Speech by Dr Amy Khor, Senior Minister of State for Health, at the Singapore Health Quality Service Award 2016, 26 January 2016

CEOs and Healthcare Leaders,
Distinguished Guests,
Ladies and Gentlemen,

Introduction

1        It gives me great pleasure to join all of you here today at the Singapore Health Quality Service Award 2016 to recognise and celebrate the exemplary efforts of healthcare professionals in delivering excellent quality health services.

2        This signature award ceremony is now into its sixth year. It is indeed very heartening to see more participants each year, and more award winners from both the private as well as the intermediate and long-term care (ILTC) sectors. This year, we have a record number of recipients – an impressive 3,343 exemplary individuals from 23 organisations. Winners hail from the ILTC sector including Kwong Wai Shiu Hospital, National Kidney Foundation, Orange Valley Nursing Homes, and St Luke’s Eldercare.

Reflecting on the Challenge of Healthcare 2020

3        Our healthcare family has expanded significantly in the past few years. Under our Healthcare 2020 plan, we have set goals to expand healthcare capacity, enhance the quality of care and improve the affordability of care. We have made improvements in each of these fronts.

4        In June last year, we opened Ng Teng Feng General Hospital and Jurong Community Hospital. In December, Yishun Community Hospital took in its first patients. New nursing homes and senior care centres also opened last year. By 2020, the Government targets to have 9,000 acute beds and 3,000 community hospital beds. We are also doubling home care places from 6,500 to 10,000, centre-based places from 3,100 to 6,200, and nursing home beds from 9,800 to 17,000. These are all part of the Healthcare 2020 master plan to enhance capacity and accessibility of healthcare.

5        In 2015, we moved decisively to improve affordability of care, with the launch of MediShield Life in November. All Singapore citizens and permanent residents now have universal healthcare coverage for life, even those with pre-existing conditions, who were not covered by healthcare insurance in the past.  MediShield Life provides assurance and peace of mind to Singaporeans that their large hospital bills would be more manageable, with Medishield Life paying out more, and patients paying less.

6        As we stay the course towards Healthcare 2020, we must also acknowledge that the growing healthcare needs of our population will increase the complexity of healthcare delivery. In 2015, we had approximately 500,000 inpatient admissions. This means that every day, there were about 1,370 inpatient admissions, and these would have translated to a greater number of clinical assessments, diagnoses, interventions, procedures and prescriptions. Even as healthcare delivery becomes more complex, our challenge then is ensuring that the highest quality of care and patient safety is provided. This means healthcare teams working better together and continuing to find new ways to improve care including designing care around patients.

Designing Care around Patients to Improve Quality of Care

7        So, even as we increase capacity, we must also continue to improve the quality of our care delivery. Most importantly, we must do more to design care around patients, and make care more person-centred, rather than episodic and fragmented. Let me highlight a couple of outstanding efforts from this year’s award recipients.

8        Long-term tracheostomy is a surgical procedure to create an opening in the neck for insertion of a tube into the windpipe to help patients breathe. It is socially stigmatising and often intimidates both patients and their families. The tracheostomy tube also causes physical discomfort in patients, and the wait to be weaned off the tube is agonising. Determined to relieve patients of this agony, a multi-disciplinary team in Ren Ci put their heads together to design a new workflow. Instead of requiring ENT surgeons from acute hospitals to initiate the weaning from the tracheostomy tube, Ren Ci nurses are now trained to initiate the weaning. The team will be sharing their project with other ILTC organisations, and aims to scale-up their new workflow into a national programme.

9        Another noteworthy initiative that may seem trivial and upstream in patient care yet impacts many of our patients, is when patients or their families call a healthcare institution’s hotline.  They could be calling for various reasons but mostly, it is to check or cancel appointments. Very often, they have to wait more than a minute before a call centre officer is available.  A quarter of these callers do not bother to wait for the call centre officer and simply hang up the phone. Recognising that call wait times should not deter callers from timely care, a cross-institutional team consisting of 14 administrators from eight SingHealth institutions developed an Interactive Voice Response system, which automates the checking or cancellation of appointments. The system also transfers callers to the desired departments, and frees up call centre officers to attend to other callers.  The results of this initiative were significant – Callers were attended to in half the time, and the abandoned call rate dropped from 25 to 6%.

10        These initiatives show us that person-centred care goes beyond medical treatment. Often times, it starts off simply with us putting ourselves in the shoes of our patients, challenging the status quo, and coming up with innovative solutions.

The Human Touch is the Quintessence of Quality Care

11        While we continually seek opportunities for improvement, we must not forget that the quintessence of quality patient care is the human touch from caring and compassionate healthcare professionals. When work demands overwhelm us, we may forget the importance of the human touch. However, there are colleagues amongst us who have faithfully delivered on quality patient care. 

12        Ms Wendy Chin is one such colleague from the Singapore General Hospital. As a service quality senior executive who handles patient feedback, Wendy once encountered a caregiver whose private insurance claims for her Parkinson’s disease stricken husband were rejected twice, furthering her woes from caring for her husband. Empathising with the caregiver, Wendy discovered that the caregiver had a poor understanding of the medical terms. Wendy went the extra mile to consult the medical team in-charge and translated all the medical jargons into layman terms for the caregiver. Wendy also followed up closely with the doctors to ensure that all necessary forms were duly completed. Wendy’s persistence paid off and the patient’s claims finally got approved, lifting a heavy load off the caregiver’s shoulders.  

13        Mary Ann Losa, a senior staff nurse at Ang Mo Kio-Thye Hua Kwan Hospital is yet another such inspiring colleague. Recovery is a long journey for stroke patients. Mary Ann had a young stroke patient with two children, aged 4 and 6. The illness left the patient despondent and resistant to rehabilitation. To spur her patient on, Mary Ann counselled the patient’s husband to bring their young children when visiting, and rallied the family to motivate the patient to go for her rehabilitation exercises. Mary Ann also constantly reminded her patient that she would be well on her way to recovery after rehabilitation and continue to be an integral figure in her children’s happy childhood. Thanks to Mary Ann’s encouragement, the patient got back on her feet, only needing a walking frame for support upon her discharge.

14        Work demands may take a toll on us and the occasional emergence of gaps may be disheartening, but we are all in this together. We stay positive and keep each other going. We acknowledge that there is room for improvement and we learn from one another and move on.

Conclusion

15        Ladies and gentlemen, on behalf of our patients and their families, let me thank each and every one of you for your relentless commitment and selfless contribution to caring for patients and improving healthcare delivery. Each of you, through your individual small gestures and commitment to your high standards of care delivery, impact patients’ lives in very special and positive ways.

16        To all the award recipients, my heartiest congratulations on your most deserving win! The pathway to excellence is an ongoing journey. Keep doing what you are obviously doing so well and continue to inspire and lead service excellence in your organisations.

17        Thank you and I wish all of you a pleasant day ahead.