Touching Lives, Pioneering Care,Making a Difference

March2015

Special edition

Mita (P) 147/08/2003 Co. Reg. No. 52929306D

a l e x a n d r a h e a l t h i n a c t i o n

Alexandra Health System remembers Mr Lee Kuan Yew, our Founding Father and Prime Minister

Alexandra Health System remembers Mr Lee Kuan Yew, our Founding Father and Prime Minister

Our Founding Prime Minister and the architect of Singapore’s success, Mr Lee

Kuan Yew, left us on 23 March 2015. We were honoured to have Mr Lee grace the official opening of Khoo Teck Puat Hospital (KTPH) in 2010. His profound legacy and values will continue to touch and inspire us at Alexandra Health System (AHS).

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I had the great honour of taking care of the late Mrs Lee from May 2008 to March 2010 as a Nurse Clinician. During those 22 months, I witnessed Mr Lee as a loving husband who would return home from his office and spend quality time with Mrs Lee, reading to her the news and her favourite poems at her bedside.

I was touched that Mr Lee, knowing that I was from China, would engage me in conversation using Mandarin so that he could practise it. In the process, my Mandarin also improved as Mr Lee was a very keen learner. The most important lesson that I have learnt from Mr Lee is to keep learning, regardless of age. - Liu Xiaoyan, Nurse Manager

For us here at AHS, we serve the people within the heartland. We have our individual skills, talents and gifts, and many of my colleagues and I consider it a privilege to help those who are vulnerable and less fortunate. It is our way of giving back to society, to benefit mankind. We will encounter hurdles, disappointment, sceptics, and failures. But Mr Lee’s life reminds us that these are not such bad things. He is a true leader in every sense of the word. He remains an inspiration and his mark is forever imbued within the spirit of Singapore. - Dr Paul Wong, Consultant, Department of Anaesthesia

I will always be grateful for Mr Lee’s clear, unwavering vision for Singapore and his tenacity and determination to see it reach reality. His greater achievement is not what he did in the past, but in raising generations committed to keep his legacy for the future. Lest we forget. Dulce et decorum est pro patria mori.* - A/Prof Kenneth Mak, KTPH’s Chairman Medical Board

Thank you for the clean, green and beautiful Singapore. Thank you for the peace, harmony and prosperity that we have enjoyed. Rest in peace, Mr Lee. - Mr Liak Teng Lit, Group CEO, AHS

Tributes to a Great Man

* Dulce et decorum est pro patria mori is a line taken from a poem written by the Roman poet, Horace. It can be loosely translated as: “It is sweet and right to die for your country”.

The first time I was told to attend to Mr Lee, I was so scared that I had goosebumps all over. All I knew of Mr Lee was the politician from the television. But the moment I stepped into his room, he reassured and put me at ease. - Chia Kwee Lee, Deputy Director of Nursing

Mr Lee used to come to the then Toa Payoh Hospital for routine checkups. He was always relaxed so we also felt relaxed. As a senior assistant nurse then, my job was to serve him drinks and make him comfortable. Mr Lee was always very appreciative and said thank you for every small gesture. He said to me, ‘You are a good nurse, you can be a good role model.’ When I replied that I was just an assistant nurse, he said, ‘No, you’re wrong, you’re important because you do good bedside nursing.’ Mr Lee’s comments have inspired me to always care for my patients and share my skills with my juniors. - Hajjah Nor Aini Bte Hasim, Principal Assistant Nurse

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Mr Lee Kuan Yew opened KTPH officially on 15 November 2010. He was a

man who understood the healthcare industry deeply and liked how we designed the hospital. In his opening speech, Mr Lee who was also known as the Chief Gardener of Singapore, called KTPH “a hospital in a garden”. In fact, during a private visit to KTPH before we opened, he had suggested to then-CEO Mr Liak Teng Lit to green up the concrete wall at the pond, so as to beautify the hospital’s environment.

Mr Lee’s influence on KTPH

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A minimalist approach to tackling back pain

pre-operative Mri scan shows disc degeneration and disc bulge at two levels in derek’s lumbar spine.

images showing the positioning of the radio-frequency probe in the inter-vertebral disc during derek’s nucleoplasty

At the age of 22, national serviceman Derek Wong* was downgraded from a combat

unit to a desk job because of severe pain in his lower back. Despite being deskbound, the pain persisted and worsened until he was unable to move around normally. Physiotherapy reduced it slightly, but not enough for him to resume his regular activities.

Eventually, Mr Wong’s doctor referred him to the Spine Service at Khoo Teck Puat Hospital (KTPH) which offers nucleoplasty, a non-invasive treatment that was developed a decade ago and recently introduced in Singapore. The day surgery procedure involves applying a radio-frequency probe to dysfunctional spinal discs and altering them. Patients are usually able to resume a desk job within three to four weeks.

Nucleoplasty differs from most other spinal treatments in that the patient’s spine structure is not significantly altered, says Dr Aravind Kumar, a consultant with the transdisciplinary Spine Service. This is a collaboration between the Department of Orthopaedic Surgery and Neurosurgery Division, under the Department of General Surgery. In nucleoplasty, nothing is added, removed or fused together, as with other types of surgery. This is particularly important for younger patients, as the long-term effects of more invasive spinal surgery remain unpredictable.

“Spine surgery can be very invasive, destructive and risky,” says Dr Kumar. “Hence, we ensure that patients are subjected to essential surgery only. Our entire team philosophy is about doing the right thing for the right patient at the right time – we want to get them back to normal life as fast as possible, at minimum cost to society and to the patient.”

a widespread problemBack pain is far more prevalent than most people realise, and can have a great impact on patients’ lives. A study

Normal Intervertebral disc

Degeneratedintervertebral disc

Neural foramennarrowed by disc bulge

Coblation wand

in lateral view

Coblation wand

in lateral view

Coblation wand

In AP view

Coblation wand

In AP view

*Permission obtained from patient to use real name

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by a local hospital found that 60-90 per cent of the population will suffer from lower back pain at some point in their lives. Most of them will recover enough to resume daily life on their own, but some will be so seriously affected that they may need medical intervention.

Back pain is the most common cause of disability for persons under 45 years old. This is reflected in the KTPH team’s operative workload: between January and November 2014, the team saw a total of 181 patients, most of them requiring the expertise of both orthopaedic and neurology consultants.

Spinal consultations take up to three times as long as other orthopaedic consultations, because the doctors spend a large amount of the time on patient education. Often, patients have the misconception that back pain must be treated by extensive surgery, even when simpler remedies are available. Hence, the team spends considerable time explaining to each patient why a certain treatment may be more suitable.

Another common misconception is that bed rest will improve the patient’s condition, especially when patients become bed-bound because the pain is so intense that they cannot move. But bed rest actually worsens their condition, explains Dr Kumar. After just 48 hours of lying in bed, the patient can begin to lose muscle mass. And the longer the patient remains immobile, the worse the muscles deteriorate, which further aggravates the pain as the spine gets less muscular

support. In fact, back pain is often precipitated by an inability to support the back.

a surgery-free approachWhere possible, the KTPH team tries to take a surgery-free approach. Their solution is to treat the pain first, so that the patients can move around normally, then help them regain muscle tone. The Spine Service team usually begins by prescribing painkillers and physiotherapy, and most patients show some improvement over the course of several months. Only if the initial treatment does not work will the team offer other procedures, beginning with the least invasive possible. The objective is to minimise recovery time.

“We recommend that patients stay active and take no more than one or two days’ bed rest,” he says. “It may be painful for them to move, but there is no evidence that movement is harmful or aggravates their condition. We do advise them to avoid heavy lifting and similar exertion, but otherwise, they should resume their daily activities as far as possible.”

The team has already recorded many such successes with various non-invasive or minimally invasive

about Ktph Spine ServiceThe Spine Service managed by the Department of Orthopaedic Surgery collaborates with the Neurosurgery sub-specialty from the Department of General Surgery to manage patients with traumatic spinal injuries and chronic back pain. Beside Dr Aravind Kumar, the clinicians in the Spine Service are Dr Jacob Oh (Consultant, Orthopaedic Surgery), Dr Eugene Yang (Consultant, General Surgery) and Prof Hee Kwan Tak (Visiting Consultant).

treatments such as injection therapy. National serviceman Mr Wong, for example, was able to return to his job shortly after undergoing nucleoplasty. Others, especially older patients, have also been successfully treated with more permanent procedures: one patient with spinal fractures caused by osteoporosis was able to move around within a few days of undergoing vertebroplasty, a procedure which involves injecting cement into collapsed vertebrae to support them.

Some patients, of course, do need more extensive surgery in the form of spinal fusion, deformity correction and vertebral body resection. The Spine service in KTPH offers the entire spectrum of surgical treatments for our patients.

“The operation is a huge commitment for the patient as well, so we do our best to ensure that they have good results,” says Dr Kumar. “Ultimately, we are here to treat patients in the way that will restore them to normal life as safely and quickly as possible.”

Dr Aravind Kumar

treatments for back pain, in order of increasing invasiveness

Injection therapy – direct injection of medication to relieve nerve irritationVertebroplasty – injecting cement into collapsed vertebrae to support themNucleoplasty – strengthening spinal discs with heat therapyDiskectomy – removing degenerated spinal discsSpinal fusion – fusing sections of the spine to prevent abnormal movement

Less invasive

Most invasive

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When she lost her father to a hospital-acquired infection (HAI) in a local hospital,

Ms Lee Soh Hong wrote the book “Are Hospitals Safe? What Killed My Dad?” in 2012, hoping healthcare institutions could reflect and improve on patient safety. Sadly, her brother-in-law also passed away from a HAI barely two years later, which sparked her to write another book, “The “Million Dollar” Leg: Medical Misadventures”. Ms Lee implored healthcare workers to take infection control seriously and prioritise patient safety.

Chipping in to share his observations on patient safety in hospitals was Prof Donchin, the Head of Medical Education Centre, Hebrew University of Israel. He touched on human factors engineering which refers to the application of human factors i.e. human abilities, expectations and limitations, in the design of devices, systems and processes.

Prof Donchin said that medical mishaps could be prevented if the hospital has a strong safety culture and recognises the interplay of human factors and work and equipment design for safety. More importantly,

healthcare workers have to be aware of their own human limitations and consciously practise safety in their daily work.

Building a safe hospital for patientsPatient safety encompasses infection control rate, medication safety, procedural safety and inpatient falls prevention. At Khoo Teck Puat Hospital (KTPH), the Clinical Quality (CQ) division of Clinical Services, together with the patient safety officers, oversee standards and processes involved with patient safety and clinical quality.

preventing medication errorsA 2013 article in Forbes magazine estimated that there were about one million medication errors in the United States, causing about 7,000 deaths. A large number of medical errors stem from human factors such as illegible handwriting.

At KTPH, we have formed a medication safety workgroup which studies carefully all medication errors and near misses that are reported in the hospital’s electronic hospital occurrence report (eHOR). Root cause analysis is performed to define

the causes of the errors and near misses so as to implement changes to systems and processes to reduce and prevent a recurrence.

preventing procedural oversightsIn line with best practices in all good hospitals, KTPH has implemented surgical time-outs and adopted the surgical safety checklist to prevent occurrences of the four ‘Wrongs’ i.e. wrong patient, wrong site, wrong side and wrong procedure.

Such procedural oversights may occur because of human factors such as miscommunication, fatigue or complacency, which may be addressed by having checkpoints in place. Prior to surgery, the surgical team will go through every point on the surgical safety checklist to ensure adherence. During the surgery, time-outs are called regularly as studies have shown that these help to improve communication among the various members of the surgical team.

preventing inpatient fallsInpatient falls is another indicator in which hospitals measure patient safety. In 2011, KTPH had 1.3 falls per 1,000 inpatient days. This has been cut to

Keeping our patients safeMs Lee Soh Hong and Prof Yoel Donchin provided much food for thought with their sharing at Alexandra Health System’s quality convention on 24 November 2014, which was themed around preventing medical mishaps in the hospital.

Guest speakers at the Quality Convention: Ms Lee Soh Hong and Prof Yoel Donchin.

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0.9 and 0.86 per 1,000 inpatient days in 2013 and 2014 respectively. The improvement could be attributed to the formation of a Falls Prevention workgroup in 2012 to strengthen measures and enhance staff and patient education on falls prevention.

KTPH’s nursing team performs compulsory falls risk assessment on all newly admitted patients, and categorises patients according their level of falls risk. Improvements have also been made to the physical environment to reduce falls risk, such as easy accessibility to call bells at bedside, having low beds and even ensuring patients’ pants are of the appropriate length to prevent them tripping over.

preventing hospital-acquired infections (hais)KTPH managed to keep Methicillin-resistant Staphylococcus Aureus (MRSA) bloodstream infections (bacteraemia) to 0.3 cases per 10,000 patient days in 2014. This compares favourably with the national average of 0.9 MRSA bloodstream infections per 10,000 patient days for all public hospitals in 2013. Hospital-acquired MRSA (HA-MRSA) infection rates is one important index that most hospitals track as part of their infection control programmes.

KTPH was one of the first public hospitals to implement a policy of screening all patients for MRSA carriage upon admission to hospital. By identifying which individuals are carrying MRSA on their skin, we can apply appropriate contact precautions to prevent cross-transmission to others. In addition, KTPH has, from the outset, adopted a policy of using daily

Chlorhexidine baths for all patients carrying MRSA.

Chlorhexidine is a very safe and effective topical antiseptic that helps to reduce MRSA cross-transmission as well as protecting carriers from developing MRSA infection. Data for the past four years show a very significant protective effect against MRSA infection for MRSA-carriers who bathe daily with Chlorhexidine. The KTPH Infection Control team has also adopted various strategies to nudge our healthcare staff and patients to comply with good hand hygiene practices such as washing hands and using hand rubs before and after patient contact. This basic practice is an important cornerstone in preventing the proliferation of HAIs.

A pilot initiative in the works is designed to further boost the hand hygiene compliance rate. Upon approaching a patient, an LED message is activated at the patient’s bedside to remind healthcare staff to clean their hands before patient contact. The Infection Control team will study the impact of this initiative before considering a broader implementation.

KTPH practises surgical time-outs and adopts a surgical checklist to prevent errors before and during operations.

Nurse Clinician Foo Meow Ling from Infection Control conducting an infection control training workshops for nurses.

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KTPH organises Ear, Nose & Throat courses to facilitate cross-sharing

Khoo Teck Puat Hospital’s (KTPH) Department of Otolaryngology, Head and Neck Surgery (Ear,

Nose, Throat) organised two courses for overseas facial reconstruction surgeons to share their expertise with local clinicians.

Invited speakers include internationally renowned teaching faculty such as Prof Peter A Adamson (Canada), Prof J Regan Thomas (USA), Prof Kurt Laedrach (Switzerland) and Mr Ullas Raghavan (UK), and doctors from local restructured and private hospitals. The Singapore Advanced Rhinoplasty and Facial Fracture And Soft Tissue Reconstruction Fresh Frozen Cadaveric Dissection Courses attracted about 120 participants from Singapore and 17 other countries such as USA, Australia, Sweden, Poland, Kuwait and Hong Kong.

Comprising lectures and hands-on demonstrations which were held at the Surgical Skills Lab in KTPH, the

two courses - from 29 October to 4 November 2014 - aimed to provide a platform for local Ear, Nose, Throat (ENT) surgeons and specialists to expand their knowledge and surgical skills in the management of facial fractures, facial soft tissue defects, nasal deformities

and nasal obstruction. A unique feature of the course was systematic surgical demonstrations by the expert faculty followed by hands-on dissection by participants using cadaver heads.

ENT clinicians in public hospitals are increasingly using reconstructive and aesthetic facial plastic surgery techniques for helping patients with deformities resulting from burns, road traffic accidents, other facial injuries and skin cancer. The two courses aimed to provide an avenue for ENT clinicians to learn from one another, as well as from respected professionals from abroad, and colleagues from general plastic surgery and maxilla-facial surgery.

“We are delighted at the overwhelming response and excellent feedback received from the participants and the international and national faculty alike regarding the quality and breadth of the scientific programme. We hope to build on this success and conduct these courses on a yearly basis,” said Mr Sandeep Uppal, the Course Director and a Consultant Otolaryngologist with KTPH.

Prof J Regan Thomas, Mr Sandeep Uppal (the Course Director), Mr Ullas Raghavan, Prof Peter A Adamson and Prof Kurt Laedrach.

Prof Thomas (right) and Mr Raghavan demonstrating facial reconstruction techniques to the course participants in the surgical skills lab.

BUILDING ALEXANDRA HEALTH SYSTEM

Planning for the Woodlands Integrated Healthcare Campus (WIHC) - first announced by National Development Minister Mr Khaw Boon Wan in

February 2014 – went up another notch recently.

Mr Liak Teng Lit, Group CEO of Alexandra Health System (AHS), which will manage WIHC when it opens in 2022, and Dr Jason Cheah, Chairman, Pro-Tem Planning Committee of WIHC, led a team to visit several institutions in Norway and Denmark in September 2014. Their purpose was to learn more about healthcare infrastructure planning and design, clinical service planning, community integration and delivery of aged care services in these Scandinavian nations renowned for their patient-centred healthcare systems.

The visit provided valuable insights to the team on the use of space designs that are familiar, practical and flexible, ideas to promote active, independent lifestyles within the healthcare campus, and concepts to streamline the patient journey in A&E. The observations made also inspired the team to continue to innovate and transform healthcare, with an emphasis on enabling patients to lead independent lives in the community.

The Woodlands Integrated Healthcare Campus (WIHC) planning team at Akershus University Hospital, Norway.

Welcoming environment with copious daylight exposure and open spaces that interact with the surroundings – at Oslo University Hospital, Norway (left) and Aertebjerghaven Nursing Home, Denmark.

A designated senior consultant acts as a ‘flow-master’ to unblock chokes in the A&E department, with the help of a computer system that visualises a patient’s pathway.

Scandinavian study trip garners insights into planning of Woodlands Integrated Healthcare Campus

St Olav’s University Hospital has thoughtfully designed spaces that make it convenient to promote active lifestyles for staff and visitors.

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about Woodlands integrated healthcare campus (Wihc)

site in Woodlands

7.7 hectares

Will sit on aTo contain an acute

hospital, a community hospital and a nursing home with a total of 1800 beds

Will open in phases from

2022

Design of campus aims to integrate with the community to promote healthy living and connect residents to health and social care providers

IN AND ARoUND KTPH

Nurturing a new generation of skilled healthcare workers requires strong partnerships between our education and healthcare institutions. Such collaborations allow our students to benefit from a holistic learning experience, as they move seamlessly between classroom-based learning in the schools, and clinical training in the hospitals.A/Prof Muhammad Faishal Ibrahim at the launch of the teaching dispensary

Students pursuing the Diploma in Pharmaceutical Sciences at Republic Polytechnic (RP)

will get to experience working in a realistic hospital pharmacy with the launch of the RP – Khoo Teck Puat Hospital (KTPH) teaching dispensary on 8 January 2015.

The RP-KTPH dispensary is the first in a local polytechnic that is developed in partnership with a public healthcare institution. When ready by mid-2015, the new facility at RP will house over 600 types of oral, injectable, inhaled and topical medications that will enable students to acquire hands-on dispensing skills before they start their internships at hospitals. This will stand the students in good stead when they graduate and begin their careers as pharmacy technicians.

Pharmacy technicians assist pharmacists in the processing, packing and dispensing of medications to patients. They may oversee other aspects of pharmacy operations including counselling on use of medication, medication safety and ordering and maintenance of inventory. One RP alumnus who is forging a rewarding career in KTPH as a pharmacy technician, is Mariem Bte Anwar. She graduated in 2010 with a Diploma in Pharmaceutical Sciences.

In the four years with KTPH, Mariem’s job scope has grown from assisting pharmacy operations to becoming a member of the hospital’s pharmacy

technician training team. She trains student interns in the safe and efficient processing of medication orders and dispensing. One-third of KTPH’s pharmacy technicians are graduates from RP.

“This collaboration expands our partnership with RP which started in

2008. Many of their graduates have joined us and this collaborative effort will ensure they have the industry experience to hit the ground running, resulting in a magnified impact on patients’ safe use of medication when the students eventually join the healthcare industry,” said Dr Doreen Tan, KTPH Chief Pharmacist.

Republic Poly & KTPH set up teaching dispensary to train tomorrow’s pharmacy techs

KTPH’s pharmacy technician Mariem Bte Anwar with A/Prof Muhammad Faishal (centre), Mr Yeo Li Pheow, RP Principal & CEO, and Mrs Chew Kwee Tiang, KTPH CEO, at the RP-KTPH teaching dispensary which is designed to simulate a real hospital pharmacy.

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IN AND ARoUND KTPH 13

Alexandra Health System (AHS) uses analytics extensively in our Population Health

Programme to screen Sembawang and Choa Chu Kang residents over 40 years old for chronic diseases, understand their lifestyle habits, and then target the appropriate interventions to at-risk residents.

To plan and deploy resources for community health screenings more effectively, we had to identify the ‘clusters’ where residents with chronic conditions reside. This also helps us to identify community partners in the vicinity of the clusters to provide targeted interventions. AHS’ Healthcare Analytics Unit worked on a geospatial analytics project to identify and map the locations of residents.

The team first collated anonymised data of Khoo Teck Puat Hospital (KTPH) patients with chronic conditions to map according to the patients’ residential addresses. Using a statistical method called Local Indicator of Spatial Association (LISA), they transposed each patient address onto a hexagonal grid to form a larger picture of area data, thus better mapping out and identifying clusters of patients.

From their project, the team was able to find out where pockets of patients with chronic diseases reside, as well as drill down to the locations of patients based on their age groups. For example, they found that a group of patients with diabetes aged between 31 to 39 years old lived in an area near Woodlands and Admiralty. This

information could help AHS work with community groups in the area to organise intervention programmes for residents here.

Analytics in healthcare is becoming increasingly important in the light of an ageing population and rise in chronic diseases. AHS is one of the first regional healthcare clusters to explore the use of analytics in the planning of our out-of-hospital programmes such as the Ageing-In-Place and Population Health programmes.

The good work done by the Healthcare Analytics Unit’s population health geospatial analytics project won a bronze in the Singapore Young Investigator Award at the Singapore Health & Biomedical Congress 2014.

Thia Kai Xin (centre) from the Healthcare Analytics Unit with the Population Health team (from left: Executives Eric Tan and Ken Tham, Manager Tan Siew Yong and Senior Manager May Lim).

More effective population health screening with analytics

Areas where AHS carries out Population Health community health screenings

choa chu Kang division

Sembawang & nee Soon Grc

IN AND ARoUND KTPH14

63-year-old Senior Portering Attendant Teo Giap Seng and his colleagues walk a total of

26km every day, transferring inpatients between hospital departments with an accompanying nurse. With each bed weighing up to 360kg, it is hard work for this senior staff. He is not alone, as seven out of 10 of Khoo Teck Puat Hospital’s (KTPH) porters are aged 50 years and above.

To reduce the physical toll on our porters and nurses, three departments - Nursing, Operations and the Transformation Office - worked with a vendor to develop a bed that is easier and safer to move.

The result is Abacus Global Technology Pte Ltd’s automated speed and turning sensing system called EPush. This mechanised feedback control system can be attached to the hospital’s existing Hill-Rom beds and greatly reduces the pushing load for staff whilst its gyroscope increases manoeuvrability. It now only takes one porter to push the bed so the accompanying nurse can focus solely on the patient during the transfer.

Mr Teo was involved in tests to assess the EPush technology. He moved a bed fitted with the system and gave it the thumbs up.

“We don’t need so much strength with this system. This is especially good for the elderly porters as we now have lesser risk of straining our muscles,” said Mr Teo.

To improve safety, staff must use their employee tag to activate the EPush system via radio frequency identification (RFID) technology.

KTPH will be fitting up to 100 Hill-Rom beds with the motorised system by the middle of 2015. The system will be

Award-winning technology lightens the load for portering staff

further evaluated before a decision is made on whether to roll it out to all the hospital’s beds.

The EPush bedside motion system won Abacus the top spot in the Innovation Award at the inaugural Healthcare Supplier Awards 2014, organised by the National Healthcare Group.

Senior Portering Attendant Teo Giap Seng pushing a patient on the Hill-Rom hospital bed that is fitted with the EPush system, while Senior Staff Nurse Tan Hwee Ting watches out for the patient’s comfort.

“KTPH is forward-looking in embracing technology to automate labour intensive work processes to drive productivity. In addition, as our population ages and people work longer beyond their retirement age, we aim to create and foster an elderly-friendly working environment to keep our people working meaningfully for as long as possible,” said Ms Yen Tan, KTPH’s Chief Operating Officer.

For an older workforce, better suitability of job role for the ageing population

Easy to use

Facts

Benefits

6.2 man-hours saved

Less strenuous and less risk of staff injury

70% of Portering staff > 50 years old

Each bed weights between 260-360kg

125 bed-transfers/day

IN AND ARoUND KTPH 15

Alexandra Health System (AHS) won the Work-life Achiever Award at the Work-life Excellence Awards 2014, organised by the Tripartite Committee on Work-Life

strategy.The Work-Life Achiever Award commends organisations for their efforts in implementing Work-Life strategies and promoting Work-Life harmony within the organisation.

AHS was evaluated on criteria such as benefits, flexible work arrangements, employee support initiatives and senior management’s commitment to promoting work-life. AHS’ Five Pillars of Health – Exercise Regularly, Eat Wisely, Be Happy, Practise Personal Hygiene and Quit Smoking – guide our efforts and activities in creating a happy, healthy and harmonious environment for our staff.

An integral aspect of Work-Life is physical and mental well-being. In this area of workplace health promotion, AHS has previously won three Singapore H.E.A.L.T.H awards conferred by the Health Promotion Board and also became the first Singapore organisation to win the inaugural Global Healthy Workplace Award in the Big Enterprises (more than 3,000 employees) category in 2013.

Work-Life Award boost for AHS

Student athletes get a healing touch from KTPH’s Sports Medicine team

KTPH CEO Mrs Chew Kwee Tiang receiving the Work-life Achiever Award from Mr Hawazi Daipi, Senior Parliamentary Secretary for Manpower and Education, and Chairman of the Tripartite Committee on Work-Life Strategy.

Dr Teoh Chin Sim (right) and Senior Physiotherapists Cheng Bijun and Wong Shi Yun were part of a four-man team which supported the Singapore contingent at the 6th Asean School Games.

A team from Khoo Teck Puat Hospital’s (KTPH) Sports Medicine Centre provided medical coverage to the 200 student athletes

and 52 officials representing the Singapore Schools contingent as they chased sporting glory at the 6th ASEAN School Games in Marikina City, Philippines, from 29 November to 7 December 2014.

The team of four from the Sports Medicine Centre - led by Senior Consultant and Director of the Sports Medicine Centre Dr Teoh Chin Sim – treated sports injuries and common ailments such as upper respiratory tract infection and gastroenteritis as our students aged between 13 to 18 competed in 11 sports.

The ASEAN School Games aims to foster interactions and cross-learning of respective cultures for student athletes from ASEAN. The Sports Medicine team was delighted to contribute to the success of the Singapore Schools contingent’s sporting efforts which netted 10 Gold, 10 Silver, and 19 Bronze medals.

IN AND ARoUND KTPH16

Almost a decade ago, when we were at Alexandra Hospital, some of our staff went to Banda

Aceh in three teams to help the victims of the Asian Tsunami. The devastating disaster brought out the best in our people as they had to think out of the box to provide basic nursing care and treatment. Three of our staff volunteers shared their learning points from this century’s worst catastrophe.

a little bit of creativity goes a long way“When I was in Banda Aceh, we could not provide ideal nursing care as we lacked basic equipment like pumps etc. We had to improvise and make do with what we had. Equipment is just accessories to a nurse; the most important thing is still your nursing knowledge and skills. I believe in upgrading my knowledge and skills,

Sister Pauline tube-feeding a tsunami casualty. Senior Staff Nurse Amy comforting an elderly tsunami casualty.

Dr Anton Cheng (behind) with another volunteer doctor carrying patients on stretchers.

and have shared with my young nurses my experience in Indonesia. Don’t take things for granted, rely on your foundation and creativity to provide nursing care in a difficult environment.”Senior Nurse Manager Pauline Tan

learnt to walk a mile in others’ shoes“My experience volunteering in Banda Aceh taught me to count my blessings, as life is so fragile. We are fortunate to live in a wonderful country which is insulated from natural disasters. Even though the people in Banda Aceh lost their loved ones and property, they had the fortitude to bounce back and carry on with their lives. Helping the victims taught me to treasure my loved ones. Returning to work, I learned to work better with patients and colleagues, and understand better their perspectives.”Senior Staff Nurse Amy Chin

Working with like-minded people in adversity“Having volunteered in Banda Aceh and other regions affected by natural disasters, I have come to admire the fortitude of the people living in these developing countries. They counted their blessings and were genuinely grateful for what little assistance that we could give them. The ability to improvise was probably the biggest asset in a situation like Banda Aceh. My personal experience showed me that in such situations, it helps to have volunteers who are experienced, willing to listen, adaptable and observant, so that they can ‘survive and thrive’ in these trying environments. These are the people whom I have come to depend on in my everyday work in our hospital.”Dr Anton Cheng, Senior Consultant, Department of Surgery

Drawing lessons from the Asian Tsunami relief mission…a decade on

ECo BUZZ 17

It is common to spot birds perched in the many nests around Khoo Teck Puat Hospital (KTPH) compounds.

Nothing unique, you may think. Except, that for two birds – pink-necked green pigeons – were actually using the abandoned nest of another native species, the scaly-breasted Munia.

According to our Operations team that also looks after the green environment in KTPH, pink-necked green pigeons – a common local species – had only just “returned” to KTPH. The birds’ natural habitat was affected during the hospital’s construction, and they “disappeared” for a few years. Pink-necked green pigeons typically build their own nests using twigs, and the sight of them taking over an abandoned nest was interesting to our staff, who together with several of the hospital’s volunteers, helped to record the different species of butterflies, dragonflies, fish and birds found in the biodiverse hospital.

A healing environment for patients; a centre of biodiversity

This floating structure installed in Yishun Pond attracts birdwatchers and residents.

Pink-necked green pigeons ‘recycling’ the nest of another species, the scaly-breasted Munia, on a tree in KTPH.

“engineered biodiversity” Learning from our time at Alexandra Hospital – which has lush greenery and a buzzing biodiversity – the management of Alexandra Health System had requested the architects of KTPH to design a “hospital in a garden and a garden in the hospital” to provide a healing environment for patients.

When KTPH opened in 2010, many native plants and shrubs were introduced to attract birds and insects to enhance the biodiversity of the hospital. From just 23 species of birds recorded in 2012, there are now about 60 birds spotted/recorded in KTPH as of February 2015.

KTPH aims to eventually have 100 species of birds, dragonflies, butterflies and fish in the hospital. Mid last year, we worked with our landscaping contractor Tropical Environment to install a floating structure in the adjacent Yishun Pond to attract birds to rest. It is not uncommon to see different native and migratory birds resting at the floating structure throughout the day. The floating structure has also become a conversation starter

*As of February 2015

for residents and KTPH staff who exercise around Yishun Pond.

“We are thankful that we have dedicated and helpful volunteers with specialised interests in various wildlife, who have come forward to share their knowledge and time with us. This has helped to boost the hospital’s biodiversity footprint tremendously and enhanced our healing environment for patients, as well as made our work environment so uniquely pleasant,” said Ms Rosalind Tan, KTPH’s Chief Gardener.

Flora & Fauna in Ktph*

23 species of dragonflies

100 species of fish

63 species of birds

150 species of native plants and shrubs

50 species of butterflies

IN AND ARoUND KTPH18

Ask the Promicrobiological properties of the drug to ensure that they are within safe standards. For example, to meet the standards for microbiological content, the bacteria count should not exceed a certain number that is known to be harmful to the human body. It is important to note that the expiry date is only valid if the medication is stored in the conditions as recommended by the manufacturer, e.g. to keep in the refrigerator, or in a cool and dry place.

After the expiry date, the medication should be discarded, as the nature and quality might be compromised. This includes any change in efficacy, appearance, colour or taste. Micro-organisms, e.g. bacteria, yeast and mould, may also multiply within the medication and cause symptoms similar to food poisoning when consumed. Although these processes may not occur and cause harm immediately after the expiry date, it is not advisable to take medication beyond the expiry date.

If you find that your mother’s medication stock keeps increasing, to the extent that some of them expire before use, or there are so many different types of medications that you are unsure if your mother still needs them, you can check with the doctor or pharmacist if she should continue with these medications.

Pharmacists can also advise on the appropriate amount of medications to collect (an amount sufficient to last till the next appointment, taking into account the stock that you already have), help to repack and label the medications to indicate if they should be stopped or discontinued, and provide you with an updated list of your mother’s current medications. This service is especially useful to patients who collect medications from different institutions or have frequent hospital admissions. With proper reconciliation of your mother’s medications, overstocking of medications can be prevented, and hopefully the chances of having expired medications at home can be minimised too.

Reply by Carol Chan,Senior Pharmacist, Khoo Teck Puat Hospital

My elderly mother has to take several types of medications for various chronic conditions. Some of them have expired. are these medications still safe for consumption?

Many elderly patients have multiple medical conditions. Different medications are required for the management of different conditions, and that may explain the several types of medications that your mother is on. Sometimes, medications may expire before use despite your best efforts. Although it may seem like a waste to throw the expired medications away, it is the right thing to do as they may not be safe for consumption.

In Singapore, the expiry date of medications is derived from rigorous

stability tests, which study the physical, chemical and

Here is a chance to ask any question you may have about various health topics or health conditions. Write in to aha@alexandrahealth.com.sg with your full name and address and receive our special Alexandra Health dragonfly thumb drive if your letter is published.

Q.

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Continuing Medical Education for Doctors Continuing Medical Education (CME) plays an important role in keeping medical professionals current with changes in medicine.

Khoo Teck Puat Hospital organises regular Continuing Medical Education Programmes to update you of the latest trends and practice.

Venue: Kaizen 1 or auditorium Khoo Teck Puat Hospital, 90 Yishun Central S768828For more information, please call our GP Engagement Office at 6602 3016

date (Sat, 12pm - 5 pm)

presenting department

11 July 2015 Urology

25 July 2015 Nutrition and Dietetics

1 August 2015 Ophthalmology and Visual Sciences (Eye)

15 August 2015 Endocrinology

26 September 2015 Orthopaedic / Sports Medicine

19 September 2015 Renal

3 October 2015 General Surgery

24 October 2015 Cardiology & Sports Medicine

31 October 2015 Geriatric

21 November 2015 General Medicine

*Info correct at time of publishing.

For an updated listing, please visit https://www.ktph.com.sg/gpcme.

Scheduled CMEs for 2015*

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