Improving Quality, Cost and Delivery
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The Business Times, Tuesday, December 4, 2012 PRODUCTIVITY MATTERS 13 HEALTHCARE Improving quality, cost and delivery The sector is leveraging on productivity by boosting infrastructure and growing and training the workforce. NISHA RAMCHANDANI reports ACED with an the best healthcare out- boost the resident health- increasing de- comes possible. care manpower supply by mand for ser- Singapore currently raising the annual intake of vices and a spends 1.6 per cent of its healthcare training pro- shortage of la- GDP on healthcare, though grammes in Singapore. bour, Singa- this figure is expected to According to a paper by F pore’s health- climb to 2 per cent by the National Population care sector is 2016. and Talent Division of the leveraging on productivity As at 2011, there were Prime Minister’s Office, Sin- to transform the quality, 30 hospitals in Singapore – gapore will need to grow its cost and delivery of health- 15 private and 15 public – pool of professional health- care. providing nearly 11,400 care workers from 46,000 Rising demand is fuelled beds, as well as 240 public in 2011 to 78,000 in 2030. in part by the double wham- sector dental clinics and 18 Meanwhile, the number Improvement: A nurse dispensing medicine at NUH using a computerised, close-loop inpatient medication system. PHOTO: NUH my of a growing and ageing polyclinics. of support care staff will population. As part of the Health- need to expand from 4,000 ary pressures, also means ferent productivity mea- An ageing population al- care 2020 roadmap, the in 2011 to 13,000 in 2030. higher costs for healthcare sures, including procure- so means that demand is Ministry of Health (MOH) is “Due to Singapore’s lim- organisations as salaries ment and the redesigning working on improving the not limited to acute care ited human capital and re- are adjusted upwards. of job scope and processes. Healthcare but will extend to other are- accessibility, quality and af- sources, supply of health- MOH is also trying to en- It will also devote $21 as of the healthcare spec- fordability of healthcare for care professionals of all lev- courage local healthcare in- million over the next five trum, such as intermediate Singaporeans. els has not kept pace with FAST FACTS (as at 2011) stitutions to become more years so that staff in the IL- and long-term care (ILTC). increasing demand,” says productive so that patients TC sector can undergo con- Lifestyle changes too Infrastructure Kelvin Loh, chief executive are better cared for, the tinuing and advanced skills HOSPITALS HOSPITAL BEDS PUBLIC SECTOR POLYCLINICS are increasing the preva- Investments are being of Mount Elizabeth Hospi- DENTAL CLINICS work environment im- training. lence of chronic diseases, made towards new and ex- tal. proves and healthcare staff “We are working on im- while Singapore’s reputa- isting infrastructure such “One of the biggest chal- proving productivity in the are equipped with more tion as a medical hub also as hospitals, towards grow- lenges the healthcare sec- healthcare system as a 30 11,394 240 18 skills as this too will play a attracts patients from re- ing and training the health- tor faces is a shortage of whole, and also specifically role in attracting Singapore- gional markets and be- care workforce as well as skilled professionals from within the public and ILTC ans to work in the sector. yond. expanding the financing nurses (to) allied health pro- sectors,” says an MOH Public sector Acute care For instance, the govern- 15 8,304 Unlike other industries, framework so that health- fessionals and doctors,” Dr spokesman. + + healthcare serves a social care is affordable for the Loh adds. ment will spend up to $96 Within each sector, Extended million over the next five Source: Yearbook of Statistics aim so it needs to be afford- low and middle income The shortage of staff, MOH is working together Private sector care Singapore, 2012, Healthcare able, especially in the pub- brackets. compounded with the tight years to work with provid- with healthcare providers 15 3,090 lic sector, while providing MOH is also striving to labour market and inflation- ers in the ILTC sector on dif- to reap cost-savings, cut down on manpower hours, enhance the quality of care and improve retention of employees. In September this year, Boosting productivity the Healthcare Cluster Tri- partite Workgroup was set up to improve productivity For the acute sector across the public acute care sector. I Healthcare Cluster Tripartite Workgroup formed in September 2012 to coordinate productivity initiatives and It is helmed by MOH and facilitate sharing and diffusion of best practices the National Trades Union Congress (NTUC), and is I Chaired by MOH and NTUC, consists of the six public healthcare sectors: Alexandra Health, Eastern made up of the six public Health Alliance, Jurong Health Services, National Healthcare Group, National University Hospital and healthcare clusters – Alex- SingHealth Services andra Health, the Eastern Health Alliance, Jurong Health Services, National For the intermediate and long-term care sector (ILTC) Healthcare Group, National I $96 million over the next 5 years: to support productivity initiatives University Hospital (NUH) and SingHealth Services. $21 million over the next 5 years: to support skills training I Aside from training, boosting productivity will PROGRAMME WHAT IT IS AGENCY help staff cope with the growing demand for ser- MANPOWER Health • HMDP was initiated by MOH to provide advanced skills training Agency for vices while still providing Manpower for healthcare professionals Integrated quality care, say healthcare Development • Extended to the ILTC sector in 2002 to provide funding support for Care (AIC) operators. Plan – advanced skills training in elderly and continuing care. Some are already mak- Intermediate ing strides in introducing • Two funding schemes: and Long-Term measures which can boost Care (HMDP-ILTC) a) Fellowship scheme: 90% funding support for ILTC staff to productivity, cut expendi- pursue advanced skills training or attachments at local or overseas ture and improve operation- healthcare institutions al efficiency. Streamlining: The Parkway Pantai Group, which operates four hospitals in b) Visiting expert scheme: 100% funding support for ILTC Automation Singapore, leverages on one management team to operate Mount Elizabeth and institutions to invite overseas or local experts to impart skills and Mount Elizabeth Novena. This allows for the sharing of best practices, flow of NUH’s pharmacy depart- knowledge as well as skills between the two hospitals. FILE PHOTO share knowledge via lectures, workshops or visits to ILTC ment, for instance, is using institutions. automated identification MANPOWER Intermediate & • A scholarship programme initiated and supported by the National Agency for and data capture technolo- at Mount Elizabeth quicker Fund and by MOH) for pro- TC sector, having a more Long-Term Care Productivity Fund Integrated gy to process its invoices, than it otherwise might. ductivity initiatives in these professional and better which makes work easier “We have been looking areas. trained workforce is impor- – Upgrading Care (AIC) • Aims to help high-performing nurses and allied health for staff while cutting down at areas where we can In terms of procure- tant. ILTC professionals Programme professionals in the ILTC sector upgrade their skills and knowledge costs. adopt technology to cut ment, AIC and SingHealth can upgrade themselves (ILTC-UP) have spearheaded a project through clinical and • Complements the HMDP-ILTC and the AIC Learning Institute “Where it used to re- down the workload of our quire six steps to process staff, and ways technology that brings ILTC institu- non-clinical courses at the • First batch of 10 scholarship recipients received awards in October each invoice, it now only re- can help streamline or tions together to bulk pur- AIC Learning Institute quires three steps and has speed up certain processes chase medical supplies, (LI),” says Dr Cheah. MANPOWER Career • A centralised employment scheme supported by the National Ministry thus saving on costs. “There is also the IL- helped the department from administration and Resourcing and Productivity Fund of Health Since the project started TC-Upgrading Programme save close to $20,000 annu- operations to patient care,” Development of Holdings in January 2010, 30 ILTC (ILTC-UP), a scholarship • Aims to attract more allied healthcare professionals into the ILTC ally since its implementa- adds Dr Loh. Allied Health institutions have saved for healthcare profession- sector, to meet growing demand and counter staff retention (MOHH) tion,” says an NUH spokes- Doctors at Mount Eliza- Talents (CREATE) challenges some $1 million by buying als in this sector to pursue man. “The system looks set beth Novena can also send supplies in bulk, while se- a Degree in Nursing or Al- • Provides them with broader exposure and opportunity to train in for an upgrade, with the en- their pharmacy orders elec- curing better contract lied Health disciplines,” he both acute care and community healthcare settings, offers more hanced version promising tronically, which cuts down terms and quality assur- adds. varied and better career pathways a larger-screen tablet in- on the need for manual la- ance from suppliers as well A total of 10 ILTC health- stead of PDA device, re- bour as porters do not have as saving time. care professionals have EFFICIENCY Shared • Aims to lower the costs of medical supplies by aggregating Agency for al-time transfer of data and to carry handwritten manu- “To raise the capability been given the scholarship Procurement purchases; SingHealth Group Procurement Office acts as a third Integrated enhanced interface capabil- al prescriptions from one and productivity of the IL- to date. Programme party procurement agent and aggregates demand, enabling Care (AIC) ity.” place to another. (for ILTC sector) participating voluntary welfare organisations to enjoy bulk volume The Parkway Pantai discounts on milk feeds, diapers, sterile dressing sets and hand rub.