areas. The Isolating at-risk staff frequency of wipe-downs and cleaning for Developing new ways to care for patients, high-touch areas was also increased. and train staff and students
Support for Primary Care Partners CONTAINING RISK OF NHGP also provided support to its CROSS-CONTAMINATION General Practitioner (GP) partners in the Central region during the COVID-19 Triage Area Measures period. NHGP’s nursing team helped Since Singapore confirmed its first conduct mask-fitting sessions for GPs in case of COVID-19 in January 2020, all the Central-North Primary Care Network patients and visitors had to undergo (CN-PCN), as well as non-CN-PCN GPs mandatory temperature screening and and their clinic staff. The CN-PCN travel history declaration prior to entering administrative team also assisted with any of NHGP’s six polyclinics. Patients the procurement of key items, such as were further triaged depending on their masks, protective goggles and hand temperatures, symptoms displayed and sanitisers. To ensure these GPs kept up travel history to mitigate the risk of with the evolving situation, the team cross-infection spread between patients helped set up virtual meetings to provide of different risk levels. Screening and triaging area at Ang Mo Kio Polyclinic. regular and timely updates.
NHGP nurse conducting mask-fitting for a General Practitioner.
Segregation Measures After being triaged, patients were OBSERVING SAFE assigned to Green, Orange or Red Zones. DISTANCING Patients suspected of having COVID-19 To create more safe distancing spaces were managed in tentages at the Red for patients and visitors, screening areas Zone outside the main building. The at all NHGP polyclinics were expanded. Orange Zone catered to patients with Tentages and standing fans installed symptoms of upper respiratory tract outside all six polyclinics in February infection such as sore throat, cough, 2020 increased screening capacity and breathlessness, runny nose or fever. reduced cross-contact contamination. The Green Zone saw patients with chronic conditions, who passed the Additionally, patients were limited to screening criteria and did not have only one accompanying visitor to further acute respiratory symptoms. Satellite contain the spread of infection within the pharmacies were also set up at the clinic premises. Safe distancing measures Orange and Red Zones in the clinics to markers were also placed at queues, seats help minimise and contain cross-contact and lifts to ensure that safe distancing between patients and visitors from guidelines were strictly adhered to. different triaged zones. This allowed pharmacists to prioritise and manage the prescription needs of these patients.
Patients suspected of having COVID-19 were isolated and managed at designated Red Zones. Tentage set up to expand screening areas at Toa Payoh Polyclinic to aid infection control and safe distancing measures.
12 Chapter 1 – Combatting a Global Pandemic Annual Report FY2019 13 VERIFYING INFECTIONS QUICKLY DEVELOPING NEW METHODS OF PATIENT CARE Swab and Send Home Programme Contact Tracing Video-Consultations with Doctors Since February 2020, NHGP actively For patients or visitors who were Eligible patients with well-controlled facilitated systematic and national swab in close contact with a COVID-19 chronic conditions were encouraged to opt testing efforts in the community under patient while they were at a clinic, for video-consultations as part of NHGP’s the Ministry of Health (MOH)’s Swab and contact tracing was managed by shift towards the new norm of care. Send Home (SASH) Programme. The aim NHGP’s Operations and Contact Centre. of the SASH Programme was to detect Affected individuals were alerted on To reduce the risk of infection transmission the virus early and reduce the risk of the same day MOH released its daily during COVID-19 period, NHGP introduced further transmission in the community. confirmed case announcements. The Video-consultations in February 2020 for A courier team from National Healthcare Contact Centre also conducted follow- eligible patients to consult their doctor from Group Diagnostics (NHGD) supported ups after two weeks to check on the the comfort of their homes via a video call. the delivery of swab samples from health of affected individuals. If they In the first three weeks of implementing this polyclinics to the National Public Health were unwell, they were asked to seek service, the number of patient visits to the Lab and other referral laboratories in medical attention immediately. polyclinics were reduced by 30%. Apart from hospitals. As of 31 March 2020, NHGP’s six its own patients with well-controlled chronic polyclinics had conducted 1,000 swabs. conditions, Hougang Polyclinic also offered NHGP nurse conducting a swab test on a patient. and extended Tele-consultation services to the elderly patients of Sunlove Home who had regular follow-ups with the care team.
IMPLEMENTING STAFF MEASURES Video-Consultation session being conducted with an eligible patient. Staff Travel History and Split Team Arrangements Health Surveillance To ensure the business continuity of All staff were required to declare essential functions, NHGP implemented Tele-Psychology their travel history and record their workplace segregation and split team To allow patients to better manage temperature twice daily using the Staff arrangements from February 2020. depression, anxiety, insomnia and Health Surveillance System (S3). Staff in Face-to-face interactions between other stress-related problems in the close contact with those on Stay-Home staff were kept strictly within the convenience of their homes, NHGP Notice (SHN) and Leave of Absence (LOA) designated split teams, even outside launched the Tele-psychology service were also advised to closely monitor their of working hours. Full work from in March 2020. This service offers health. Staff who were unwell were asked home arrangements commenced patients with existing psychologist to seek medical attention. These measures from April 2020, as the government appointments the option of a telephone ensured that infection risk was minimised implemented nationwide containment consultation with a psychologist, which for the safety of other staff and patients. measures in three phases. reduces the need for a physical visit to the polyclinic. NHG’s Staff Health Surveillance System for temperature recording.
CONDUCTING TRAININGS REMOTELY Tele-Psychology services offer patients with existing psychologist appointments the option of telephone consults. SimConsults Residency Tutorials Continuing Medical In February 2020, Year 5 medical students In strict compliance with infection Education Sessions from the Lee Kong Chian School of Medicine control guidelines, face-to-face teaching While Continuing Medical Education (CME) Tele-Dietetics (LKCMedicine), who were in the midst of sessions were no longer possible during sessions have been live-streamed To allow patients to receive timely their Family Medicine Student Assistantship the COVID-19 period. NHGP’s Family since 2018, NHGP ramped up its CME dietetic consults from the safety of their Programme clinical placements at NHGP Medicine Residency Team re-organised offerings delivered via a video- homes, NHGP started the Tele-dietitics had their clinical postings at the polyclinics all teaching sessions to be delivered via conferencing platform since the start of service in March 2020. This service offers shortened due to COVID-19. Nevertheless, a video-conferencing platform, while still COVID-19. This gave NHGP the opportunity patients with chronic conditions, as NHGP’s Family Physicians continued to provide providing adequate supervision, teaching to engage more speakers across different well as paediatric patients with feeding clinical training to the medical students and assessments for residents through specialties and hospitals, and also and nutritional needs, the option of a through simulated training sessions. Named didactic teaching, tutorials, and project improved the accessibility of the talks to telephone or video consultation with ‘SimConsults’, these simulated sessions audit presentations. NHGP’s clinicians and community partners. NHGP’s dietitians instead of having to allowed students to carry out mock-up make a physical visit to the polyclinic. consultations on simulated patients with conditions commonly seen in primary care. Family Physicians observed these sessions in real-time via a video-conferencing platform.
After each consultation, in-depth feedback was NHGP Dietitian on a video call with a patient. provided to students on their communication and clinical management skills.
14 Chapter 1 – Combatting a Global Pandemic Annual Report FY2019 15 Photos included here were taken before Circuit Breaker measures started on 7 April 2020. TRIBUTES Tokens of Appreciation for NHGP Staff During the COVID-19 period, NHGP received an outpouring of support and appreciation from our partners and the community. Thoughtful gestures and encouragement for our staff included hand-written ‘Thank-You’ notes, lunch boxes and care packages, among others.
Appreciation gifts from Bishan-Toa Payoh MP Mr Saktiandi Supaat and the Toa Payoh East-Novena Grassroots Marine Parade MP Mr Tan Chuan-Jin gave out beverages and snacks, sponsored by Koufu, Leaders & Youth Network (above); as well as the Nee Soon East Youth Network (right and below). to NHGP staff for their continued dedication during this period.
Members of Al-Istiqamah Mosque presented tokens of appreciation to NHGP staff.
Hand-written appreciation notes from Hougang Secondary School students.
Staff from Al-Muttaqin Mosque Kindergarten presented care packages to NHGP staff. Hand-written ‘Thank you’ cards made by Woodlands Ring Primary School students were presented to NHGP staff. NHGP Staff from HQ put together COVID-19 Love Packages to show support for their colleagues serving in the frontline at the polyclinics. This initiative aimed to boost staff’s morale and spirits during the battle against COVID-19. 16 Chapter 1 – Combatting a Global Pandemic Annual Report FY2019 17
MOVING HEALTHCARE UPSTREAM BRINGING CARE CLOSER TO HOME In FY2019, NHGP delivered a series of community initiatives to help patients adopt healthy lifestyle In FY2019, NHGP continued its efforts to help patients receive appropriate care in the community and habits and better manage their health outcomes. closer to home.
Primary Tech-Enhanced Care Frailty Screening in Primary Care Hypertension Pilot Piloted at Toa Payoh Polyclinic in 2019, In collaboration with the MOH Office for NHGP’s Frailty Screening Programme Healthcare Transformation (MOHT), NHGP aims to prevent the progression of conducted a hypertension management frailty. Patients identified as frail1 or tele-health pilot at Ang Mo Kio Polyclinic at-risk elderly patients display symptoms from September 2018 to March 2019. such as evident slowing of mobility, and This pilot was the first in a series of requiring assistance for basic physical and Primary Tech-Enhanced Care (PTEC) cognitive activities. initiatives, which aims to provide simple- to-use technologies to enable patients For frail adults with more complex with chronic diseases to confidently self- dietary restrictions or physical limitations, manage their condition. NHGP’s multi-disciplinary care team provides customised advice to help The pilot involved the use of a Bluetooth- them better manage their condition. enabled blood pressure monitoring At-risk elderly patients aged 65 years and device, which transmitted weekly readings Patients enrolled in NHGP’s Lighter Life programme are coached by a multi-disciplinary care team to achieve weight loss in a above are provided individualised advice to the patient’s care team in Ang Mo Kio healthy and safe manner. on nutrition, fall prevention measures Polyclinic. By monitoring and managing Tiered-Risk Interventions for Lighter Life and home exercises to help them better their condition from their homes, patients Managing Weight First launched in October 2018 at manage their condition. saved at least one visit to the clinic in a In order to identify the needs for specific Ang Mo Kio Polyclinic, NHGP’s Lighter year. For patients with poorly-controlled groups of patients and provide the Life is a risk-stratified weight management Patients with milder degrees of frailty are hypertension, they received additional Primary Tech-Enhanced Care (PTEC) pilot conducted at Ang Mo Kio Polyclinic in 2019. right level of care, NHGP launched the programme designed for patients with referred to community exercise programmes tele-consultation advice from a nurse, and Tiered-Risk Interventions for Managing chronic conditions. The programme aims organised by the People’s Association (PA) had their medication adjusted if required. Weight (TRIM) programme at Ang Mo Kio to help patients achieve weight loss in a and Health Promotion Board (HPB) through As part of the pilot, the first SMS Chatbot Polyclinic in 2018 and at Woodlands healthy and safe manner with the help of the Community Network for Seniors. for hypertension co-developed with a Polyclinic in 2019. As part of this process, peer and community support. Patients are polyclinic care team was also trialled. The NHGP reviewed and activated patients by monitored and coached over six months on The Frailty Screening Programme will be While tele-health is not new, this pandemic has accelerated the chatbot provided timely and interactive systematically ascertaining health risks behavioural changes by a multi-disciplinary progressively introduced to all six NHGP adoption of technology much faster among both healthcare advice for patients, and prompted and starting relevant conversations as Care Team comprising a Family Physician, polyclinics by the end of 2021. providers and patients. It has spurred healthcare providers to patients who had missed submitting their part of their care. These patients were nurse, dietitian, physiotherapist, clinical innovate and create solutions to continue providing care for weekly readings. then referred to suitable health coaching psychologist, and health experts. patients & provided a nudge towards greater acceptance of and intervention programmes within and simple-to-use technology for patients to monitor their own Interim results from the study announced outside of the polyclinics such as the In addition to Ang Mo Kio Polyclinic, the condition and engage with providers.” in July 2019 showed improvements in NHG FitterLife weight-loss programme. programme was also made available to blood pressure control for all participants, Associate Professor Chong Phui-Nah, patients of Woodlands Polyclinic and especially for patients who had poorly- Chief Executive Officer of NHGP and Primary Care As of 31 January 2020, 15,000 patients have Toa Payoh Polyclinic by the end of 2019. controlled hypertension at the start of the been engaged in weight management pilot study. The final pilot study results will conversations. More than 70% either be released in FY2020. took up the recommended intervention Enhanced Community Screening programme or opted for health coaching. for Breast Cancer and Osteoporosis To meet the increased screening needs in the community, NHG Diagnostics (NHGD) Preventing Diabetes Workshop AT A GLANCE First held at Toa Payoh Polyclinic in 2019, officially launched its second Mammobus NHGP’S FRAILTY the Preventing Diabetes Workshop is a and second Mobile Bone Mineral SCREENING Densitometry (BMD) in October 2019. two-session workshop held on a quarterly PROGRAMME basis. It aims to educate participants on With this addition, screenings for breast impaired fasting glucose, impaired glucose By 31 March 2020, cancer and osteoporosis are made more tolerance and its risks. Participants are also Seven accessible and convenient for residents in out of 10 the Central region of Singapore. taught how to prevent diabetes and learn 1,200 identified as frail more about proper nutrition and exercise. patients screened or pre-frail They are also introduced to community The Mobile BMD is available at involvement programme that would Ang Mo Kio Polyclinic, Geylang Polyclinic, Elderly patients who are identified to be frail and at-risk are Woodlands Polyclinic and Yishun Polyclinic. support their lifestyle modifications. educated on how to prevent adverse health effects. NHGD’s Mobile Ultrasound service brings convenience to patients. 1 Frailty is a condition where patients become more prone to adverse events from relatively minor health stressors. People with frailty are at an 20 Chapter 2 – Developing Population Health increased risk of falls, disability and hospital admissions Annual Report FY2019 21 World Heart Day 2019 EDUCATING THE PUBLIC In conjunction with World Heart Day To encourage patients to lead healthier lives, NHGP spared no effort in educating and motivating the in September 2019, NHGP organised community through various programme and events in FY2019. roadshows at all of its six polyclinics to raise awareness on the symptoms and risks of cardiovascular disease. During the roadshows, NHGP staff educated patients on what a healthy blood pressure range is, and explained how lifestyle changes can help reduce the risk of cardiovascular diseases. Patients above 40 years old were encouraged to attend regular screenings for early detection and prevention. NHGP conducted roadshows to raise awareness on the symptoms and risks of cardiovascular disease at all NHGP polyclinics in September 2019.
World Podiatry Day In April 2019, NHGP celebrated World Podiatry Day by hosting interactive booths NHGP organised roadshows to educate patients on diabetes prevention and management in NHGP Dietitians helped participants understand food labels and buy the right products during a at Geylang Polyclinic and Woodlands conjunction with World Diabetes Day 2019. supermarket tour in November 2019. Polyclinic. At these booths, podiatrists World Diabetes Day 2019 Health Education Roadshows Supermarket Tour educated patients and members of the To mark World Diabetes Day in 2019, Throughout November 2019, health In November 2019, NHGP also organised public on the importance of foot health, NHGP organised various events, such as education roadshows were held at all a supermarket tour for 25 participants and provided simple foot care tips. a series of health education roadshows six NHGP polyclinics. At the roadshows, with diabetes or pre-diabetes. During the and a supermarket tour to Fairprice Xtra participants were taught about lifestyle tour, NHGP dietitians taught participants at AMK Hub. These efforts were targeted changes to reduce the risk of developing how to pick the right products through at creating more awareness about diabetes. Through an interactive activity, understanding food labels. Participants diabetes management, and educating participants learnt about the hidden also learnt how to choose healthier NHGP Podiatrists taught patients on managing foot health and simple foot care tips. patients on adopting healthier lifestyle sugar content in popular local dishes, and products such as low Glycemic Index (GI) changes to reduce their risk of diabetes. were reminded to limit their sugar intake food to avoid blood sugar spikes and NSA Roadshows to less than 11 teaspoons daily. weight increase. Primary Care Academy (PCA) participated in a National Silver Academy (NSA) roadshow held in August 2019 at the National Library. World Mental Health Day During the roadshow, PCA’s public courses, In conjunction with World Mental Health such as ‘Care of the Elderly’ and ‘Basic Day in October 2019, NHGP conducted a First Aid’ were offered to seniors. series of talks titled ‘The Healing Power of Optimism for Mind and Body Wellness’ The roadshow coincided with NSA’s third The talks were delivered in English, Malay anniversary celebrations. Dr Irwin Chung, and Mandarin by NHGP psychologists to Director, PCA received a token of senior citizens in the community, and staff appreciation from Guest-of-Honour at all six NHGP polyclinics. President Halimah Yacob for PCA’s support and efforts in promoting lifelong learning. For the full list of workshops and courses conducted in FY2019, please refer to Dr Irwin Chung, Director, PCA (left) received a token of appreciation from President Halimah Yacob at the NSA roadshow in August 2019. Appendix B. NHGP Psychologists interacting with senior citizens in the community as part of World Mental Health Day in October 2019. World Physiotherapy Day Hand Hygiene Day 2019 In September 2019, NHGP celebrated In celebration of Hand Hygiene Day 2019, World Physiotherapy Day by co-organising NHGP organised roadshows across all its roadshows with St Luke’s Eldercare and six polyclinics in May 2019. An activity All Saints Home at Ang Mo Kio Polyclinic booth at each clinic was also set up to and Yishun Polyclinic respectively. educate patients and visitors on hand Themed ‘Making Every Move Count,’ hygiene matters. 150 participants learnt how to manage and reduce chronic pain through physical therapy. Participants also took part in a group exercise class designed to address common muscle joint pains in the knees and shoulders.
Participants learning simple shoulder and knee exercises. Activity booth at Toa Payoh Polyclinic to educate patients and visitors on hand hygiene matters in conjunction with Hand Hygiene Day 2019. 22 Chapter 2 – Developing Population Health Annual Report FY2019 23
BUILDING RESEARCH CAPACITY MOH Value-Driven Care Conference 2019 To bring patient care to the next level, NHGP recognises the importance of building and developing On 25 September 2019, the Ministry talent in research. In FY2019, NHGP organised and participated in various local and international of Health (MOH) held the Value- conferences which focused on transforming primary healthcare. Driven Care (VDC) Conference to bring together healthcare administrators and professionals from various public Primary Care Forum 2019 healthcare institutions to learn and share NHGP held its annual Primary Care Forum from one another. on 10 and 11 October 2019. Themed ‘Primary Care: Innovative Communities, Dr Sabrina Wong, Family Physician and Co-Design for Quality’, the forum was held Consultant, Assistant Director, Clinical in conjunction with the Singapore Health Services, and Dr Kung Jian Ming, Family and Biomedical Congress (SHBC) 2019. Physician and Associate Consultant, Dr Sabrina Wong, Family Physician and Consultant, Assistant Director, Clinical Services, speaking at the MOH Value-Driven Care Conference 2019. Yishun Polyclinic, were awarded the The forum focused on moving primary Outstanding Oral Presentation for healthcare upstream to detect various their respective projects titled ‘NHGP social determinants of health at an early Teamlet Care Model: Improving Patient stage, and the importance of consumer Outcomes Through Redesign of Chronic experience within a patient-centered care Care Delivery Model’ and ‘Nurse Initiated delivery system. In addition, a General Bronchodilator Therapy at Woodlands’. Practitioner (GP) symposium was also held for GPs to share and discuss a range of clinical issues and workflow challenges encountered.
Guest plenary speaker, Professor Kevin Grumbach (3rd from right), shared his thoughts on how to shape and co-create patient-centred care at the Primary Care Forum 2019.
Singapore Primary Care Research Scientific Competition Dr Kung Jian Ming, Family Physician and Associate Consultant, Yishun Polyclinic, receiving the Outstanding Oral Presentation Award. The Singapore Primary Care Research Scientific Competition recognises research efforts of healthcare professionals and showcases a culture of research in primary healthcare. In 2019, the competition attracted 56 submissions on a wide range of topics. For the list of Oral and Poster Presentations by NHGP Staff at Local and International Conferences abstracts accepted for the Singapore Health and Biomedical Congress (SHBC) Scientific Competition 2019, please refer to Appendix A. The following table highlights the various research programmes undertaken by NHGP staff that have been presented at local and The following NHGP winners were announced during the opening ceremony of SHBC on 10 October 2019: international conferences in FY2019:
ORAL CATEGORY ASIA PACIFIC PRIMARY CARE RESEARCH CONFERENCE 2019 NORTH AMERICAN PRIMARY CARE RESEARCH GROUP ANNUAL MEETING GOLD SILVER BRONZE Oral Presentation Short Oral Presentation 2019 AND DISTINGUISHED TRAINEE RESEARCH AWARDS Ms Koh Hui Li Dr Lee Eng Sing Ms Julia Zhu Xiaoli FIRST PRIZE FIRST PRIZE Patients with Multi-morbidity The Ethnic and Sex Fragile Wounds, Precarious Selves: An Dr Lee Eng Sing Dr Sabrina Wong – Does It Always Mean a Differences in the Patterns Interpretative Phenomenological Study Family Physician Family Physician Oral Presentation Lower Quality of Life? of Multi-morbidity on the Experience of Diabetic Amputees Senior Consultant, Consultant, THIRD PRIZE in Primary Care and Deputy Head of and Assistant Director of Dr Lee Eng Sing Clinical Research Unit Clinical Services Family Physician Senior Consultant, The Ethnic and Sex Differences in Outcomes of the NHGP Teamlet care and Deputy Head of the Patterns of Multi-morbidity in model on Chronic Disease Management Clinical Research Unit Singapore Primary Care Patients in Singapore A Systematic Review on the POSTER CATEGORY THIRD PRIZE Instruments Used for Measuring Ms Xie Ying the Level of Multi-morbidity GOLD SILVER BRONZE Senior Executive Ms Teo Sok Huang Dr Karen Ng Ming Yann Ms Liow Hui Shi Office of Clinical Informatics A Pilot Evaluation of the Prescription of Omeprazole Targeting Muscle Loss with NHGP Chronic Care Plan in a Primary Care Setting Medical Nutrition Therapy in Prevalence of Multi-morbidity in in Singapore Older Adults – Dietary Protein Singapore: An Epidemiological Study Intake and Hand Grip Strength Using Administrative Data
26 Chapter 3 –Charting Our Way Forward Annual Report FY2019 27 Health Manpower Development LEARNING AND SHARING Plan Visits NHGP organised and participated in various learning sessions in collaboration with both local and In October 2019, a team from NHGP The team also learnt how the Danish overseas intuitions as part of its continuous efforts to learn and share experiences. visited three cities in Denmark, namely Ministry of Health and municipal Copenhagen, Aarhus and Odense. There, authorities designed and ran various tele- they gained system-level insights into the health systems in Aarhus and Odense. Danish health, social and preventive care Site visits were also made to the Steno system. The two-week visit was hosted Diabetes Centre in Aarhus, university by Professor Roar Maagaard, a General hospitals in Aarhus and Odense, as well Practitioner (GP) and researcher. During as various GP clinics and community the visit, the team received first-hand care facilities, exposing the team to how experience of the Danish after-hours care technology was used for the delivery of system, and managed to shadow a group health and social care services. of GPs who conducted teaching, research, and community care sessions. NHGP team with Prof Roar Maagaard in Denmark who shared more about the Danish healthcare setting.
Visits to NHGP Ang Mo Kio Polyclinic Between May to July 2019, Ang Mo Kio Polyclinic hosted two visits, one from the Southern California Permanente Medical Group (SCPMG), a subsidiary of American care consortium Kaiser Permanente, and A/Prof Brauer (back row, centre) with NHGP staff at Yishun Polyclinic. the other, a group of foreign nursing Visits from Overseas Experts delegates who attended the International NHGP hosted three overseas experts, Council of Nursing Congress (ICNC). Associate Professor (A/Prof) Paula Brauer, A/Prof Matthew Boyd and Professor Louise Robinson, between July 2019 to In July 2019, a group of foreign nursing delegates, who was in Singapore for the ICNC, toured Ang Mo Kio Polyclinic. January 2020. A/Prof Brauer sits on the faculty in the Applied Human Nutrition Woodlands Polyclinic Programme of the Department of Family In August 2019, a delegation from Relations and Applied Nutrition, University Indonesia’s Public Health Services visited of Guelph, Ontario, Canada. During her Woodlands Polyclinic. During these visits, visit to Yishun Polyclinic from 11 to various clinic teams brought the delegates 26 July 2019, A/Prof Brauer discussed on a tour of the clinic premises, shared the effectiveness of delivering allied about the history and transformation of health services in the prevention and primary care in Singapore, and explained management of chronic conditions. On the rationale behind NHGP’s operational the other hand, A/Prof Boyd in Patient workflows and infrastructures. Safety and Pharmacy Practice, University of Nottingham, United Kingdom (UK), NHGP and MOH co-hosted A/Prof Boyd (1st from left) at Yishun Polyclinic, who shared about pharmaceutical services in the UK. shared his experiences on implementing community pharmaceutical services in the An NHGP team brought the Indonesian delegates on a tour around the Woodlands Polyclinic premises. UK during his visit to Yishun Polyclinic on 5 October 2019. Yishun Polyclinic Between April to July 2019, Yishun NHGP also hosted overseas expert Polyclinic hosted several visits Professor Louise Robinson, a General including the Ministry of Home Affairs Practitioner from the UK renowned for (MHA), the World Health Organization her expertise on dementia care. During (WHO), and Mr Michael Chihoski, a her visit from 13 to 17 January 2020, consultant with the Joint Commission Prof Robinson visited all three polyclinic International (JCI). clusters and the Tsao Foundation. She also shared her thoughts on the various aspects of dementia management in primary healthcare at NHGP’s medical forum, which saw over 100 doctors attending the event. For the list of medical forums and workshops conducted in FY2019, In July 2019, NHGP hosted Dr Takeshi Kasai (fourth from right), Regional Director of WHO Western Pacific Region Office; and nd please refer to Appendix C. NHGP hosted Prof Robinson (2 from right), who shared insights on dementia care. Dr Ying-Ru Jacqueline Lo (fifth from right), WHO Representative for Malaysia, Brunei and Singapore. 28 Chapter 3 –Charting Our Way Forward Annual Report FY2019 29 NHG Teaching Award MOH In-Service Scholarships ACHIEVING PROFESSIONAL STANDARDS Dr Tan Sherie NHG’s Teacher’s Day was held on 6 September and NHGP Scholarships NHGP encourages lifelong learning as a means to constantly improve and deliver the best evidence-based Resident Physician 2019. This annual event included an award In FY2019, several NHGP staff attained Geylang Polyclinic care to patients. To this end, NHGP supports staff in their professional and academic pursuits. ceremony, where 13 NHGP doctors and the MOH In-Service Scholarship and nurses were recognised for their roles as NHGP Scholarship. These scholarships Dr Wong Xiu Yi clinical teachers and educators. Medical Officer allow staff to be equipped with essential Geylang Polyclinic competencies and leadership capabilities First Family Physician in to fulfil future healthcare needs. Dr Leonard Leng Qi An NHG TEACHING AWARD FOR NHG to be conferred PhD in Dr Laxmanan Raja Rajeswari Family Medicine Resident Family Medicine MASTER OF MEDICINE IN JUNIOR DOCTORS 2019 FAMILY MEDICINE Family Physician Hougang Polyclinic Ms Evonne Oh Siew Gek In October 2019, Dr Lee Eng Sing, Family Yishun Polyclinic Dr Ian Koh Jan Ming Assistant Nurse Clinician Physician, Senior Consultant and Deputy Dr Teo Jia Hui Family Physician – Associate Consultant Ang Mo Kio Polyclinic 16 NHGP doctors passed the Master Toa Payoh Polyclinic Head of the Clinical Research Unit, NHGP, Dr Lee Yew Weng Andrew Family Medicine Resident Ms Valerie Chong Chui Mei of Medicine in Family Medicine Family Physician was the first Family Physician in NHG to Hougang Polyclinic Dr Ooi Chung Ping Staff Nurse examinations in November Yishun Polyclinic Ang Mo Kio Polyclinic be conferred a PhD in Family Medicine. 2019. These doctors either did a Family Physician Dr Wong Wai In Ang Mo Kio Polyclinic Ms Aslina Asbil Dr Lee’s PhD programme was offered three-year NHG Family Medicine Dr Seet Qi Sharlene Resident Physician Resident Physician Senior Assistant Nurse by the Department of Family Medicine, Residency Programme or NHGP Hougang Polyclinic Dr Vivek Bansal Geylang Polyclinic Schulich School of Medicine and Dentistry Programme B. The respective Yishun Polyclinic Family Physician – Associate Consultant Dr Ang Ling Min Woodlands Polyclinic Ms Nor Hidayah Mohd Salleh at the Western University in Ontario, programmes prepare the doctors for Dr Soh Puey Huang Jobina Resident Physician Senior Assistant Nurse Canada. Dr Lee is also NHGP’s first the breadth of exposure to acquire Resident Physician Geylang Polyclinic the competencies required to Toa Payoh Polyclinic Clinician Researcher. Yishun Polyclinic NHG TEACHING AWARD FOR practice as Family Physicians. SENIOR DOCTORS 2019 Ms Mohanambal D/O Sundravelu Dr Ng Xin Rong Senior Staff Nurse Family Medicine Convocation Dr Chua Yu Jing Andrew Resident Physician Dr Jason Chan Hougang Polyclinic Resident Physician Toa Payoh Polyclinic Family Physician Ms Tuty Anida Masuri Organised by the College of Family Geylang Polyclinic Ang Mo Kio Polyclinic Senior Assistant Nurse Physicians (Singapore) (CFPS), the Family Dr Julius Kang Jun Kai Dr Valerie Teo Yishun Polyclinic Medicine Convocation Ceremony was held Dr Ong Ai Li Medical Officer Woodlands Polyclinic Family Physician – Consultant Ms Wang Na on 23 November 2019, during which 39 Family Physician Ang Mo Kio Polyclinic Senior Staff Nurse NHGP doctors were recognised. Four of Ang Mo Kio Polyclinic GRADUATE DIPLOMA IN Dr Tan Jinxuan Yishun Polyclinic them attained the Fellowships from CFPS, FAMILY MEDICINE Dr Chan Ke Shuang Elizabeth Family Physician NHG TEACHING AWARD FOR Mr Zeng Jin Liang 16 were conferred a Masters of Medicine in Resident Physician Woodlands Polyclinic NURSING PRECEPTORS 2019 Medical Social Worker 19 NHGP doctors passed the Family Medicine, and 19 doctors received Hougang Polyclinic Yishun Polyclinic Graduate Diploma in Family their Graduate Diploma in Family Medicine. Dr Ling Yee Von Ms Christine Chern Win Fah Dr Devasena Manoharan Medicine examinations in July 2019. Medical Officer Nursing Clinician Family Physician The diploma is a post-graduate Yishun Polyclinic Toa Payoh Polyclinic NUSMedicine Dean’s Awards 2019 Hougang Polyclinic training programme that equips Organised by the National University of family doctors in Singapore with skills Dr Zeng Zhiyong Ms Wendy Ong Kim Leng Senior Nurse Manager Singapore (NUS) Yong Loo Lin School of FELLOWSHIP COLLEGE OF FAMILY Dr Ding Si Yan to enhance their level of patient care. Resident Physician Woodlands Polyclinic Medicine, the Appreciation for Clinical Teachers PHYSICIANS (SINGAPORE) Resident Physician Yishun Polyclinic Dr Ang Wei Luong event held on 5 November 2019 honoured Hougang Polyclinic Resident Physician Ms Xiao Hui Four NHGP doctors completed Senior Staff Nurse excellence in teaching medical students. Ang Mo Kio Polyclinic the 24-month Advanced Training Dr Amelia Ahmad Hatib Yishun Polyclinic Programme in Family Medicine, Resident Physician Dr Darice Jill Ng Yu Ping and passed the summative exit Toa Payoh Polyclinic Resident Physician DEAN’S AWARD FOR examinations in 2019. Dr Christopher NHG OUTSTANDING NURSE TEACHING EXCELLENCE Dr Gan Wei Chun Ang Mo Kio Polyclinic NHGP Best Family Medicine TEACHERS AWARD 2019 Chong, Family Physician, Associate Dr Richard Lee Meng Kam Consultant and Head of Ang Mo Kio Resident Physician Trainers’ Award Dr Liew Pui Mun Ms Christie Anna Family Physician – Consultant Polyclinic also obtained the Koh Eng Dr Kee Kok Wai and Dr Steven Chao Toa Payoh Polyclinic Resident Physician Nurse Educator Yishun Polyclinic Kheng Gold Medal for being the best Ang Mo Kio Polyclinic Chien Chih, both Family Physicians and Nursing Services Fellowship Graduate in the 2019 Dr Kwek Sock Yuen Cassandra Associate Consultants at Toa Payoh Resident Physician Dr Ten Dick Xiang fellowship examinations. Polyclinic, were the recipients of the Ms Susan Loh JUNIOR DOCTOR TEACHING AWARD Woodlands Polyclinic Resident Physician NHGP Best Family Medicine Trainers’ Assistance Nurse Clinician Dr Christopher Chong Ang Mo Kio Polyclinic Award 2019. The annual award recognises Ang Mo Kio Polyclinic Dr Steven Chao Chien Chih (Dr Koh Eng Kheng Gold Medal) Dr Moses Tan Mong Heng Family Physician – Associate Consultant the dedication, passion and commitment Family Physician - Associate Consultant Resident Physician Dr Janan Lee Ms Vernice Tay Ah Kiok Toa Payoh Polyclinic
and Head of Ang Mo Kio Polyclinic Woodlands Polyclinic Family Physician of Family Medicine Trainers. Senior Staff Nurse Geylang Polyclinic Geylang Polyclinic Dr Karen Ng Ming Yann Dr Tan Eng Liang Melvin Ms Rajoo Thilaga Rani CERTIFICATES OF APPRECIATION Family Physician - Senior Consultant Resident Physician Dr Lim Teck Khai NHGP Nursing Best Clinical Medical Officer Senior Staff Nurse and Director Clinical Services Woodlands Polyclinic Instructor Award Dr Richard Lee Meng Kam Geylang Polyclinic Ms Kang Yi Min, Senior Staff Nurse, Hougang Polyclinic Family Physician – Consultant Dr Teh Kailin Dr Chee Jia Yi (Lydia) Woodlands Polyclinic, received the Yishun Polyclinic Family Physician - Associate Consultant Dr Loh Soon Shan Resident Physician NHGP Nursing Best Clinical Instructor NHG INTER-PROFESSIONAL Ang Mo Kio Polyclinic Medical Officer Dr Steven Chao Chien Chih Yishun Polyclinic Geylang Polyclinic Award 2019. The annual award TEACHING AWARD 2019 Family Physician – Associate Consultant Dr Gilbert Yeo recognises excellent contribution Toa Payoh Polyclinic Dr Ee Runhua Michelle Dr Sim Shin Wei Dr Lim Ziliang Family Physician - Associate Consultant in providing effective clinical teaching Family Physician – Consultant Resident Physician Resident Physician Dr On Todd Woodlands Polyclinic to newly-recruited nurses and students Yishun Polyclinic Yishun Polyclinic Geylang Polyclinic Family Physician – Associate Consultant in Nursing Services. Toa Payoh Polyclinic
30 Chapter 3 –Charting Our Way Forward Annual Report FY2019 31
NHGP Quality Day 2019 INNOVATING FOR BETTER CARE NHGP held its annual Quality Day on In FY2019, NHGP was recognised for its various innovative solutions to provide the best care possible for 11 October 2019. Themed ‘Innovative its patients. Communities, Co-design for Quality’, the event highlighted how co-designing programmes and processes with key BCA UD Mark Awards 2019 AHMA 2019 partners and stakeholders could lead to On 22 April 2019, Ang Mo Kio Polyclinic, At the Asian Hospital Management better outcomes and impact. Kallang Polyclinic and Yishun Polyclinic Awards (AHMA) in September 2019, were among 37 projects to be conferred NHGP was awarded two Excellence During the event, keynote speaker the Building Construction Authority (BCA) Awards —one under the Community Mr Keith Tan, Chief Executive of Singapore Universal Design (UD) Mark Award. Involvement category and the other under Tourism Board (STB), shared STB’s Ang Mo Kio Polyclinic and Kallang the Facility Management and Financial experience in designing quality visitor- PLUS Polyclinic clinched BCA’s UD Mark Gold Improvement category. centric experiences by first having an Winners at NHGP’s Quality Day 2019 were lauded for implementing innovative solutions that improved the quality of care. award, while Yishun Polyclinic was in-depth understanding of their target conferred the UD Mark Gold Award. In the first category, NHGP’s entry titled audience and, thereafter, assessing and ‘From Clinic to Community – Starting a leveraging suitable technology solutions. Weight Management Conversation in the SPAA 2019 Clinic and Supporting Lifestyle Modification A total of 24 OurCare and iCARE awards NHGP’s Guiding Hands Volunteers in the Community’, showcased NHGP’s were given out to staff during the event. The clinched the Singapore Patient Support Mr Ryan Ang (left) and Ms Soh Ying Hua (right) received the awards recognised NHGP’s staff efforts in efforts to enhance patient activation for Excellence Awards on behalf of NHGP at the AHMA 2019. Group / Volunteer Group Award at the therapeutic lifestyle modification. delivering service excellence and quality Singapore Patient Action Awards (SPAA) improvement, as well as exhibiting innovation 2019. Organised by Tan Tock Seng In the second category, NHGP’s entry titled CSISG 2019 and transformation, during the year. Hospital, the award honours volunteers ‘Re-Development of Ang Mo Kio and Yishun NHGP received a 72.6 point rating for the for making a positive difference to the Polyclinics to Increase Patient Capacity and Customer Satisfaction Index of Singapore For the list of Quality Improvement Projects healthcare ecosystem in Singapore. Improve Patient Care Delivery’, showed how (CSISG) 2019, an increase from 71.7 points completed in FY2019, please refer to NHGP’s careful design and planning, coupled in 2018. The survey, conducted annually by Appendix D. with improved work processes, enabled it the Singapore Management University’s NHGP’s winning staff and teams at NHG Quality Day 2019. to achieve highly-desirable outcomes for Institute of Service Excellence, studies the NHG Quality Day 2019 Action Awards (EIAA) for contributing enhancing experiences in healthcare patients, leading to a significant improvement customer satisfaction level of consumers On 11 September 2019, NHG celebrated significantly to work practices that service delivery. Quality Improvement in how patients managed their conditions. in Singapore. Quality Day 2019 themed ‘System have improved customer service or Awards (QIA) were also given to Reliability: Designing It Right, Doing It patient safety. Two NHGP patients and eight project teams in recognition of National HIP Medals 2019 Right, Detecting the Risk Right’. Nine caregivers received the Exemplary Patient their contributions in improving and NHGP staff clinched the Excellence in and Caregiver Award (EPCA) towards transforming care delivery for patients. On 9 May 2019, NHGP was awarded the National Healthcare Innovation and Productivity (HIP) Excellence Champion Medal for the redesign of its care model. BRINGING GREATER CONVENIENCE FOR PATIENTS Dr Sabrina Wong, Assistant Director, Clinical Services, who led the transformative As part of NHGP’s efforts to create a more streamlined patient journey, enhancements have been made to work for NHGP’s Teamlet Care Model, both front-end patient-facing platforms as well as back-end systems. received the award from Minister for number of staff required for routine tasks, Health Mr Gan Kim Yong on behalf of Enhancements to HealthHub the team. and allowed staff to offer more value-added and Self-Help Kiosks assistance at the clinics. For self-payment As of September 2019, enhancements to kiosks, payment via one’s Child Development the HealthHub mobile application allowed Account (CDA) was also made available. MOH PES FY2019 for more self-service options for the NHGP achieved a composite of patient following services at NHG’s Polyclinics: satisfaction score of 91.3 per cent in Enhancements to Laboratory MOH’s Patient Experience Survey (PES) Information System • Registering for appointments As of February 2020, the Laboratory 2019. All six NHGP polyclinics attained • Getting a queue number individual score of above 88%. Information System (LIS) in laboratories • Viewing the electronic itinerary at Ang Mo Kio, Hougang, Toa Payoh, • Checking queue status Woodlands and Yishun Polyclinics was The survey assessed patients’ experience • Viewing upcoming appointments upgraded from TD-Synergy to TDNexLabs at public healthcare institutions and • Updating of particulars e.g. mailing (TDNL). The upgraded LIS comes with helped identify areas of improvement. address and contact number improved security features for the user • Requesting for medication refill interface, and provides full automation of Dr Sabrina Wong receiving the overall Excellence Champion Medal from the Minister for Health Mr Gan Kim Yong. processes such as e-orders and e-results, Besides offering patients more convenience, thereby increasing the processing these enhancements also reduced the efficiency of NHGD’s laboratories. 34 Chapter 4 –Advancing Towards a New Norm of Care Annual Report FY2019 35
ACKNOWLEDGING OUR PEOPLE Nurses’ Merit Award 2019 Ms Elane Zhang, Nurse Manager, Hougang To build and inspire a culture of distinction, NHGP takes pride in celebrating staff achievements Polyclinic, and Ms De Roza Jacqueline that contribute to better patient care delivery. In FY2019, several staff were recognised for their Giovanna, Advanced Practice Nurse, commendable efforts. Geylang Polyclinic, were presented the Nurses’ Merit Award on 17 July 2019. The award recognised their outstanding National Day Awards performance and dedication over the Investiture 2019 course of their nursing profession. On 26 November 2019, five NHGP staff and one NHG Pharmacy staff received the National Day Awards in recognition of Ms De Roza Jacqueline Giovanna, Advanced Practice Nurse (third from right), and Ms Elane Zhang, Nurse Manager their merit and service. (second from left), received the Nurses’ Merit Award 2019.
LONG SERVICE MEDAL MOH Appreciation & Awards 2019 Dr Valerie Teo Hui Ying, Family Physician, Ms Alice Wong Choy Phin Associate Consultant, Deputy Head, Executive, Finance Ang Mo Kio Polyclinic, and a member of the National Medication Safety Committee, was presented the Minister EFFICIENCY MEDAL for Health Award 2019 at the Ministry of Ms Chang Lee Peng Health (MOH) Appreciation and Awards Assistant Director, Finance Ceremony on 13 November 2019. Mr Derek Chiew Kuo Hwa Assistant Director, Human Resource At the same award ceremony, Associate Ms Tan Seok Peng Professor (A/Prof) Chong Phui-Nah, CEO Manager, Operations of NHGP and Primary Care, Dr Karen Ng, Ms Kavitha D/O Parada Raju Director, Clinical Services, and Dr Sabrina Assistant Manager, Human Resource Dr Melissa Guay, Dental Surgeon at Geylang Polyclinic, received an ‘Honourable Mention’ at the Healthcare Humanity Awards 2019. Wong, Family Physician-Consultant, Clinical Dr Valerie Teo Hui Ying, Family Physician, Associate Consultant, received the highest accolade conferred by MOH with the Minister Services, received the Long Service Awards. for Health Award 2019.
COMMENDATION MEDAL Healthcare Humanity Award (Open Category) on 25 April 2019. The award Dr Melissa Guay Peiru, Senior Dental was given in recognition of her dedication Ms Ong Soo Im SHA 2019 Surgeon, Woodlands Polyclinic, was and commitment to the development of Senior Pharmacist, NHG Pharmacy On 4 October 2019, NHGP was awarded conferred an ‘Honourable Mention’ clinical guidelines in the area of special the Achievement Award during the for the Healthcare Humanity Awards needs dentistry in primary care. Singapore HEALTH Award (SHA) 2019 Symposium organised by the PST Awards 2019 Health Promotion Board. This award At the Public Sector Transformation acknowledged NHGP’s efforts to integrate (PST) Awards 2019 ceremony on health promotion into primary care 19 July 2019, Ms Sharon Chen, by promoting workplace health and Deputy Director, Operations, received enhancing the well-being of employees. the Exemplary Leader Award; and Ms Dong Lijuan, Deputy Director, Nursing Services, and Ms Angie Lim Hui Li, Senior Executive, NHG Pharmacy (NHGPh), were NHGP team received the Achievement Award at the Singapore HEALTH Award (SHA) 2019 Symposium. presented the Exemplary SkillsFuture @ Public Service Award. NHGP Family Appreciation Day A/Prof Chong Phui-Nah, CEO, NHGP and Ms Anna Tang, Senior Medical Technologist, Primary Care, presented six book prizes NHG Diagnostics (NHGD), was presented to the children of NHGP staff during the the Dare to Do Award. NHGP Family Appreciation Day 2019 on 25 November 2019.
In addition, 13 family members received the Stand by Me Awards as an appreciation of the dedication and support they gave to NHGP staff, so that they could focus on and Ms Sharon Chen, Deputy Director, Operations, received the Exemplary Leader Award and Ms Dong Lijuan, Deputy Director, Nursing Services, received the Exemplary SkillsFuture @ Public Service Award at the PST Awards 2019. perform their work. NHGP Family Appreciation Day was celebrated on 25 November 2019. 38 Chapter 5 –Enhancing Our Capabilities Annual Report FY2019 39 NHG Awards 2019 The National Healthcare Group (NHG) conferred 41 individuals and 13 teams across 7 award categories at its annual NHG Awards, in UNITING OUR PEOPLE recognition of their exemplary contributions to public healthcare in Singapore. Among the awardees, 13 NHGP staff and 4 teams received To forge camaraderie and team spirit, NHGP regularly organises bonding activities, sharing sessions and awards in the various categories. The awards were presented by Guest-of-Honour and NHG Chairman, Madam Kay Kuok, on 24 May 2019. staff engagements.
Townhall Sessions NHG OUTSTANDING NHG RECOGNITION AWARD NHG RECOGNITION AWARD During FY2019 CEO Townhall sessions, CITIZENSHIP AWARD A/Prof Chong Phui-Nah, CEO, NHGP and Primary Care, gave an update on NHGP’s Dr Wee Wei Keong SILVER BRONZE Director primary care transformation efforts. Health Promotion and Chronic Care Plan Lighter Life – Tiered Weight She shared NHGP’s achievements for Preventive Care Team Lead – Mr David Kok Management for Patients the past year and provided an overview with Chronic Diseases NHGP’s Chronic Care Plan (CCP) of the results for the Employee Climate Mr David Kok Hwa Chieh Team Lead – Dr Donna Tan Director offers an annual treatment plan Survey 2018. A/Prof Chong also encouraged Finance and payment option for patients The 6-month risk-stratified weight all clinics to continue providing the best with chronic diseases listed under management programme is aimed service to our patients. the Chronic Disease Management at helping eligible patients NHG YOUNG ACHIEVER AWARD Programme. Designed to empower with chronic conditions achieve and incentivise patients with weight loss in a healthy manner. National Steps Challenge 2019 Dr Lim Ziliang A/Prof Chong Phui-Nah, CEO, NHGP and Primary Care, sharing updates on NHGP’s primary care transformation efforts chronic diseases to better manage Launched at Ang Mo Kio Polyclinic The fourth season of the National Steps during Townhall sessions. Family Physician, Consultant their conditions, CCP was first in October 2018, suitable patients Challenge, organised by the Health Head of Yishun Polyclinic piloted in Yishun Polyclinic are monitored and guided Promotion Board, saw more than 300 Dr Serene Zhang Ruiping in 2017 before being extended throughout the programme by NHGP staff participating in 81 teams. The to Ang Mo Kio Polyclinic in a multi-disciplinary primary Senior Dental Surgeon Challenge saw NHGP being ranked second January 2019. care team comprising a family Woodlands Polyclinic in the Health and Social Services sector. physician, nurse, dietitian, physiotherapist, clinical NHG DEVELOPMENTAL AWARD Medication Clinic psychologist and health experts. NDP 2019 Marching Contingent Team Lead – Dr David Ng HMDP MEDICAL On 9 August 2019, Dr Evan Sim, Family Medication Clinic, a joint- Physician, Principal Staff, and Head of Dr Gabriel Ding NHGP Advance Care initiative between NHGP and Woodlands Polyclinic, led a team of Family Physician, Planning Pilot NHG Pharmacy, is a pre-consult Associate Consultant Team Lead – Dr Susan Lim NHGP staff to participate in the National medication reconciliation Geylang Polyclinic Healthcare Group (NHG) Marching service. The aim of this In moving patients’ care upstream, Contingent for the National Day Parade 2019. NHGP team as part of the NHG Marching Contingent for the National Day Parade 2019. Medication Clinic is to educate Advance Care Planning (ACP) HEALTH MANPOWER patients on their medications provides patients and their family DEVELOPMENT PLAN and reduce medication members greater accessibility (HMDP) TEAM-BASED discrepancies during transitions and convenience to discuss NHGP Dinner & Dance 2019 Dinner and Dance on 2 November 2019. members and polyclinic teams. Close to 900 staff from NHGP, National Themed ‘A Dazzling Musical Night’, staff Staff and guests also enjoyed fringe Dr Irwin Chung of care. Medication Clinic was and complete their ACP in the Healthcare Group Diagnostics and Family Physician, implemented at all NHGP community. NHGP commenced its dressed up in glittering and vibrant activities, including photo taking at Associate Consultant polyclinics in August 2018. first ACP sessions at Toa Payoh National Healthcare Group Pharmacy outfits. Musical performances were the photo booths and a lucky draw. Director of Primary Care Academy Polyclinic in October 2017, came together for NHGP’s annual staged by NHGP Senior Management and extended it to Ang Mo Kio Ms Wendy Ong Polyclinic in June 2018. Senior Nurse Manager Woodlands Polyclinic Ms Santhi D/O Govindan Nurse Manager II Hougang Polyclinic
STRATEGIC NURSING DEVELOPMENT PROGRAMME TEAM-BASED Ms Nor Diana Togeman Nurse Manager II Geylang Polyclinic
Dazzling musical performances staged by polyclinic staff. NHGP staff in colourful and vibrant outfits for the group performances.
40 Chapter 5 –Enhancing Our Capabilities Annual Report FY2019 41 APPENDIX A ABSTRACTS BY NHGP STAFF AND COLLABORATORS FOR SHBC
NO. ABSTRACT TITLE AUTHORS NO. ABSTRACT TITLE AUTHORS
1 Patients with Multi-Morbidity – Does It Always Mean a Ms Koh Hui Li, Ms Zhang Yue Jue, Dr Edimansyah Abdin, 11 Exploring Adherence Trends and Patterns of Patients Ms Yap Hui Rei, Ms Bek Siew Joo Esther, Lower Quality of Life? Dr Sabrina Lee Poay Sian, Ms Vaingankar Janhavi Ajit, with Diabetes Mellitus in a Primary Care Setting in Ms Christine Teng Bee Choon, Dr Tang Wern Ee A/Prof Mythily Subramaniam, Dr Lee Eng Sing Singapore Using Proportion of Days Covered
2 Perceptions of Patients with Hypertension in Primary Dr Ong Kah Pieng, Dr Tan Hue Min, Ms Evonne Oh 12 Fragile Wounds, Precarious Selves: An Interpretative Ms Zhu Xiaoli, Dr Evelyn Chew Ai Ling, Care on the Use of a Technology-Enabled Home Blood Siew Gek, Ms Teo Sok Huang, Dr Evelyn Chew Ai Ling, Phenomenological Study on the Experience of Diabetic Ms Goh Ling Jia, Dr Lee Ching Ling Mary, Pressure Monitor Ms Nur Atiqah Surya Akmaja, Ms Chia Kai Li, Amputees in Primary Care A/Prof Bernadette Bartlam, Dr Dong Lijuan Ms Er Lian Hwa, Dr Valerie Teo Hui Ying 13 The Association Between Multi-Morbidity and Dr Sim Sai Zhen, Dr Lee Eng Sing, Ms Koh Hui Li, 3 Effectiveness of Fenofibrate in Delaying Albuminuria in Dr Seah Ee-Jin Darren, Dr Matthias Paul Toh Han Sim, Healthcare Utilisation in the Middle-Aged Population Dr Sabrina Lee Poay Sian, Ms Teo Sok Huang, Patients with Type 2 Diabetes Ms Wong Lai Yin at a Primary Care Setting in Singapore Ms Kyreen Lee Chen Ting, Dr Judith Goh Xiu Hui, Dr Muhamad Zulhakim, Prof Doris Young 4 The Use of Medication Packaging Aids in Improving Mr Mah Choon Siong, Dr Lee Eng Sing, Dr Kee Kok Wai, Adherence and Clinical Outcomes Ms Pratibha Nair 14 A Pilot Evaluation of the National Healthcare Group Ms Teo Sok Huang, Dr Tang Wern Ee, Dr Lim Ziliang, Polyclinics Chronic Care Plan Mr David Kok Hwa Chieh
5 Prevalence of Depression and Anxiety Among Patients Dr Sabrina Lee Poay Sian, Ms Koh Hui Li, with Multi-Morbidity in Primary Care Ms Zhang Yun Jue, Ms Vaingankar Janhavi Ajit, 15 Targeting Muscle Loss with Medical Nutrition Therapy Ms Liow Hui Shi A/Prof Mythily Subramaniam, Dr Lee Eng Sing in Older Adults — Dietary Protein Intake and Hand Grip Strength
6 Community Case Managers’ Perspective on the Dr Gilbert Yeo Tian Seng, Dr Predeebha D/O Kannan Challenges of Collaborating with Primary Care Services 16 Prescription of Omeprazole in a Primary Care Setting Dr Karen Ng Ming Yann, Ms Eunice Lim, When Managing Complex Patients in the Community: in Singapore Dr Lee Eng Sing A Qualitative Study 17 How do Clinical Instructors Use Questions to Engage Ms Christie Anna, Ms Goh Ling Jia, Mr Ong Yu Han, 7 Severe Distress and Denial Among Asian Patients with Ms Cheryl Tan, Ms Xu Yingqi, Ms Joyce Lee Yu-Chia Nursing Students During Short Clinical Placements in Ms Cindy Lee, Mr Lim Yong Hao Type 2 Diabetes in the Primary Care: A Prospective, Primary Care Settings? Cross-Sectional, Multi-Centre Study 18 Knowledge, Attitude and Perceptions of Tuberculosis Ms Tjhin Silvana, Ms Wen Xia, Ms Hamha Mohamed 8 A Study to Determine the Proportion and Characteristics Dr Bansal Vivek, Prof Helen Smith, Dr Lee Eng Sing Disease Among Patients with Tuberculosis: A Survey in Hamzah, Ms Goh Ling Jia, Ms Lau Pei Ern of Post-Stroke Patients with Optimal Secondary the Primary Healthcare Prevention in Primary Care Setting in Singapore 19 Evaluation of the Safety and Effectiveness of TcB as an Ms Goh Ling Jia, Ms Tan Pek Hoon, Ms Chow Choon Har, 9 A Cross-Sectional Study to Compare the Lifestyle Mr For Wei Chek, Ms Soh Ying Hua, Ms Jayalakshmy Initial Screen for Jaundice in NHGP Mr Richard Low Sai Yin Practices of National Healthcare Group Polyclinics Staff Aarthi Ananthanarayanan, Dr Wee Wei Keong Between 2018 and 2019 20 Attitudes of Patients with Diabetes Mellitus Towards Dr Wan Jinhui Seeking Professional Psychological Treatment Within 10 National Healthcare Group Polyclinics Staff’s Adoption Mr For Wei Chek, Ms Soh Ying Hua, Ms Jayalakshmy Primary Healthcare Setting: A Cross-Sectional Study of Healthy Lifestyle Habits in Relation to the Ability to Aarthi Ananthanarayanan, Dr Wee Wei Keong Cope with Life’s Demands 21 Usage of Omeprazole in the Local Primary Care Setting Ms Eunice Lim Pei Chin, Dr Karen Ng Ming Yann
42 Appendices Annual Report FY2019 43 APPENDIX A ABSTRACTS BY NHGP STAFF AND COLLABORATORS FOR SHBC
NO. ABSTRACT TITLE AUTHORS NO. ABSTRACT TITLE AUTHORS
22 Analysis of Insulin Acceptance Among Type 2 Diabetics Dr Maganlal Neesha, Dr Jaganmohan Raja Ramasamy, 32 Epidemiological Trends Amongst Elderly Patients Coming Ms Irene Chew Ker Sing, Ms Durga Devi D/O Kurusamy, with HbA1c > 9% in a Team-Based Care in Comparison Dr Evan Sim Chin Sing for Pneumococcal Vaccine Ms Jeena Varghese, Dr Lye Yik Fan, Ms Fadzlina Sujak, with the Non-Team-Based Care Patients — Followed-Up Ms Tang Qing Ying, Ms Valli Rajaram, at Woodlands Polyclinic, NHGP, Singapore, from July 2016 Ms Srimathi Litshumanan, Ms Vellasamy Palaniammal to June 2017 33 Prevalence of Ottawa Ankle Rules in Patients Presenting Dr Andrew Chin Wai Meng, Dr Lye Yik Fan, 23 The Association Between Multi-Morbidity and Dr Sim Sai Zhen, Dr Lee Eng Sing, Ms Koh Hui Li, with Ankle Trauma Dr Ong Sin Hwee, Dr David Ng Wei Liang Health-Related Quality of Life (HrQoL), and Dr Sabrina Lee Poay Sian, Ms Teo Sok Huang, Sociodemographic Factors in the Middle-Aged Ms Kyreen Lee Chen Ting, Dr Judith Goh Xiu Hui, 34 It’s All About TIME for Patient Involvement: Ms Wan Lili, Ms Angie Yong Aun Khei, Ms Wei Lili, Population at a Primary Care Setting in Singapore Dr Muhamad Zulhakim, Prof Doris Young A Case Series of Managing Extensive Diabetic Foot Ms Julia Zhu Xiaoli Wound in Primary Care 24 HALT-CKD - Median Time to Optimisation of ACE-I/ARB Dr Yap Chun Wei, Ms Tan Sher Leen Therapy in Primary Care 35 "What is Diabetes" — Perspectives from Patients with Ms Goh Ling Jia, Ms Julia Zhu Xiaoli, Dr Evelyn Chew Diabetic Lower-limb Amputation in Singapore Ai Ling, Dr Dong Lijuan
25 HALT-CKD - Progress in Optimisation of ACE-I/ARB Dr Jeremy Koh Zhong Wei, Ms Tan Sher Leen 36 Effectiveness of Treatment Modalities for Patients Dr Nicholas Leong Jiajie, Dr Leow Chee Yong, Therapy in Primary Care Presenting with Plantar Fasciitis in Toa Payoh Polyclinic Dr Leong Ying Hua, Dr Esther Geraldyn Yap Hui Hwa, Dr Kee Kok Wai, Dr David Ng Wei Liang 26 Shared Decision-making in Patients with Chronic Dr Chan Zhi Yi, Ms Teo Sok Huang, Dr Tang Wern Ee Diseases in Primary Care: A Systematic Review 37 Game-Based Learning for Medical Student Teaching in Dr David Ng Wei Liang National Healthcare Group Polyclinics
27 A Powerful Tool in Patient Diabetes Self-Management: Ms Wong Yuefen 38 Awareness of Diabetes Mellitus Among Women Who Had Ms Goh Ling Jia, Ms Siti Rasyidah Gozali, Carbohydrate Counting Group Education in Primary Care Gestational Diabetes: A Survey in Hougang Polyclinic Ms Quek Geok Hong Lina, Ms Chua Siew Ching Maryann, Ms Chua Yan Hoon 28 Exploring Factors Influencing Non-Attendance at Ms Vellasamy Palaniammal, Ms Lim Ing Taur, Diabetes Foot Screening Service at Toa Payoh Polyclinic Ms Linna Chin Lee Ching, Ms Zhou Xueqin, 39 Analysis of Chronic Kidney Disease and Obesity in Diabetics Dr Maganlal Neesha, Dr Ramasamy Jaganmohan Raja, Ms Chua Shi Yuan Aged Between 40-65 years with HbA1c 9 - 10%, Followed-Up Dr Evan Sim Chin Sing in a Team-Based Care at Woodlands Polyclinic, National Healthcare Group Polyclinics, Singapore 29 Analysis and Interventions to Reduce Percutaneous Ms Lily Lang, Ms Ang Wei Wei Injuries in Dental Clinics from 2013 to 2018 40 Do the Personal Beliefs of Primary Care Physicians Affect Dr Chong Wern Siew Christopher, Ms Xe Ying Their Clinical Practice Behaviours in Weight Management? 30 Sedating Antihistamine Use in the Treatment of Upper Dr Ong Wen Chong, Dr Cordez Sherry Hugo, Respiratory Tract Infection Among Elderly at a Polyclinic Dr Kunwar Bir Singh, Dr Vittal Sunil Pawar, 41 The Accuracy of Various Automated Blood Pressure Dr Lim Ziliang, Ms Keely Lim Xue Qi, Ms Emily Lim Xin Yi, in Singapore Dr David Ng Wei Liang Devices for Self-Service Measurement in a Primary Ms Norherawati Mohd Yasin Healthcare Setting in Singapore 31 Medication Adherence Among Hypertensive Patients Ms Teo Sok Huang, Dr Valerie Teo Hui Ying, Enrolled in a Blood Pressure Self-Monitoring Pilot in Dr David Ng Wei Liang, Dr Tang Wern Ee 42 Knowledge, Attitudes, Behaviour Towards Needlestick Dr Ong Ming Wu Warren, Mr Jeff Hwang, Primary Care Injuries Amongst Doctors in Singapore Dr Lim See Ming, Dr Judy Sng
44 Appendices Annual Report FY2019 45 APPENDIX B APPENDIX C LIST OF PRIMARY CARE ACADEMY WORKSHOPS CONDUCTED IN FY2019 MEDICAL FORUMS AND WORKSHOPS CONDUCTED BY NHGP IN FY2019
LIFE SUPPORT DATES TOPICS SPEAKERS / TRAINERS
BCLS + AED Re-Certification 30 May 2019 Post-Stroke and Rehabilitation Care: Dr Tan Ping Ping BCLS + AED Instructor Course Nuts and Bolts for Family Physicians Consultant, BCLS & AED Full Certification TTSH Rehabilitation Centre, CPR + AED Tan Tock Seng Hospital Basic First Aid Workshop
MEDICAL KNOWLEDGE 18 July 2019 Doctor, Can I Have A Memo Please? Mr Michael Lim Foundation Chronic Disease Management Legal Advisor, National Healthcare Group GDFM Mock OSCE MMed Mock OSCE MMed Mock Slides Introduction to Research 19 September 2019 Beating Eating Disorders: Dr Ranjeev Ramachandran Introduction to Qualitative Research in Primary Care How Do We Help Adolescent Patients? Senior Consultant, Publication Workshop * Division of General Ambulatory Paediatrics and Family Planning in Primary Care Adolescent Medicine, Department of Paediatrics, An Introduction to Common Skin Complaints Khoo Teck Puat - National University Children’s Medical Institute, PATIENT CARE, CLINICAL & PROCEDURAL SKILLS National University Hospital Surgical Diathermy Workshop * Common Eye Conditions Update for the Family Physician Interpretation of Spirometry Results 28 November 2019 Old Age vs. Frailty: Dr Justin Chew Diabetic Foot Screening Is There Really a Difference? Associate Consultant, Early Childhood Nutrition Workshop for Registered Nurses and Doctors Centre for Geriatric Medicine, Advanced Course on Wound Management for Registered Nurses Tan Tock Seng Hospital Developmental Assessment for Registered Nurses Foundation Course in Women's Health Ms Alvernia Chua Advanced Course in Women's Health Senior Dietitian, Diabetic Retinophotography (DRP) for New Nurses Ang Mo Kio Polyclinic, Nurse-Initiated Bronchodilator Therapy * National Healthcare Group Polyclinics Childhood Immunisation For Registered Nurses * Foundation Course On Vaccination and Traveller’s Health In Primary Care * Ms Cindy Soh Managing Diabetic Foot Ulcer from Primary Healthcare Nursing Perspective * Principal Physiotherapist, Essentials of Preceptorship Programme * Woodlands Polyclinic, Fundamentals of Breastfeeding Counselling in Primary Care * National Healthcare Group Polyclinics
COURSES FOR THE PUBLIC AND THE COMMUNITY 16 January 2020 Managing Dementia in Primary Care: Professor Louise Robinson Care for the Elderly What Lies Ahead For Us? Director, Newcastle University Institute for Ageing; GP Assistant - Basic Professor of Primary Care and Ageing; and GP Assistant - Advance Regius Professor of Ageing, Newcastle University Community First Aid Awareness Workshop Public Health Talks * New
46 Appendices Annual Report FY2019 47 APPENDIX D QUALITY IMPROVEMENT PROJECTS COMPLETED IN FY2019
NO. PROJECT TITLE CLINIC / HQ PROJECT LEADER/S NO. PROJECT TITLE CLINIC / HQ PROJECT LEADER/S
1 A Nurse-Initiated Written Asthma Action Plan (WAAP) HQ Ms Lee Ching Lian & 13 A 6S project for Minor Procedure Room layout AMK Ms Cleo Li Shen Dr Valerie Teo Hui Ying 14 To improve sterility check to 100% at NHGP Toa Payoh TPY Ms Siti Rafeah Selamat 2 To increase the monthly uptake of PCV 13 administered to TPY Ms Irene Chew Ker Sing Dental Clinic all eligible elderly patients in Toa Payoh Polyclinic from 2.6% & Ms Durga Devi D/O to 40% over 6 months Kurusamy 15 To increase the uptake rate of Fecal Immunochemical Test WDL Dr Teo Wei Shan in eligible teamlet patients in Woodlands Polyclinic from 20% 3 To reduce 20% of eFaxes that Care Managers received over the AMK Ms Valerie Chong & to 25% over 6 months from August 2019 to January 2020 period of 6 months in Ang Mo Kio Polyclinic Ms Er Lian Hwa 16 To increase the number of post-menopausal women with high AMK Dr Heng Jian- Xiong Roy 4 To review the intensity of light used in Diabetic Retinal HQ Mr Teoh Qi Xian & risk of osteoporosis screened with a bone mineral density test Photography Room Ms Lim Ing Taur 17 To increase cervical cancer screening rates for Woodlands WDL Dr Tan Sze Huei Elisa 5 To increase the number of fluoride applications to 100% TPY Dr Tan Sze Lin Polyclinic teamlet patients from 28% to 50% from at NHGP Toa Payoh Dental Clinic in 8 months September 2019 to February 2020
6 To increase the percentage of Chronic Obstructive Pulmonary GL Dr Ruby Cheng Geok 18 To improve the uptake of Screening Mammography for women YIS Dr Evonne Koh Ruiyu Disease patients in Geylang Polyclinic who have valid annual Min & aged 50 to 69 years In Yishun Polyclinic Teamlet E influenza vaccinations from 22.2% (average of preceding 5 months) Ms Yogeswari D/O 19 To increase the provision rate of Written Asthma Action Plan YIS Dr Lawerence Wu to 50% over a period of 8 months Rama Krishnan in asthma patients on preventer inhalers in Yishun Polyclinic
7 To improve the rate of screening malnutrition risk for elderly YIS Ms Chan Sau Ling 20 To increase the uptake rate of influenza vaccination among WDL Dr Emma Samijono patients aged 85 years old and above from 0% to 100% in teamlet patients with diabetes in Woodlands Polyclinic over Teamlet D at Yishun Polyclinic within 6 months 6 months
8 A Faster and Painless Way of Screening for Neonatal Jaundice HQ Mr Richard Low Sai Yin 21 To increase the percentage of identified teamlet patients in WDL Dr Quek Jing Sheng Woodlands Polyclinic from 50% to 70% over 6 months 9 To reduce prescriptions of sedating antihistamines among TPY Dr Ong Wen Chong elderly patients at Toa Payoh Polyclinic seen for acute Upper 22 To improve the uptake of cervical cancer screening for women YIS Dr Lim Chee Luan Respiratory Tract Infection from 51.43% to 0% within 6 months aged 25 to 69 years old in Yishun Polyclinic Teamlet E 10 To increase the percentage of patients diagnosed with HOU Ms Su Jie & new Diabetic Foot Ulcers who receive ABI/TBI/Toe pressure Dr Jonathan Chong measurements within 5 working days from 23% to 100% in 3 months, in Hougang Polyclinic
11 To increase percentage of patients with diabetes who are YIS Dr Tai Zu Huang newly initiated on basal insulin2 in Yishun Polyclinic to achieve target fasting blood glucose3 < 7 mmol/L within 3 months
from 30% to 60% over 6 months AMK - Ang Mo Kio Polyclinic GEY - Geylang Polyclinic 12 To improve the percentage of osteoporosis patients WDL Dr Nirmala Kandasamy HOU - Hougang Polyclinic HQ - NHGP Headquarters receiving lifestyle counselling by Care Managers TPY - Toa Payoh Polyclinic from 2% to 50% in 6 months at Woodlands Polyclinic WDL - Woodlands Polyclinic YIS - Yishun Polyclinic
48 Appendices Annual Report FY2019 49
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