National Healthcare Group6 Commonwealth Lane, Level 6,

GMTI Building, Singapore 149547

www.nhg.com.sg

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ANNUAL REPORT 09/10

NHG Profile, Mission, Vision And Values 01 Chairman’s Statement 03 CEO’s Message 05 Board Of Directors 07 Senior Management 11

Putting Patients First 13 Quality Initiatives For Better Care 19 Community Care And Public Engagement 25 Enabling Care With Technology 29 Nurturing People 31 About Our Institutions 35 Statistics 2009/2010 39

Caring it Forward 51

Contents

We started this past year to lay the groundwork

for population health management. That means

to go beyond managing diseases, or even early

detection through screening – as health is not just

the absence of disease.

NHG Profile

NHG’s vision is “Adding years of healthy life”. This vision departs from merely healing the sick to the more difficult and infinitely more rewarding task of preventing illness and preserving health and quality of life.

NHG is a leader in public healthcare in Singapore, recognised at home and abroad for the quality of its medical expertise and facilities.

Care is provided through an integrated network of primary healthcare polyclinics, acute care and tertiary hospitals, national specialty centres, innovative virtual specialty centres and business divisions. Together, they bring a rich legacy of more than 340 years of medical expertise to our philosophy of patient-centric care.

By designing accessible and seamless healthcare services around patient needs, NHG ensures that patient care is fully coordinated within the cluster and is also extended to high level collaboration with other healthcare providers at home and abroad.

Our Vision

Adding years of healthy life

Our Mission

We will improve health and reduce illness through patient-centred quality healthcare that is accessible and seamless, comprehensive, appropriate and cost-effective; in an environment of continuous learning and relevant research.

NHG Profile, Vision, Mission & Values

Our Values

CollegialityWe nurture success by promoting collaboration, participation and trust between individuals and other healthcare organisations, within an environment of sharing and mutual respect.

CompassionOur paramount concern is the welfare and well-being of our fellow human beings. We sympathise with those struck by illness and suffering and will do our best to alleviate their condition.

RespectWe treat everyone with honesty, decency and fairness.

IntegrityWe are committed to the highest standards of ethical conduct.

Social ResponsibilityWe contribute positively to the well-being and welfare of the community.

ProfessionalismWe are committed to being the best in what we do, and to achieve the best possible outcome for our patients.

01 | NHG Profile, Vison, Mission & Values NHG Profile, Vison, Mission & Values | 02

Early Successes I am encouraged by the early successes of some pilot projects that we have already begun to test different parts of the care continuum. TTSH’s Community Health Engagement Programme or CHEP – implemented in collaboration with family service and senior activity centres – targets the frail elderly staying in one- and two-room flats. Through CHEP, residents in the community are taught skills in healthy ageing and self-management of chronic disease. In Caring it Forward, neighbours help neighbours to identify those who are at risk, especially the elderly, who may be sick and frail, so as to help them live and age with dignity in their community. We have also engaged the Home Nursing Foundation to link their nurses with patients in Tan Tock Seng Hospital even before discharge to facilitate transition of care to the patient’s home. Over at IMH, about 1,200 outpatients are currently under the Community Mental Health Team or CMHT programme. The aim is to maintain adults with mental illness in the community for as long as possible and reduce hospital re-admissions and length of stay. A study done one year before and one year after patients were placed on CMHT has shown that patients greatly benefited from the continued psychosocial rehabilitation provided by the CMHT in their homes. Statistics show that re-admission was reduced by 60% while the length of stay per admission was reduced by 68% in FY 09.

Another IMH landmark initiative is the Job Club – a one-stop vocational rehabilitation service which offers practical aid and harnesses community ties to help persons with mental illness choose, secure and keep a job. Job Club matches clients with suitable jobs and works with prospective employers and community groups to create employment opportunities for and better understand individuals with psychiatric conditions. The second initiative was the introduction of 24/7 helpline services to provide support for both patients and their caregivers. NHG Polyclinics have been promoting health management through various channels such as community health screenings and public education on disease prevention. Since April 2007, we have stepped up our Opportunistic Health Screenings (OHS) for

residents above 40 years to help them in the detection and early intervention of chronic diseases. We have followed up with more than 13,000 people who were diagnosed with chronic conditions such as high blood pressure, high cholesterol and overweight issues after going through OHS. Following the success of the Tele-Ophthalmology trial in 2008, the NHG Eye Institute and Hougang Polyclinic piloted the service in April 2009. Patients can now consult an eye specialist via video consultation at the Polyclinic. This reduces the rate of unnecessary referrals to specialist eye centres while maintaining a low mis-diagnosis rate. Other patient-centric projects will be introduced as we continue to incorporate more elements into our population health management programme which we have code-named “NHGXUS”. At NHG, we are ever mindful that our achievements are attributed to our people – from our steadfast management team to every single dedicated staff member who has invested time and effort in our organisation. Therefore, it was a very proud moment in September 2009 when NHG became one of the 10 international organisations to receive the coveted AARP International Innovative Employer Award – in recognition of our age-friendly HR practices. It is heartening to see all our efforts garnering such positive outcomes, thanks to the indefatigable commitment and care shown by NHG management and staff. I am also grateful to my Board Members for their constant support and wisdom in charting the course of NHG over the past year. I would also like to thank NHG’s former Chairman, Mr Michael Lim and his team for having guided NHG in its first 10 years and providing us with a strong foundation to move forward on. I wish also to express my gratitude to Mr Ong Yew Huat who stepped down from the Board in March 2010. The population health management journey ahead of us will not be easy. But it is certainly going to be an interesting and exciting ride with the worthy goal of Integrated Care for our Population.

Mdm Kay KuokChairman

03 | Chairman’s Statement

At the National Healthcare Group (NHG), our vision of “Adding years of healthy life” became even more meaningful when we entered our 10th year. 2010 is our cluster’s 10th anniversary, and NHG’s community wellness initiative to celebrate our first decade is about Caring it Forward which encourages everyone to be proactive in passing on good health practices to family and friends. In the last 10 years, we championed disease management programmes. We took quality to a higher level. We exploited IT. We continue to provide finance back-office and HR shared services to MOHH and the new regional health clusters spun off from the original NHG. The journey ahead for us will be to build on these achievements, look further beyond the walls of NHG and our institutions so that we can truly be “Adding years of healthy life” to the population we are called to look after. We started this past year to lay the groundwork for population health management. That means to go beyond managing diseases, or even early detection through screening – as health is not just the absence of disease. An important milestone in that preparation was a joint Board and management study visit to Kaiser Permanente in San Diego, USA, and Jönköping County Council in Sweden, two healthcare systems which have demonstrated successful results in improving the health outcomes of their populations. Although our circumstances are different, it was a very fruitful trip, and we came home with several valuable insights. A Patient-Centric Vision We must remember first that we exist to deliver value to our population, so we have to put them central in what we do. Second, we must also expand our horizons and modify our mindsets. This means we take the patient-centric – rather than institution-centred – approach for care. This requires our doctors, nurses, allied health professionals to work together with one another and with partners outside NHG possibly in ways that would take them beyond how they are trained, evaluated or rewarded. A Culture of Continuous Improvement NHG has adopted a framework code named “MyCare” which borrows from Lean concepts and the Toyota Production System to drive continuous improvement in daily work. There’s been good progress across NHG – with many projects deployed which makes care for our patients Faster, Better, Cheaper and Safer. We must redouble our efforts to further this culture and look to achieving such improvements together with our partners and not just within an NHG ward or clinic.

Chairman’s Statement | 04

The journey ahead for us will be to build on these achievements, look further beyond the walls of NHG and our institutions so that we can truly be “Adding years of healthy life” to the population we are called to look after.

Chairman’s Statement

Over at NHG 1-Health in Ang Mo Kio, more specialist treatments are gradually being added so patients can receive such services in a convenient location without having to visit hospitals. Faster, Better, Cheaper and Safer As technology advances, we will continue to leverage on its possibilities to help us achieve faster, better, cheaper and safer healthcare delivery.

Since the Electronic Medical Records (EMR) project was implemented, NHG institutions have increasingly phased out manual tasks. The final component of the EMR is the E-notes module – used to capture all doctor, nursing and allied health consultations to produce structured and legible consult notes accessible online by any healthcare team member. The module was rolled out for NHG Polyclinics from May 2009 with full adoption by March 2010.

Specialty clinical notes have also been implemented for Endoscopy, Dental, Eye and Mental Health (Emergency Service) services. An electronic medication system was also launched to enable the automatic ordering, dispensing, administering and recording of medication to inpatients whose wrist-bands are bar-coded for added precaution

By harnessing the possibilities of technology, we now use e-applications on myriad procedures, including tele-radiology outsourcing, temperature charting via RFID and releasing of critical results to doctors via SMS.

Waiting time is a perennial challenge faced by hospitals. To tackle the problem at its Emergency Services, IMH introduced advanced triage and redesigned some of its clinic processes so that only patients classified as P1 are immediately seen by the consulting doctor. In addition, registered nurses were trained to execute advanced triage and medical officers designated to attend to remand and general hospital cases, facilitating patients movement.

At NHG, we are committed to keeping costs down, and in 2009, our Group Purchasing Office succeeded in chalking up savings worth S$9.8 million for the hospitals participating through NHG. This monumental effort was achieved through volume aggregation and product standardisation.

Apart from collaborating with partners and engaging the community we live and work in, NHG continues to bolster the capabilities of our people as we gear up for the next phase of NHG’s journey to become an integrated regional health cluster. Gearing up for NHGXUS While NHG can be proud of our achievements in the last 10 years, to truly be “Adding years of healthy life” and managing the health of our population, NHG has to look outside our cluster walls and do things differently. We have to clearly define our role and understand where we can add value.

Several questions come to mind as we start to include more elements into our population health management programme which we have code-named NHGXUS. What more do we need to do? What new ideas do we continue to explore to develop a fully integrated regional health system? What new capabilities and skill sets must we develop – both at the institutional and individual levels?

We have already noted some early successes in our collaboration with partners such the Home Nursing Foundation. Over at TTSH, we have set up sub-acute wards in the adjoining Ren Ci Community Hospital, and worked together on shared clinical protocols and governance for their community hospital patients.

In other community health initiatives, we sent a team of doctors and nurses out to four nursing homes – St. Theresa’s Home, Lions Home for the Elders Toa Payoh, Society for the Aged Sick Home and Ling Kwang Home for Senior Citizens – to help them better care for terminally ill patients.

Moving forward with our Board’s guidance, NHG has to be clear about how our relationships with MOH, community hospitals, GPs and other partners will evolve in striving to achieve the new system. In Appreciation Every success and achievement that NHG and our institutions have enjoyed in the last 10 years can be attributed to the contributions and commitment of our people and our management team. There was much we had to overcome but even more reasons to celebrate. I also wish to express my gratitude to the Chairman and Board members for their astute guidance in charting the course of NHG.

It is apt that NHG’s community wellness initiative in celebration of our 10th Anniversary is about Caring it Forward. Every patient we nurture back to health is a testimony of how care and compassion can transform lives. They can then, in turn share with their family, friends and the community. What we do every day resonates beyond our workplace. We are in fact, Caring It Forward on a daily basis.

Dr Lim Suet WunChief Executive Officer

05 | CEO’s Message

The National Healthcare Group (NHG) celebrates our 10th Anniversary in 2010. As we take stock of what we have achieved over the last decade, it is even more important to ensure that we move forward in the right direction so that NHG can remain a relevant pillar of healthcare in Singapore and the region. Adding Years of Healthy Life 2009 was a particularly eventful year for NHG with the outbreak of H1N1 on 27 April 2009. Ironically, it was on that same day that Tan Tock Seng Hospital (TTSH) launched the Clean, Safe, Infection-free: Wash & Win Promotion to raise public awareness that effective hand hygiene prevents life-threatening infections. Public hand washing demos were held at TTSH and three popular shopping malls – with lucky draws and giveaways.

As a result, the campaign directly contributed to 43% drop in MRSA (Methicillin-resistant Staphylococcus aureus) cases and 60% plunge in VRE (Vancomycin-resistant Enterococcus) cases, year on year.

Raising awareness of health issues is often the first line of defence. This is even more crucial when our vision is “Adding years of healthy life”. NHG institutions initiated numerous public education and outreach events during the year to promote a healthy lifestyle and increase public knowledge of various diseases.

NHG Polyclinics continued their Opportunistic Health Screening (OHS) for over 19,000 HDB heartlanders to detect undiagnosed chronic conditions and provide early medical intervention. Thanks to a computerised health screening software and protocol approach, each patient received a personalised health screening report instantaneously and was counselled by a nurse about health risk factors. New Specialist Clinics and Services Always responsive to evolving patient needs, NHG institutions launched several new specialist clinics and services in 2009. At IMH, the National Addictions Management Service, or NAMS for short, dedicated to the treatment of addictions was set up in July 2009 in anticipation of the rise in such cases, particularly in problem gambling.

The outpatient clinic provides a range of comprehensive services in addiction – encompassing assessments, treatment planning and case management, relapse prevention training, psycho-education and counselling programmes for patients and their families. It also offers public education and training as well as counselling sessions. Some 914 new addictions cases were seen during the year.

TTSH heralded a Sport Medicine and Surgery clinic in October 2009 with extensive facilities, including a fully equipped rehabilitation gym. In cardiology, a second generation Dual Source CT Scanner was introduced as part of its non-invasive cardiac imaging services. This is the first of its kind in Southeast Asia and offers high speed and quality images with lower radiation doses.

Another milestone in patient-centred service is the VTRAC Excimer Lamp service offered by NSC – the first in Singapore. The state-of-the-art Excimer Lamp has been proven capable of clearing skin conditions such as psoriasis and vitiligo quicker and more effectively than the traditional NB UVB. It also complements existing phototherapy treatments. NSC also started its weekly Acne Clinic in May 2009 to provide comprehensive acne management for teenage and adult patients with moderate-to-severe acne vulgaris, the second most common new condition seen at NSC.

Extending its reach to the community, NHG Polyclinics opened two new physiotherapy centres at Toa Payoh and Woodlands Polyclinics, bringing the number of such centres to three. At the Polyclinics, NHG Pharmacy also ran Smoking Cessation Clinics to help patients kick the habit. In an extension of the programme, NHG Pharmacy partnered with the Health Promotion Board to provide offices and employees with clinic-based counselling, workshops for smokers and train-the trainer programmes.

CEO’s Message | 06

CEO’s Message

Mr Paul ChanMr Paul Chan was appointed to the Board in November 2006. He is also Director of SIA Engineering Company Ltd, Singapore Power Ltd, SP Services Ltd and Integrated Health Information Systems Pte Ltd.

Mr Chan has previously served on the boards of various companies, including Singapore Telecommunications Ltd, the Singapore Economic Development Board, Verigy Ltd, and the Advisory Board of Lee Kong Chian School of Business, Singapore Management University. Formerly the Senior Vice President & Managing Director (Asia Pacific & Japan) of Hewlett-Packard Asia Pacific Pte Ltd and the Vice President & Managing Director (Asia Pacific) of Compaq Computer Asia Pacific Pte Ltd, his leadership and foresight contributed greatly to their business excellence. Mr Chan was awarded the Public Service Star in 2005.

Mr Cavinder Bull Mr Cavinder Bull is a Director at Drew & Napier LLC. He studied at Oxford University where he took First Class Honours and at Harvard Law School which he attended on a Lee Kuan Yew Scholarship. He has also been called to the Bar in England and Wales as well as in New York. Cavinder practised in New York with Sullivan & Cromwell from 1996 to 1997.

Mr Bull is an active member in the legal fraternity. He serves on several committees such as the Law Reform Committee of the Singapore Academy of Law, the Singapore Law Committee and the referee board of the Industrial Arbitration Court.

07 | Board of Directors Board of Directors | 08

MdM Kay KuoKChairMan

Mdm Kay Kuok Oon Kwong is a Barrister-at-Law from Gray’s Inn, London, and works full-time in her family business, the Kuok Group of Companies, as Executive Chairman of Shangri-La Hotel Ltd, Singapore.

She is serving and has served on several community service and statutory boards including the Singapore Tourism Board, National University of Singapore (NUS) Board of Trustees, South West Community Development Council (CDC), National Arts Council, Singapore Environment Council, National Environment Agency, National Youth Achievement Award Council and the Wildlife Reserves Singapore Conservation Fund.

Mdm Kuok was awarded the Public Service Medal in 1998 and the Public Service Star in 2005.

Ms anita FaM Ms Anita Fam was formerly a partner of Khattar Wong & Partners and thereafter Senior Legal Counsel, Enron Capital & Trade Resources before she retired 10 years ago to devote herself to her family. Since then, she has immersed herself in community work and is a full-time volunteer, both at charity and national level in the areas of disability, hospice, family and marriage.

Ms Fam chairs Marriage Central, an upstream marriage initiative, under the auspices of the National Family Council on which she also sits. She is also the Vice President of the Asian Women’s Welfare Association, chairperson of AWWA TEACH ME Integration Services and Vice-Chairperson of Covenant Community Methodist Church’s Local Church Executive Committee. Ms Fam also serves as board member of the National Council of Social Service, Singapore Hospice Council, Singapore International Foundation, Assisi Hospice, St Andrew’s Autism Centre, St Andrew’s Autism School and Sembawang Family Service Centre among others.

Ms Fam was conferred the Public Service Medal (PBM) in 2008 for her work in the community. She joined the NHG Board in 2009.

Board ofDirectors

Mr Goh aiK GuanMr Goh Aik Guan is currently the Deputy Secretary (Health Services) in the Ministry of Health (MOH) and the Managing Director (Group Corporate Services) of MOH Holdings Pte Ltd. He is a member of the Administrative Service in the Singapore Civil Service.

Mr Goh’s first posting was at the Ministry of Labour as Assistant Director (Policy). He then moved to the Ministry of Trade & Industry (MTI), serving in various capacities from January 1994 to October 1997, including Economic Cooperation, Asia Pacific Trade and Corporate Services. At MTI, he led in international trade and economic cooperation matters, including World Trade Organisation (WTO) and Asia-Pacific Economic Cooperation (APEC).

Mr Goh later moved to the Ministry of Defence as Director (Planning & Co-ordination). From 1999 to 2002, he served in the Prime Minister’s Office as the Principal Private Secretary to then-Deputy Prime Minister Lee Hsien Loong. Mr Goh subsequently returned to MTI as Deputy Secretary (Trade).

dr liM suet WunDr Lim Suet Wun’s earlier appointments were as COO of Kandang Kerbau Women’s and Children’s Hospital (‘91-‘95), CEO of National University Hospital (‘95-‘01) and then CEO at Tan Tock Seng Hospital since then. In ‘04, he was also appointed concurrently as CEO, National Healthcare Group.

He also sits on the various Boards which include MOH Holdings, National University Health System (NUHS), Johns Hopkins Singapore International Medical Centre, Integrated Health Information Systems (IHIS) and Joint Commission Resources (USA) which accredits hospitals internationally. He is also a member of the Biomedical Sciences Executive Committee (BMS Exco).

Mr onG yeW huatMr Ong Yew Huat is a Chartered Accountant who has had a broad accountancy career spanning audit and advisory work. He became Country Managing Partner of Ernst & Young in 2005 and Executive Chairman in 2008. He is currently also the Chief Operating Officer of Ernst & Young Asia-Pacific Area.

Mr Ong serves on a variety of bodies including grassroots organisations, educational and cultural institutions. He is a member of the Board of the Accounting and Corporate Regulatory Authority and the Public Accountants Oversight Board. A keen collector of South East Asian art, Mr Ong is on the Board of The National Art Gallery Singapore. He joined the NHG Board in April 2009 and stepped down in March 2010.

dr ross WilsonDr Ross Wilson is Senior Vice President, Chief Quality Officer & Deputy Chief Medical Officer, New York City Health and Hospital Corporation.

Prior to taking on the role as lead for the Quality agenda at the large public health system in New York, Dr Wilson was the Director of the Centre for Healthcare Improvement in the Northern Sydney Central Coast Health Service in Australia. In addition, he has had many leadership, Board and management roles in Australian and international public health systems.

Dr Wilson was the Chairman of the Strategic Advisory Board for the International Forum for Quality and Safety in Health Care and International Advisor to the Australian Commission for Safety and Quality in Health Care until July 2009. Previously, as a member of the Executive (2001-2006) of the Australian Council for the Safety and Quality of Health Care and inaugural Chair of the NSW Ministerial Advisory Committee for Quality in Health Care (1996-2002), he had significant strategic and policy roles in the improvement of the quality and safety of health care. As leader of the Quality in Australian Health Care Study (1993 -1995) and more recently, the Eastern Mediterranean and African WHO regional study of patient safety in developing economies (2005-2008), he has a long research and publication experience in the epidemiology of patient safety. Since 1999, leadership, training and project support for “clinical improvement” through the Clinical Practice Improvement programme and its associated projects have been key interests.

Dr Wilson has been a member of the WHO World Alliance for Patient Safety Expert Advisory Group, a contributor to the WHO Patient Safety Research Council, a member of the WHO International Steering Committee for Patient Safety Solutions, a member of the Asia-Pacific Regional Council for Joint Commission International and a member of the Editorial Board of the British Medical Journal.

Until 2005, Dr Wilson had a clinical role as Senior Specialist in Intensive Care Medicine at Royal North Shore Hospital, a teaching hospital of the University of Sydney.

09 | Board of Directors Board of Directors | 10

dr Wilson WonGDr Wilson Wong is a graduate of the Medical Faculty, National University of Singapore, 1981. Shortly after completing his National Service in 1984, he joined Raffles Medical Group as a family physician and has since been a key member in Raffles Medical Clinics, the primary healthcare division of Raffles Medical Group.

In 1997, when Raffles Medical Group was listed on the Stock Exchange of Singapore, Dr Wong was the Clinical Director and General Manager of the Raffles Medical Clinics and was responsible for the business, operations and clinical standards in all Raffles clinics.

Today, Dr Wong is the Medical Director and a Consultant in Raffles Medical. As the Medical Director, he oversees all professional and clinical matters in the Raffles chain of clinics throughout Singapore. Dr Wong continues to actively practise Family and Occupational medicine in the Changi Airport Medical Centre as well as train and mentor newer doctors in the Group. He also acts as medical advisor to companies on staff health and medical issues. He joined the NHG Board in 2009.

Mr PanG Kin KeonGMr Pang Kin Keong, Permanent Secretary of the Ministry of Law, was appointed to the NHG Board in April 2006. Mr Pang was formerly the Director of the Internal Security Department, and before that, the Principal Private Secretary to the Prime Minister. He had previously also been Director of Trade in the Ministry of Trade & Industry.

Mr r. sinnaKaruPPanMr R. Sinnakaruppan is presently Chairman / CEO of Singapore Education Academy (AsiaPac) Pte Ltd, a holding company for a group of education companies involved in a wide range of products and services for children and adult education.

He has served and continues to serve in statutory boards/ community organisatons / listed companies including HDB, CAAS, MDA, ITE, Singapore Polytechnic, NTU, NTU Alumni Club, Singapore Polytechnic, TTSH, SINDA Board of Trustees, Accel Frontline Ltd, and SLF Leisure Pte Ltd and many more. He also served as a Member of Parliament from 1991 to 2001.

He is a Foreign and Commonwealth Scholar and was educated in Harvard Business School, Loughborough University and NTU (NTI).

Mr soh GiM teiKMr Soh Gim Teik advises corporations through his firm, Finix Corporate Advisory LLP, and has more than 32 years of experience in accounting, finance and general management.

He has previously served as an executive director and Finance Director/Chief Financial Officer of Sincere Watch Limited, a company listed on the SGX, for 15 years until his retirement from active employment in August 2008. Prior to that, he had worked in the public accounting sector and was the founding partner of Soh, Wong & Partners, the predecessor firm of LTC LLP.

Mr Soh is a member of the Institute of Certified Public Accountants of Singapore (‘ICPAS’) and a Fellow of the Singapore Institute of Directors. He is the Chairman of the CFO Committee of ICPAS, and a committee member of the Professional Accountants in Business Committee of the International Federation of Accountants (‘IFAC’). He was named the Best CFO of the Year at the inaugural Singapore Corporate Awards in 2006 in the Main Board Listed Companies by Market Capitalization of below S$500 million’ category.

Currently serving as an independent director on the boards of several SGX listed companies, he has also been a director of a Hong Kong listed company as well as various other private companies in Singapore, Malaysia, Thailand, Taiwan, PRC and India. He is also a director and finance committee chairperson in a number of charitable and non-profit organizations and regularly participates as panelist and speaker for various organizations.

Mr Soh holds a Bachelor of Accountancy degree from the University of Singapore.

dr Judith lea sWainDr Judith Lea Swain is a cardiologist and physician scientist, and Executive Director of the Singapore Institute for Clinical Sciences (A*STAR) and the Lien Ying Chow Professor of Medicine, NUS Yong Loo Lin School of Medicine, and Adjunct Professor, University of California, San Diego.

Dr Swain previously served as Dean for Translational Medicine at UC San Diego, Chair of Medicine at Stanford University and Chief of Cardiovascular Medicine at the University of Pennsylvania. She is a physician scientist who has worked in molecular cardiology and in medical device development. She joined the NHG Board in 2009.

11 | Senior Management Senior Management | 12

Dr Lim Suet WunChief Executive Officer, National Healthcare Group

Chief Executive Officer, Tan Tock Seng Hospital

Professor Chee Yam ChengAssistant Chief Executive Officer (Clinical), National Healthcare Group

Mr Leong Yew MengChief Executive Officer, Institute of Mental Health/ Woodbridge Hospital

Chief Executive Officer, National Healthcare Group Polyclinics (wef Dec 2009)

Professor Roy ChanDirector, National Skin Centre

Professor Philip ChooChairman, Medical Board, Tan Tock Seng Hospital

Mrs Nellie Yeo Chief Quality Officer, National Healthcare Group

Executive Director, National Healthcare Group College

Dr Eugene Fidelis SohChief Operating Officer, Tan Tock Seng Hospital

Mr Ho Khai Leng Group Director, ITD

Mr Choo Kin PooExecutive Director, Research & Development Office, National Healthcare Group (wef Feb 2010)

Associate Professor Rathi Mahendran Chairman, Medical Board, Institute of Mental Health/ Woodbridge Hospital

Ms Lim Yee JuanChief Financial Officer, National Healthcare Group

Mrs Olivia TayChief Human Resource Officer, National Healthcare Group

Ms Olivia BransonDirector, Corporate Communications, National Healthcare Group

Director, Corporate Communications, Tan Tock Seng Hospital

Dr Tan Weng MooiChief Projects Officer, National Healthcare Group (wef Nov 2009)

SeniorManagement

13 | Putting Patients First

The concept of Caring it Forward is primarily about putting our patients first. By building on our facilities and services, and reaching out to people in need, we empower individuals to take charge of their own well-being as well as that of their loved ones. This is our foundation for a lasting legacy of community healthcare.

nhG 1-health In a landmark effort towards seamless integrated care, NHG 1-Health was launched in 2008 as an ambulatory care centre established to provide specialist treatments at the the patients’ doorstep in the Ang Mo Kio heartland. Its first year report card revealed exemplary results – with steady growth from walk-in patients and referrals from private GPs, NHG Polyclinics and TTSH. Endoscopy services were introduced at NHG 1-Health in January 2010, relieving patient load and cutting down waiting time at NHG Polyclinics and TTSH for the service.

NHG 1-Health’s convenience and affordability are major plus points. During the year, efforts to foster closer ties with the community in Ang Mo Kio were made via public forums about topics such as cataracts, glaucoma, colorectal and stomach cancer, as well as GP upgrading workshops.

Looking forward, NHG 1-Health will pilot the concept of specialty hospitals in an outpatient setting, focusing on Oesophagastroduodenoscopy (OGD) procedures and eye cataract surgery employing Value Added Process (VAP) techniques. The VAP centre for Cataracts and OGD will be the first of its kind in Singapore where selected procedures are decentralised to alleviate the patient load at tertiary hospitals.

swift and effective response to infectious diseasesWhen the first wave of H1N1 infections hit Mexico in April 2009 with 59 deaths, TTSH and the Communicable Diseases Centre (CDC) responded swiftly by decanting the wards in preparation for the infection to reach Singapore. From 27 April, TTSH was designated as the official screening centre and the initial strategy was for screening and containment.

A second screening centre was set up at the Communicable Diseases Centre (CDC) on 2 June, to supplement the one at TTSH. Low risk patients were sent home while awaiting results. If the results turned out to be positive, they were served home quarantine orders and given home treatment. At its peak, 396 were patients screened in a single day.

During that period, the Department of Laboratory Medicine at TTSH implemented a round-the-clock Influenza A/B Polymerase Chain Reaction (PCR) test and support for the National Organ-transplant infectious disease-screening programme for H1N1.

Putting Patients First | 14

Putting Patients First

The outpatient clinic provides a range of comprehensive services in addiction – encompassing assessments, treatment planning and case management, relapse prevention training, psycho-education and counselling programmes for patients and their families. It also offers public education and training courses, as well as counselling sessions in a conducive environment. Some 914 new addictions cases were seen during the year.

At TTSH, a Sport Medicine and Surgery clinic was set up in October 2009 with extensive facilities, including a fully equipped gym for rehabilitation programmes. In cardiology, a second generation Dual Source CT Scanner has been introduced as part of its non-invasive cardiac imaging services. This is the first of its kind in Southeast Asia and offers high speed and quality images with lower radiation doses.

Another milestone in service is the VTRAC Excimer Lamp service offered by NSC – the first in Singapore. The state-of-the-art Excimer Lamp has been proven capable of clearing skin conditions such as psoriasis and vitiligo quicker and more effectively than the traditional NB UVB. It also complements existing phototherapy treatments. In addition, NSC started its weekly Acne Clinic in May 2009 to provide comprehensive acne management for teenage and adult patients with moderate-to-severe acne vulgaris, the second most common new condition seen at NSC.

Following the success of the Tele-Ophthalmology Trial in 2008, NHGEI and Hougang Polyclinic piloted the service in April 2009. Patients can consult an eye specialist via video consultation at the polyclinic, reducing the rate of unnecessary referrals to specialist eye centres while maintaining a low mid-diagnosis rate.

Extending its reach to the community, NHG Polyclinics opened two new physiotherapy centres at Toa Payoh and Woodlands Polyclinics, bringing the number of such centres to three. At the Polyclinics, NHG Pharmacy runs Smoking Cessation Clinics to help patients kick the habit. In an extension of the programme, NHG Pharmacy partnered with the Health Promotion Board to provide offices and employees with clinic-based counselling, workshops for smokers and train-the trainer programmes.

enhanced Psychiatric CareIn November 2009, IMH’s Job Club, a one-stop vocational rehabilitation service, was officially launched by Madam Halimah Yacob, Member of Parliament for Jurong GRC and Assistant Secretary-General of NTUC. A programme under the National Mental Health Blueprint, Job Club aims to help persons with mental illness choose, secure and keep a job. Such an initiative is critical in enabling patients to find employment, boost self-esteem and integrate with the community.

Job Club provides comprehensive services that include personalised vocational counselling, psychosocial and vocational readiness assessment, job placement and coaching, and job-site follow-up. Apart from matching clients with suitable jobs, Job Club also works with prospective employers and community groups to create employment opportunities and better understand individuals with psychiatric conditions. Since its setup in April 2008, the programme has received 1,791 referrals, facilitated 474 job placements and registered 59 employers with the scheme.

15 | Putting Patients First Putting Patients First | 16

As it became clear that the virus had spread to the general population and was a milder strain than originally feared, the focus shifted to a mitigation strategy rather than containment. Only high risk patients were screened by early July 2009 and the CDC2 screening centre ceased operations on 18 July 2009. By the end of 2009, a total of 4,253 suspected and 1,385 confirmed cases of H1N1 were managed at TTSH/CDC.

During the year, the ICU Committee and Facilities Management Team jointly implemented a MOH-funded project to increase ICU capability in preparing for a pandemic. A convertible facility, a first in Singapore, comprising four single isolation rooms, three twin isolation rooms and six four-bedded cubicles were created. In a pandemic situation, these rooms, which have a vastly different usage during normal time, can be quickly transformed into negative-pressure isolation rooms within three hours. The converted rooms, complying with stringent standards, provide protection and segregation to the nursing staff when housing highly infectious patients.

new specialist Clinics and servicesAlways responsive to evolving patient needs, NHG institutions initiated numerous new specialist clinics and services during the year. At IMH, a Specialist Outpatient Clinic C dedicated to the treatment of addictions was set up in July 2009 in anticipation of the rise in such cases, particularly in problem gambling.

NHG 1-Health’s first year report card revealed exemplary results – with steady growth from walk-in patients and referrals from private GPs, NHG Polyclinics and TTSH.

IMH recognises the challenges faced by families with members who suffer from psychiatric conditions. Caregivers often feel burdened and trapped, which often lead to high levels of stress, fatigue and other social and emotional problems. To help caregivers, IMH initiated the Caregiver Support Programme which includes training for caregivers, resources and support in handling a difficult situation. Social activities and networking sessions are also regularly organised for caregivers to meet and support one another.

Patients and caregivers now also have round-the-clock access to IMH support, thanks to the extension of helpline services from office hours on weekdays to 24/7.

Cutting Waiting time and CostPatient load management is an ongoing issue faced at public hospitals. To reduce waiting time at its Emergency Services, IMH introduced advanced triage and redesigned some of its clinic processes so that only patients classified as P1 are immediately seen by the consulting doctor. A dedicated station was set up for staff to arrange medical records in accordance to Patient’s Acuity Classification to enable smooth patient flow without unnecessary interruptions.

To speed up the process even more, registered nurses were also trained to execute advanced triage. Medical officers were designated to attend to remand and general hospital cases, and healthcare attendants trained to become ‘floor managers’ to monitor and facilitate the flow of patients.

17 | Putting Patients First Putting Patients First | 18

Always responsive to evolving patient needs, NHG institutions initiated numerous new specialist clinics and services during the year.

Job Club provides comprehensive services that include personalised vocational counselling, psychosocial and vocational readiness assessment, job placement and coaching, and job-site follow-up.

At NSC’s Department of STI Control (DSC), an appointment booking system was introduced in May 2009 to better manage patient load. This has helped DSC achieve a more evenly distributed patient load and reduce waiting time for patients with appointments.

Cost savings is another positive outcome of process improvement. During the year, the NHG Group Purchasing Office managed to drive down costs through volume aggregation and product standardisation, achieving savings worth $9.8 million for the hospitals participating through NHG. These cost savings can be passed on to patients, resulting in better service for customers.

19 | Quality Initiatives for Better Care

Quality is integral to everything we do in NHG. By continuously raising quality standards through ground-breaking research, clinical processes and systems, we are contributing daily towards faster, better, cheaper and safer healthcare for patients.

Process Improvement InitiativesMyCare is an NHG-initiated framework that utilises LEAN tools and principles to streamline work processes for the delivery of faster, better, cheaper and safer care. MyCare is more than a technical framework. It is also a culture change framework that empowers staff.

It has enabled TTSH to reap significant improvements, having completed more than 11 value streams and 125 ground-up projects. With bed demand steadily on the rise every year, TTSH faces a compelling need for measures to address a perennial bed shortage situation. Working in tandem with an earlier initiative to strengthen the discharge process, a TTSH team implemented protocols and consolidated practices in FY2009/10 for the care management of General Surgery patients in a short-stay ward. The short stay initiative has been shown to potentially discharge 25%-30% of patients daily, helping to alleviate the effects of the bed shortage situation.

At NSC, MyCare is also practised judiciously. Non-value added activities are systematically removed to reap improvements. IMH has established a framework and curriculum that incorporates LEAN principles within the culture of the organisation, otherwise known as Kaizen, for improved processes.

Through a formal training framework and curriculum, 779 staff from NHG Polyclinics were trained in LEAN principles and techniques by March 2010. Across the clinics, 57 projects were completed.

The Clinical Practice Improvement Programme (CPIP), instituted in NHG since 2002, trains clinicians to improve and redesign the care processes using validated approaches. In 2009, 101 clinicians attended the 20th and 21st workshops by NHG College.

Seven CPIP projects were completed in TTSH during FY 2009. One such project was to have 100% of heart failure patients without any contraindications by receiving Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers (ACE-I/ARB) or Beta-blockers (BB) upon discharge from TTSH in six months. The outcomes were very positive – with improved hospital compliance to MOH Clinical Pharmacy Practice Guidelines. The readmission rate was 7.4% in patients on ACE-I/ARB or BB compared to 21.1% for those on neither.

In February 2009, IMH launched a set of Nursing Clinical Practice Guidelines for best practices in the assessment and management of suicide, management of disturbed, aggressive and violent behaviour, fall prevention in older adults,

Quality Initiatives for Better Care | 20

Quality Initiatives for Better Care

21 | Quality Initiatives for Better Care Quality Initiatives for Better Care | 22

medication administration, and the reduction of assault incidents. Road shows and pilot projects translating the guidelines into practice were carried out and the guidelines implemented in the wards.

Promoting Quality across InstitutionsDuring the year, there were several inter-institution collaborations to improve standard operating procedures. The Critical Laboratory Results Collaborative which involved TTSH, IMH, AH, NUH, and NHG Polyclinics worked on standardising communication workflows and escalation pathways. The Healthcare Messaging System automatically routes critical results to ordering doctors via SMS. This significantly reduced the communication times of critical results by over 40% and increased documentation of actions of crucial results by up to 98%.

Another collaboration was High-Alert Medication (HAM) aimed at reducing patient harm resulting from the use of a group of drugs frequently involved in medication errors. Since its establishment, NHG institutions have standardised a HAM list based on locally reported and detected medication errors, adverse drug events and sentinel events.

Advancing Healthcare Through Research Cutting edge research is integral to any healthcare institution’s quest towards scientific query and medical discovery. The Health Services and Outcomes Research (HSOR) unit, established since 2005, collaborates with NHG institutions to identify relevant issues within selected research areas. HSOR’s projects span many disciplines: evaluation research, medical informatics, health economics

and operations research. In 2009, HSOR worked with TTSH and NUH in epidemiological studies of chronic diseases, as well as with NHG Polyclinics in improving the organisation and delivery of services to patients. These projects have also yielded 17 publications by the team in various international and local journals.

In FY 2009, IMH embarked on a Singapore Mental Health Study which aims to establish the mental health status of the adult Singapore resident population. Some 15,000 households were randomly identified for this door-to-door, face- to-face survey which will screen and establish diagnoses of multiple mental illnesses as well as measure and assess the factors that contribute to positive mental health.

A new medical breakthrough has been achieved with the Brain-Computer Interface (BCI) robot therapy. A collaborative effort among TTSH, the National Neuroscience Institute and the Agency for Science, Technology and Research (A*STAR), the research trial resulted in a superior rehabilitative method for stroke patients. This technology uses thought-based robotic therapy via electrodes attached to the head to help stroke patients recover. When the patient thinks of moving her arm, neurons are fired within the brain producing electrical activity which is measured in an electroencephography (EEG). The BCI senses these EEG inputs and causes the robotic arm, attached to patient’s arm, to move. In BCI therapy, the arm moves an average of 140 times an hour. This way, the patient recovers limb movements faster than traditional physiotherapy.

The NHG Eye Institute Fundus Image Reading Centre (FIRC) was involved in two clinical trials in FY 2009, making it the first reading centre to be involved in multi-centre trials in the Asia Pacific region. The Everest Trial is the first multi-centre, randomised, double masked, indocyanine green angiography guided study to compare the safety and efficacy of Visudyne® Photodynamic Therapy (PDT) and Lucentis™ treatment in patients with symptomatic macular polypoidal choroidal vasculopathy. This study compares three arms of treatment over six months.

The second trial is also an international, multi-centre one on Diabetic Macular Edema (DME). The 12-month study involving 53 trial sites from six Asian countries will compare treatments for patients with visual impairment due to DME. A series of imaging diagnostic tests will be sent to the NHG Eye Institute FIRC for central reading.

Sharing Knowledge and ExpertiseBy sharing knowledge with the healthcare community across organisational and geographical borders, NHG is helping to perpetuate advances in medicine and healthcare.

Singapore’s largest annual scientific meeting namely, the 8th NHG Annual Scientific Congress (ASC) was held on 16-17 October 2009. Entitled “Medicine in Asia: Transforming Global Healthcare, Empowering Lives”, the ASC attracted more than 3,000 healthcare participants from Singapore and overseas. Over 300 scientific papers covering multi-disciplinary perspectives were shared by 250 local and international speakers.

Several symposiums and forums were also organised in conjunction with the ASC. NHGEI’s 2nd International Opthalmology Congress reviewed the latest advances in glaucoma and neuro-opthalmology while the Infectious Disease Symposium served as a platform for researchers to discuss vector borne diseases such as H1N1 and dengue. Among other events held during ASC were the Singapore Disease Management & Primary Care Forum, the 2nd TTSH-JHSIMC Clinical Oncology Symposium and Medical Dermatology Symposium.

Another event organised by NHG College to promote healthcare quality and safety was the inaugural Healthcare Improvement Festival in January 2010. Co-organised with the Healthcare Quality Network (HQN), the festival brought cross-institutional

The AHMA recognises and honours hospitals in the Asia Pacific Region that have implemented outstanding and innovative projects, programmes and best practices.

Quality champions together to share innovation and best practices, as well as foster camaraderie and trust among improvement leaders. Courses have also been customised for our partners, including the Risk Management & Patient Safety Workshop and the Process Improvement Basic Toolkit Workshop.

NHG College also extends its courses beyond institution walls – to other community partners and organisations. In 2010, the Institute of Intermediate and Long-term Care (IILTC) jointly launched an ILTC programme together with TTSH to partners such as RenCi Community Hospital, the Home Nursing Foundation and other nursing homes under Project CARE. The programme aims to help these agencies improve their capability and quality of care, so that they may facilitate care integration and the continuum of care.

Several conferences and symposiums were held throughout the year, covering a wide gamut of topics. In March 2009, the Primary Care Academy co-organised the 2nd Asian Primary Care Innovators Conference with the Taiwan Association of Family Physicians in Taiwan, where renowned experts spoke about the management of chronic diseases such as asthma, hyperlipidaemia and

gastro-oesophageal reflux disorder. From 3-5 April 2009, NHG Diagnostics played host to the 3rd International PACS and Teleradiology Symposium, an annual affair where field experts present their findings on PACS and teleradiology. In January 2010, TTSH Pathology Department organised the first Singapore Dual-Source CT Conference which offered a comprehensive review of the methodological issues and clinical aspects of CT imaging using the latest Somatom Definition FLASH Dual-Source CT.

Quality Awards and AccreditationAs a cluster, NHG has consistently demonstrated excellence in research and service. The accreditation of NHG together with National University Health System (NUHS) and Alexandra Hospital (AH) in 2007 by the Association for the Accreditation of Human Research Protection Programs (AHHRPP) – the first healthcare institutions outside the US to be honoured with this award – is a testimony to this commitment During the year, NHG, NUHS and AH received re-accreditation with a distinction.

The Excellent Service Awards (EXSA) represent the nation’s acknowledgement of exemplary service by staff. During the year, NHG institutions once again did the cluster proud –bringing home a total of 1,129 awards comprising 95 Star, 197 Gold and 837 Silver awards in the healthcare category.

At the Asian Hospital Management Awards (AHMA) 2009 held in Ho Chi Minh City, Vietnam, IMH bagged three awards, the highest number of awards won by any hospital that year. The AHMA recognises and honours hospitals in the Asia Pacific Region that have implemented outstanding and innovative projects, programmes and best practices. IMH was also the first and only hospital to be conferred the Singapore Quality Class (SQC) STAR award, which is given to organisations which meet the requirements determined by the Business Excellence Framework during the SQC Renewal Assessments.

Since 2000, Quality Week has been an annual event for NHG and our institutions to reinforce our commitment to quality and recognise staff who contribute significantly to quality improvements. The 9th Quality Week entitled “The Value Compass – tracing the Patient’s Footprints” emphasised importance of listening to patients and designing care accordingly. Some 12 NHG staff were given the Excellence in Action Awards based on their professionalism and contributions.

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By sharing knowledge with the healthcare community across organisational and geographical borders, NHG is helping to perpetuate advances in medicine and healthcare.

The Excellent Service Awards (EXSA) represent the nation’s acknowledgement of exemplary service by staff. During the year, NHG institutions once again did the cluster proud –bringing home a total of 1,129 awards comprising 95 Star, 197 Gold and 837 Silver awards in the healthcare category.

25 | Community Care And Public Engagement

As a national healthcare provider, NHG has always tried to be actively involved in the community we work and live in – through various public outreach and education programmes and activities. The people we serve are the reason for our existence, and we have a huge responsibility to educate and care for these groups and individuals, especially the needy elderly and less fortunate.

Empowering Community GroupsBy training different groups in the community, we equip them with useful hands-on skills which they can then use to provide care to others. IMH embarked on several such training programmes during the year. These included the Crisis Intervention Workshops conducted by in-house doctors, psychologists and allied health professionals for staff and volunteers from organisations such as People’s Association, Ministry of Foreign Affairs and the Singapore Police Force. The workshops aim to raise psychological preparedness during an emergency or crisis.

Another workshop organised by IMH was the Suicide Prevention Workshop – to train over 40 teachers to take on the role of School Care Officers. Jointly organised by the Samaritans of Singapore (SOS) and the Ministry of Education, the training aimed to enable teachers to help staff and students in times of crisis and conduct post-crisis psychological debriefing. IMH also conducted networking and training sessions with community partners – such as the Community Development Councils (CDCs), Volunteer Welfare Organisations (VWOs), religious institutions and Family Service Centres – in areas such as Basic Mental Health Training and Skills Training for Management of Difficult, Aggressive and Violent Persons in the Community. These courses better equip frontline staff to help people who may be going through a crisis or suffering from mental illness.

Apart from organising workshops, IMH also joined hands with community partners to raise awareness and equip more people with mental health skills. In January 2010, IMH became a member of the North East Community Development Council’s (CDC) ComCare Local Network. Through this network, IMH hopes to help CDC staff and ComCare Local Network agencies recognise people at risk and know where to refer them for help.

Public Education InitiativesRaising awareness of health issues is often the first line of defence. NHG institutions initiated numerous public education events over the year to promote a healthy lifestyle and increase public knowledge of various diseases.

Two related events were the Singapore Problem Gambling Conference and the Public Forum on Problem Gambling co-organised by the National Addictions Management Service (NAMS) and the National Council on Problem Gambling in August 2009 and April 2010 respectively. The conference brought together international problem gambling experts to share trends and treatments while the public forum shared treatment and support services with families facing problem gambling issues. NAMS also held over 30 runs of the Responsible Gambling Training Programme for the frontline staff of gambling operators, polyclinic staff, school counsellors and social workers.

In a concerted effort to raise public awareness that effective hand hygiene prevents life-threatening infections, TTSH launched the Clean, Safe, Infection-free:

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Community Care And Public Engagement

Wash & Win Promotion on 27 April 2009. Coincidentally, H1N1 broke out on the same day, driving home the importance of hand hygiene. Public hand washing road shows were held at TTSH and three popular malls – with hand washing demos, lucky draws and giveaways. The campaign directly contributed to a 43% drop in MRSA (Methicillin-resistant Staphylococcus aureus) cases and a 60% decrease in VRE (Vancomycin-resistant Enterococcus) cases, year on year.

The media was also harnessed as a channel for public education. Lifewise – The Talkshow, the first local Medical Health Talkshow on MediaCorp Channel 8, debuted on 29 July 2009 and attracted 208,000 viewers. The three-part series gave authoritative medical information on selected chronic diseases, namely diabetes, high cholesterol, heart disease and colorectal cancer, and encouraged viewers to act on the information given. The show featured NHG family physicians, specialists and patients.

Reaching Out to the ElderlyThe needy elderly are usually the ones who require the most healthcare support. NHG institutions have traditionally gone out of their way to provide medical care for these often overlooked members of the community.

In ensuring the continuity of care from the TTSH Transitional Care team to the Home Nursing Foundation (HNF), processes were streamlined through a MyCare initiative in October 2009. The enhanced collaboration led to more referrals to HNF and better communications on the care of the patients. This partnership ensures that elderly and homebound patients continue to receive quality care in their community.

When it comes to medication, the elderly tend to need more medication and therefore face greater risks of medication problems like drug interactions, side-effects or even taking the wrong dosage due to confusion. Nurses in nursing homes often have to cope with the residents’ many medicines, and the administration of medicines is often a tedious process involving the sorting and checking of the individual resident’s medication. A user-friendly calendar pack

system to manage the patient’s medication accurately and efficiently among the suite of medication management services was provided by NHG Pharmacy to solve this problem. To date, eight nursing homes are benefiting from this solution. NHG Pharmacy also collaborated with the Home Nursing Foundation (HNF) on a referral programme which allows HNF’s needy patients to buy their surgical supplies at special rates from NHG Pharmacies.

TTSH launched the landmark Community Health Engagement Programme (CHEP) in September 2009. Implemented in collaboration with family service and senior activity centres, the programme aims to enable the frail elderly staying in one- and two-room flats to live and age with dignity within their community – by equipping them with skills in healthy ageing and self-management of chronic disease. A pilot on the Geriatric Assessment Programme component with focus on fall prevention began in Toa Payoh with 37 residents from Block 1, Toa Payoh Lorong 1. They were assessed and followed up by TTSH medical staff. Following the six-month programme with TTSH staff, CHEP participants continue with exercise programmes led by volunteers, and are referred to community healthcare providers like TOUCH Community Services for continual care if necessary. Plans are underway to extend the programme to Ang Mo Kio.

September 2009 also saw the launch of Project CARE. This pilot funded by MOH comprises a multi-disciplinary team of clinicians, nurses and medical social workers from TTSH who strive to introduce systems of care to promote Advance Care Planning (ACP) and improve end-of-life care for residents in its participating nursing homes. The programme also promotes an integration of care at the regional health system level and aims to help reduce unnecessary emergency department visits and hospitalisation. To date, four nursing homes – St. Theresa’s Home, Lions Home for the Elders Toa Payoh, Society for the Aged Sick and Ling Kwang Home for Senior Citizens – are partners in this pilot.

Community Outreach Community outreach is a crucial part of NHG Polyclinics’ public education efforts. Despite the H1N1 outbreak in April 2009, NHG Polyclinics continued to provide Opportunistic Health Screening (OHS) to more than 19,000 patients, aimed at detecting undiagnosed chronic conditions and providing early medical intervention. Using a computerised health screening software and protocol approach, each patient received a personalised health screening report instantaneously and was counselled by a nurse about his or her health risk factors.

During the year, NHG Polyclinics also provided health screening services in the heartlands in collaboration with eight Community Wellness Centres. This partnership resulted in the screening of more than 6,000 people in 2009.

Bringing Hope to the Less FortunateIn a world where not everyone has access to adequate healthcare, there are many avenues for NHG institutions to contribute meaningfully to society. On 6 March 2010, a team of ophthalmologists from NHG Eye Institute @ TTSH left for Bangladesh as part of the “Eye-See-the-World” three-day trip. Together with doctors from the Bangladesh Eye Hospital, the ophthalmologists saw over 800 outpatients in the village of Ibrahimpur, Norshindi, and performed cataract surgery on 164 patients.

Apart from medical services, NHG institutions also opened their hearts by helping to raise funds for worthy causes. A case in point, the Patient Care Centre (PCC) hosted the Red Ribbon Race – a dragon boat event – to raise funds for patients with HIV/AIDS. An estimated $40,000 was pledged for the event and channelled to the TTSH Community Charity Fund. PCC also enlisted the help of talented musician Mrs Helen Low Lee to raise funds through a piano concert at the Esplanade Recital Studio.

Other NHG institutions too played their part. NHG Diagnostics organised a series of activities in aid of its adopted charity The Moral Home for the Disabled. NSC staff visited the homes of 30 NSC patients on full Medifund assistance in August, bearing food and basic necessities.

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NHG institutions initiated numerous public education events over the year, aimed at promoting a healthy lifestyle and increasing knowledge of various diseases among the public.

29 | Enabling Care with Technology

The advancements in Info-communications Technology (ICT) have opened up exciting new horizons in healthcare. Apart from making possible new medical techniques, ICT has also given systems a boost. Now more than ever, safety, accuracy and efficiency are enhanced. Thanks to electronic assistance, we can optimise our internal processes, enabling us to provide faster, better, cheaper and safer care for our patients.

During the year, more systems went the electronic route in our journey towards going paperless. The Closed Loop Order Management programme enables clinicians to order laboratory and radiology tests electronically, and includes a smart tracking system that manages the collection of specimens and timely delivery of results. The system also alerts ordering doctors when abnormal or critical results are found, helping to enhance patient safety.

Electronic Medication SystemPart of the Closed Loop Order Management programme included an electronic medication system that enables clinicians to order inpatient medication electronically which is then packed in unit doses and kept in automated dispensing cabinets. Nurses use a hand-held device to administer and record the medication given to the patients, whose wrist-bands are barcoded for added precaution. The system heightens patient safety in ensuring the right prescription, dosage and administering of medication.

Electronic Medical RecordsSince the Electronic Medical Records (EMR) project was implemented, NHG institutions have increasingly phased out manual tasks. The final component of the EMR is the E-notes module – used to capture all doctor, nursing and allied health consultations to produce structured and legible consult notes accessible online by any healthcare team member. The module was rolled out for NHG Polyclinics from May 2009, with full adoption by March 2010.

Specialty clinical notes have also been implemented for Endoscopy, Dental, Eye and Mental Health (Emergency Service) services.

ICT as a Healthcare Solution ADHD and childhood anxiety are two common childhood disorders. In keeping with a web-savvy society, IMH partnered with Fujitsu Asia Pte Ltd and e-learning company ASKnLearn Pte Ltd to develop an innovative form of treatment – an interactive web-based portal. Named ROC-N-ASH (www.roc-n-ash.com), the portal allows users to access resources such as multimedia learning content, video clips and computer games designed to treat both ADHD and childhood anxiety. The games guide children towards concentrating better and becoming less impulsive as well as help them to overcome anxieties.

Since its launch in September 2009, the portal has won a few accolades, among them a merit award at the Asia Pacific Information Communication Technology Alliances (APICTA) awards and a Merit Award under the Private Category at the SiTF Awards 2009.

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Enabling Care With Technology

31 | Nurturing People

The crux of healthcare lies with people – the people whom we serve and the people who serve. The finest facilities would be useless without the expertise, commitment and dedication of the people who operate them. For this reason, NHG invests solidly in our staff, raising their competence and their morale, so that they can continue to keep Caring it Forward every day. Attracting Talents Job opportunities in the healthcare sector remained robust during the year and NHG stepped up the recruitment of healthcare professionals, adding 185 doctors to our fold of medical staff. Nursing staff too, received a boost. NHG institutions embarked on recruitment trips to the Philippines, Malaysia and India during the year to recruit Registered Nurses, Enrolled Nurses and students for Asian Nursing Scholarships. NHG also collaborated with MOHH in their recent trips to Taiwan. The nursing profession was promoted via the MOH-NHG Nursing Development Scholarships (MNDS). Some 13 awardees, including seven in-service employees, were offered scholarships for Advanced Diploma, Degree and Master programmes. NHG introduced several new allied health scholarships during the year to nurture a continuous pipeline of talent, including entry degree and masters, clinical masters and PhD programmes in disciplines such as clinical psychology, optometry, physiotherapy and diagnostic radiography. At TTSH, the Management Associate Programme was launched to develop a pool of individuals adept in hospital administration and operations. Developing Staff By investing in training and development, we enable our staff to make the most of their potential and grow in knowledge and skills. The Health Manpower Development Plan (HMDP) continued to allow healthcare professionals to maximise their abilities by sending them on training programmes in both locally and internationally renowned institutions. Among the new training programmes introduced under the HMDP during the year were Gerontology, Community Health, Oncology and Administration & Management, in line with national and cluster objectives. In 2009,157 HMDP Fellowship Awards valued at $5.8 million were given to NHG staff. These awards also included team-based HMDPs, where staff from different disciplines were sent on the same attachment stint. High potential staff were given opportunities to pursue postgraduate studies in general management via the NHG Postgraduate Self-Development Awards. Five awards were given out during the year. NHG College remained instrumental in offering the tools for staff development. During the year, it delivered a series of key programmes for the development of leadership talent within the cluster. These included the flagship Healthcare Leadership Course and Young Leaders Programme.

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Nurturing People

In October 2009, NHG College conducted the inaugural Essentials for Clinician Teachers Course, aimed at preparing NHG clinicians to be better teachers and educators, especially in preparation for the medical residency system to be implemented by MOH in 2010. The course comprised five modules conducted over two-and-a-half years. Also to groom clinicians was the two-day Clinical Incident Management Course designed to better prepare clinicians to communicate with patients about areas that may have gone wrong. Complementing this programme was the Open Communication Train-the-Trainer Course, aimed to train senior staff to teach their colleagues about communication skills.

IMH has been continuously holding courses to upgrade the skills of its staff. One such programme was the Nurse Clinician Course for Nurse Clinicians and Senior Staff Nurses. Accredited by the Singapore Nursing Board, the course is specially tailored for a psychiatric setting and consists of 10 modules. It received a funding of $98,000 from the Workforce Development Agency. In May 2009, NHG Polyclinics launched the Outcome-based Family Medicine Training programme to improve primary care training for its doctors. The shift in training focus from a syllabus-based model to an outcome-based training framework helps better equip primary care doctors with a holistic and reflective outlook to care for their patients.

Rewarding Merit and Service NHG staff continued to impress with their unwavering service and contributions. The string of accolades garnered by our colleagues attests to their dedication. Among these were: • Healthcare Humanity Awards which recognise healthcare workers who demonstrate extraordinary courage and commitment. NHG institutions won 18 out of the 61 awards presented by President S R Nathan on 24 May 2010. • 29 National Day Awards (four Commendation Medals, eight Efficiency Medals and 17 Long Service Medals).

• One PS21 Award by IMH for delivering exemplary service. • One May Day Model Partnership Award by IMH for demonstrating resilience and adaptability in the light of the economic crisis. • Five MOH Nurses Merit Awards by IMH, This award acknowledges nurses who contribute significantly to their profession. • One Public Spiritedness Award by the Singapore Police Force for IMH. NSC Director Prof Roy Chan did NHG proud by becoming the first Singaporean to receive the Queen Elizabeth II Gold Medal (2009), conferred by the United Kingdom’s Royal Society for Public Health in recognition of individuals who contribute significantly towards public health and health promotion within the Commonwealth. Prof Chan’s pivotal role in an innovative condom promotion

intervention project for brothel-based sex workers in Singapore led to a significant increase in condom use and a corresponding decline in STIs/HIV among sex workers. The programme won the Wilf Howe Memorial Prize (UK) in 2008 and was cited in a UN AIDS 2006 report. Being an Employer of Choice NHG strives to be an employer of choice to create a corporate culture that is conducive for service excellence and personal growth. In September 2009, NHG was one of the 10 international organisations conferred the AARP International Innovative Employer Award in recognition of age-friendly employment practices. The AARP is a US-based interest group that helps people aged 50 and older to have independence, choice and control in ways that are beneficial and affordable to them and to society as a whole. For the first time, IMH participated in the Singapore HR Awards 2009, organised by the Singapore Human Resource Institute. It took home three leading awards in Learning and Human Capital Development, Quality Work-life, and Health & Employee Wellness. It also won a Special Mention for Workplace Safety & Health. TTSH garnered two awards at the 2009 Asian Hospital Management Awards, under the Human Resource Development Project category. These are two Excellence (Runner-up) awards for TTSH MyCare Framework – Patients First, Empowered Staff and TTSH MyCare – Using Training Within Industries. The first project award was for the unique approach and rapid deployment of MyCare training. The second was for the unique approach of the TWI programme and evidence of Job Instructions and outcomes. Being an employer of choice includes taking a holistic approach towards employee well-being and providing a family-friendly work environment. NHG institutions have consistently earned the Singapore Helping Employees Achieve Life-Time Health (HEALTH) Award by HPB for their health promotion efforts. In 2010, both NHG (for the second year running) and TTSH clinched the POSB Every Day Champions Award 2010. Organised by the Singapore Sports Council and supported by POSB, the award recognises our efforts in promoting sports as part of our corporate culture.

High potential staff were given opportunities to pursue postgraduate studies in general management via the NHG Postgraduate Self-Development Awards. Five awards were given out during the year.

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NHG College remained instrumental in offering the tools for staff development. During the year, it delivered a series of key programmes for the development of leadership talent within the cluster. These included the flagship Healthcare Leadership Course and Young Leaders Programme.

tan tock seng hospitalTan Tock Seng Hospital (TTSH) was established in 1844 and named after its founder, Mr Tan Tock Seng, a philanthropist. Over the years, TTSH has grown from strength to strength to become Singapore’s second largest acute care general hospital with 1,481 beds. TTSH is accredited by the Joint Commission International (JCI),

in recognition of its world-class patient care and comprehensive range of high quality holistic healthcare services at its main hospital complex, Communicable Disease Centre (CDC), TTSH Rehabilitation Centre and specialist clinics. TTSH has 27 clinical departments and a full range of sub-specialties to meet the healthcare needs of patients. Of these, TTSH’s strengths are in Infectious Diseases, Geriatric Medicine, Rehabilitation Medicine, Respiratory Medicine and Rheumatology, Allergy and Immunology. It is also a major referral centre for Emergency Medicine, Diagnostic Radiology, Ophthalmology, Otorhinolaryngology (ENT), Orthopaedic Surgery, Gastroenterology, General Medicine and General Surgery. The hospital also encompasses two major specialty centres in rehabilitation medicine and communicable diseases. In March 2003, when Severe Acute Respiratory Syndrome (SARS) struck in Singapore, the Ministry of Health (MOH) declared TTSH the designated hospital for SARS screening and treatment. Today, the hospital continues to research on emerging infectious diseases and finds the best treatment for them. The hospital has continually played a significant role in the development of medical services and provision of healthcare to patients. Its top class clinical expertise is supported by state-of-the-art facilities and medical equipment as well as

the latest communication and information technology tools. The Art of Healing, a programme that employs all forms of art for its therapeutic quality, was launched in 2006. Held monthly during lunchtime, the programme uses the arts to achieve holistic healing of the mind and body. Over the years, local and International artistes have performed at TTSH as part of this programme. In April 2009, TTSH launched the CSI (Clean, Safe, Infection-free) campaign. The hand washing drive aimed towards educating the public on proper hand hygiene to prevent the ongoing transmission of germs that cause influenza and other serious illnesses. This is the first time a public hospital has made such a bold move to spread the message by rewarding the public, staff and patients with an opportunity to win a brand new Subaru car. institute of Mental health

Established in 1928, the Institute of Mental Health/Woodbridge Hospital (IMH/WH) is the only tertiary mental health centre in

Singapore. It is located in the sprawling 25-hectare campus of Buangkok Green Medical Park in Buangkok View. IMH was the first mental health institution in Asia to receive the Joint Commission International (JCI) Accreditation in 2005, followed by re-accreditation in 2008. It plays a leading role in shaping and supporting the Ministry of Health’s strategic vision for the development of quality patient-centric and affordable mental health services for all Singaporeans. A multi-faceted and comprehensive range of psychiatric, rehabilitative and counselling service is offered to meet the needs of three groups of patients – children and adolescents, adults, and the elderly.

IMH has a total bed complement of 2,010 and serves about 36,000 patients via its outpatient clinics yearly.

Its modern facilities include 51 wards for inpatients, six Specialist Outpatient Clinics for outpatients (including satellite clinics), and three Day Centres. Aside from services for the mentally ill, IMH also runs mental health education programmes for the public. These programmes aim to promote mental wellness and raise awareness of the importance and benefits of prevention, early detection and treatment of mental disorders. Within corporate settings, our Corporate Consulting Services unit supports corporations in their efforts to ensure the mental well-being of their workforce. IMH has also established a significant reputation for quality psychiatric research, as exemplified by its $25 million research grant from the Ministry of Health in 2008 to implement translational and clinical research into the causes of schizophrenia and related psychotic disorders. IMH currently plays lead roles in two national healthcare initiatives, namely, the National Mental Health Blueprint and the National Addiction Management Service. The National Mental Health Blueprint aims to transform the mental healthcare delivery system into a more balanced system, incorporating both institution-based and community-based models of care. The National Addiction Management Service encompasses the provision of high quality care that is evidence-based and appropriate for the local population, and education of the public on addiction prevention and treatment. national skin Centre (nsC)

The National Skin Centre (NSC) moved to its present premises in Mandalay Road in 1988. Here it operates as an outpatient specialist dermatological clinic with consultant dermatologists who have the experience and expertise to treat complex skin diseases in both their private and subsidised clinics. NSC is accredited by the Joint Commission International (JCI)

in recognition of its world-class patient care and comprehensive range of high quality holistic healthcare services. NSC is the first ambulatory care unit being surveyed in Singapore and possibly South East Asia. As a tertiary healthcare institution, NSC provides specialised dermatological services, trains medical students and postgraduates, and undertakes research in dermatology. It aims to be the national and regional referral centre for treatment of complex skin diseases. It is already recognised as a dermatological training centre for local and foreign skin specialists and paramedical personnel with its active educational programmes for undergraduates, postgraduates, professionals and the public.

nhG PolyclinicsNHG Polyclinics (NHGP) forms the primary healthcare arm of NHG. Its nine polyclinics serve a significant proportion of the population spread over northern and western Singapore.

The focus of NHG Polyclinics’ care is on disease prevention, early and accurate diagnosis, disease management, health promotion, and continued care for patients after their discharge from hospitals. NHG Polyclinics works actively with NHG hospitals and institutions to develop integrated and seamless healthcare services for patients, as typified by the Direct Access Scheme, which has since served as the model for a similar healthcare network, developed with NHG’s GP Partners. NHG Polyclinics provides a comprehensive range of health services for the family, including treatment for acute medical conditions, chronic diseases, dental care and selected specialists services. Its clinics are one-stop family health centres, equipped with high-quality support facilities such as laboratories which provide X-ray services, mammography and ultra sonograms and pharmacies which carry a wide range of drugs and non-medical items. John hopkins singapore international Medical Centre

The Johns Hopkins Singapore International Medical Centre (JHSIMC) was established as a geographical alternative to the Johns Hopkins Hospital in the USA. Its healthcare team works together to meet each and every patient’s physical,

psychological and emotional needs, hence providing high standards of oncology services and care to its local and foreign patients. JHSIMC was first opened in 2000 as a specialized oncology medical centre within the National University Hospital. It moved to its new and bigger premises at Tan Tock Seng Hospital in May 2005. With the increase in space, it has been able to expand the number of chemotherapy treatment beds from 10 to 12 and the number of inpatient beds from 18 to 30. JHSIMC treats a wide range of cancers that include but are not limited to breast, ovarian, uterine, cervical, lung, throat, nasopharynx, stomach, liver, kidney, colon, prostate, multiple myeloma and lymphoma. Our services include inpatient care in a private oncology ward, outpatient consultations and chemotherapy, internal medicine consultations/executive health screenings, as well as providing second opinions on complex medical conditions, treatment of cancers unique to Asians, and consultations with referring physicians for specialty services.

In addition, the International Patient Liaison Office at JHSIMC offers personalized services – such as interpretation, appointment co-ordination, travel arrangements and concierge services, etc – for international patients. In August 2004, the IMC achieved a monumental milestone in becoming the first private hospital in Singapore to be awarded the JCI Accreditation with outstanding overall performance. Moving forward, the IMC aims to continually improve itself so as to fulfill its commitment in providing the highest quality healthcare standards to the local and international community.

About Our Institutions

35 | About Our Institutions About Our Institutions | 36

nhG CollegeNHG College was officially established on 19 July 2002. Our mission is to support the continuing efforts in the education and development of healthcare professionals and provide an intellectually stimulating environment for learning. This is so as to improve the quality of care in our healthcare institutions and add years of healthy life for our patients. Over the years, while building up expertise and capabilities in clinical training, new focus areas including healthcare quality and intermediate and long term care have been introduced. To better reflect and support these key areas for healthcare transformation, NHG College has been structured into five institutes, namely the Institute of Healthcare Leadership (IHL), Institute of Healthcare Quality (IHQ), Institute of Clinical Education (ICE), Institute of Healthcare Workskills (IWS) and Institute of Intermediate and Long Term Care (IILTC). Moving beyond being a training provider, NHG College will be the centre for providing thought leadership in healthcare training, bridging local and regional healthcare knowledge networks, and driving a culture of excellence in healthcare leadership, quality and lifelong learning. nhG diagnostics (nhGd)Aligned with the NHG vision of “adding years of healthy life”, NHG Diagnostics (NHGD) aims to be the leading provider of diagnostic services by providing timely and accurate imaging and laboratory services. NHGD is committed to achieving excellence in quality with its framework driven by a set of quality principles that exists within an environment of continuous improvement and business excellence. NHGD has 12 static diagnostic centres, and a mobile fleet consisting of a Mammobus and a Mobile Clinic Bus. Laboratory and imaging services are available in all nine NHG Polyclinics and specialist centres for the convenience of residents in the heartlands. Services offered at NHGD include general X-ray examinations, mammography and ultrasound at selected centres. NHGD mammography centres, including the Mammobus, are accredited to provide mammography screening under BreastScreen Singapore (BSS). The Mobile Clinic is accredited to provide Pap smear screening under CervicalScreen Singapore (CSS). Both are the national breast and cervical cancer screening programme by the Health Promotion Board (HPB). NHGD centres at the nine NHG polyclinics, Buangkok Green Medical Park and St Luke’s Hospital are certified under ISO 9001 and SAC/SINGLAS standards, ISO 15189. In addition, NHGD joined efforts with NHG Polyclinics to attain the latter’s Joint International Commission (Ambulatory Care Standard) accreditation. energhy Since April 2008, NHG Diagnostics has taken over the operations Energhy Pte Ltd which has all its private local and international businesses parked under its wings. These consist of 13 service points and two mobile fleets, formed by 20-footer and 30-footer mobile X-ray containers. This is a fully owned subsidiary of the National Healthcare Group and as a full subsidiary, Energhy has the nimbleness and flexibility to cater to different business model depending on the clients’ operational needs, business plans and also

budget. With a full back up from NHG, the team is able to tap on valuable resource and expertise to ensure the delivery of quality service. Services available under Energhy Pte Ltd include providing radiology reporting services for a wide range of imaging modalities, professional management of radiology and clinical laboratory and providing consultative services in setting up full facility healthcare establishment. nhG eye institute The NHG Eye Institute was set up to meet the increasing demand for eye care services. By combining the clinical expertise and facilities across NHG institutions, it is able toachieve greater synergy and provide quality eye care to patients.

There are 10 sub-specialities within the ophthalmology services provided by NHG Eye Institute to adequately cover all aspects of the eye, its diseases and treatment. Among its services, NHG Eye Institute treats cataracts with modern methods with high rates of success. The Institute also places great emphasis on training and research to ensure a high standard of clinical care to patients. And it works with various organisations – such as the Singapore Eye Research Institute, the National University of Singapore and clinical research organisations – to undertake clinical research programmes of relevance to patients. nhG health for life At Health for Life (HFL), we strive to promote health and prevent diseases by providing a comprehensive suite of healthcare services to individuals. These services include personalised health screening packages and various vaccinations catering to individual needs. Since its inception in 2006, Health for Life has grown from strength to strength. To date, we have nine centres conveniently located within the heartlands to serve the public. In 2009 alone, more than 80,000 participants have benefited from our services. nhG 1-health The NHG 1-Health facility (an ambulatory surgical centre in the Ang Mo Kio heartland) was established for specialist consultations, endoscopy and day surgery. Linked back to Tan Tock Seng Hospital as the main supporting hospital for operational and clinical expertise, this ambulatory care centre will also be a test-bed for a new approach to integrated care between the community, restructured hospitals, and GPs. It will employ the following tools: a) Electronic linkage to GPs, allowing for online direct appointment bookings by GPs for specialist consultations. b) Direct access/appointment requests for endoscopy and day surgery. c) Integrated primary and outpatient specialist care. nhG Pharmacy The National Healthcare Group Pharmacy, a business unit of NHG, manages the pharmacy services and retail pharmacies at all NHG Polyclinics. Established in 2001, our mission is to make a difference in the care of our customers,

by supporting them to achieve the best results for their prescribed therapy and promote the safe and responsible use of medication. At the NHG Polyclinics, we work collaboratively with the physicians and other healthcare professionals to manage the patients with chronic illnesses. Among the pharmaceutical care services available are Smoking Cessation Clinics, pharmacist-led anti-coagulation clinics (ACC) and Hypertension-Diabetes-Lipidemia Clinic (HDL-C). Patients also regularly consult the pharmacists for treatment of their minor ailments. Visitors to our retail pharmacies have the convenience of obtaining their essential healthcare needs, products of which have been carefully selected by our merchandise team for their quality, efficacy and affordability. Customers can also make use of our home delivery services for both prescription and retail purchases. Besides the polyclinic patients, the pharmaceutical care we provide also extends to the voluntary welfare organizations like the nursing homes. We offer them total medication management solutions which include medication supply, weekly review of residents’ medication charts and medication use audits. In 2003, NHG Pharmacy pioneered the provision of medication supply to nursing homes in “ready-to-administer” calendar blister packs. This has helped to significantly improve the safety and the management of medications at the long-term care facilities using them. The supply and packing is done at a separate central location. To date, 17 nursing homes are using our services. NHG Pharmacy has been one of the Singapore PharmacyCouncil’s accredited pre-registration pharmacists’ trainingcentres since 2002. Primary Care academy Established in April 2007, the Primary Care Academy (PCA) was set up to meet the professional training needs of primary healthcare professionals in Singapore and the region. Its team of dedicated trainers and facilitators are senior healthcare practitioners with a wealth of experience in the delivery and management of community healthcare. As a leading primary care training provider, PCA reaches out to the public and corporate sector through its community-centered health promotion talks and workshops. Since its inception, PCA has conducted more than 550 public talks and 250 courses and workshops, which includes the ‘Patient Service Assistant’ course conducted for 138 trainees from the Health Management International (HMI) Institute of Health Sciences. In May 2008, PCA made its move towards establishing itself as a regional training centre by organising its first International Conference on Healthcare Transformation: Primary Care Focus. The three-day event was held in conjunction with the Singapore Disease Management Conference and well-received by healthcare leaders and practitioners from ASEAN and the region, who came to share pertinent issues in primary healthcare, forge networks and bridge gaps in the primary healthcare community. In March 2009, it also co-organised the 2nd Asian Primary Care Innovators Conference with the Taiwan Association of Family Physicians, which saw a total of about 250 delegates

and renowned speakers from Canada, Taiwan and Singapore. In October 2009, PCA held a two-day Forum titled “Person-Centred Care: Making It A Reality”, in conjunction with NHG’s Annual Scientific Congress. The Forum was graced by international speakers and saw an attendance of more than 350 local and foreign delegates. PCA also achieved the Training Organization accreditation and the Automated External Defibrillation (AED) Training Centre accreditation. These milestones are foundational as PCA moves closer to its vision to be an accredited regional training centre that is synonymous with quality primary care training singapore Footcare Centre SFC is one of the largest podiatry care providers in Singapore. As the leading foot care provider, we have a professional and qualified team of podiatrists and assistants. We provide a comprehensive and extensive range of foot care services to meet all your foot care needs. We are constantly keeping ourselves abreast with the latest technology to ensure that we are able to provide with the most exemplary foot care services, delivered with world class standards of excellence and quality to you.

37 | About Our Institutions About Our Institutions | 38

Above information is obtained from MOH Bulletin as at 31st March 2010, except Johns Hopkins

Statistics 09/10

Bed Complement by Hospital and Class of Bed as at 31 March 2010

216

Class B1

8422 24

Class A

No

. of

Bed

s

55 2

1,712536

Class CClass B2

176

No

. of

Bed

s

454 26 84

Class A Class B1 Class B2 Class C Classless FY 2009 FY 2008 Change Change

TTSH 55 216 454 536 127 1,388 1,255 133 11%

TTSH-CDC 2 4 26 84 189 305 305 0 0%

IMH 22 8 176 1,712 92 2,010 2,064 -54 -3%

Johns Hopkins

24 – – – – 24 24 0 0%

Total NHG 103 228 656 2,332 408 3,727 3,648 79 2%

Bed Occupancy Rate By Hospital

81% 62%

April 09 - June 09

86% 49% 65%

Jul 09 - Sep 09

85% 80%41%

81% 36%

Oct 09 - Dec 09

85% 52% 40%

Jan 10 - Mar 10

85% 82%46%

Above information is obtained from MOH Bulletin as at 31st March 2010, except Johns Hopkins

Apr 09 - Jun 09 Jul 09 - Sep 09 Oct 09 - Dec 09 Jan 10 - Mar 10

TTSH 86% 85% 85% 85%

TTSH-CDC 49% 41% 52% 46%

IMH 81% 80% 81% 82%

Johns Hopkins 62% 65% 36% 40%

No

. of

Bed

s

No

. of

Bed

s

127

Classless

92189

No

. of

Bed

s

39 | Statistics 09/10 Statistics 09/10 | 40

Above information is obtained from MOH Bulletin as at 31st March 2010, except Johns Hopkins

Apr 09 - Jun 09 Jul 09 - Sep 09 Oct 09 - Dec 09 Jan 10 - Mar 10 FY 2009 FY 2008 Change Change%

TTSH 96,829 97,813 100,820 102,115 397,577 381,928 15,649 4%

TTSH-CDC 7,384 5,754 6,552 4,367 24,057 39,509 (15,452) -39%

IMH 144,755 145,162 147,943 145,732 583,592 585,069 (1,477) 0%

Johns Hopkins

1,240 1,312 736 792 4,080 5,404 (1,324) -25%

Total NHG 250,208 250,041 256,051 253,006 1,009,306 1,011,910 (2,604) 0%

Trend in Inpatient Discharge

April 09 - June 09

No

. of

Inp

atie

nt

Dis

char

ges

Jul 09 - Sep 09

No

. of

Inp

atie

nt

Dis

char

ges

14,550

Oct 09 - Dec 09

No

. of

Inp

atie

nt

Dis

char

ges

14,818

Jan 10 - Mar 10

14,718 444

No

. of

Inp

atie

nt

Dis

char

ges

2,260 150 133

2,329541 98 1322,346

Above information is obtained from MOH Bulletin as at 31st March 2010, except Johns Hopkins

Apr 09 - Jun 09 Jul 09 - Sep 09 Oct 09 - Dec 09 Jan 10 - Mar 10 FY 2009 FY 2008 Change Change%

TTSH 14,179 14,550 14,818 14,718 58,265 53,909 4,356 8%

TTSH-CDC 1,476 900 541 444 3,361 3,645 (284) -8%

IMH 2,260 2,178 2,329 2,346 9,113 9,002 111 1%

Johns Hopkins

150 133 98 132 513 481 32 7%

Total NHG 18,065 17,761 17,786 17,640 71,252 67,037 4,215 6%

Trend in Inpatient Day

April 09 - June 09

No

. of

Inp

atie

nt

Day

s

96,829 7,384

Jul 09 - Sep 09

No

. of

Inp

atie

nt

Day

s

97,813 145,162

Oct 09 - Dec 09

No

. of

Inp

atie

nt

Day

s

100,820

Jan 10 - Mar 10

102,115

No

. of

Inp

atie

nt

Day

s

1,3121,240 5,754

6,552 736 792145,7324,367

144,755

147,943

1,47614,179 2,178900

41 | Statistics 09/10 Statistics 09/10 | 42

Average Length of Stay by Hospital and Class of Bed

12.5

Class A

No

. of

Day

s

5.3 9.73.4

Class B1

No

. of

Day

s

5.4 15.54.5

Class B2

No

. of

Day

s

6.0 14.55.1

Class C

No

. of

Day

s

112.412.87.4

Above information is obtained from MOH Bulletin as at 31st March 2010, average of 4 quarters, except Johns Hopkins.

Class A Class B1 Class B2 Class C

TTSH 5.3 5.4 6.0 7.4

TTSH-CDC 3.4 4.5 5.1 12.8

IMH 9.7 15.5 14.5 112.4

Johns Hopkins 12.5 – – –

Trend in Day Surgery

Above information is obtained from MOH Bulletin as at 31st March 2010.

Apr 09 - Jun 09 Jul 09 - Sep 09 Oct 09 - Dec 09 Jan 10 - Mar 10 FY 2009 FY 2008 Change Change%

TTSH 11,767 12,309 11,622 11,631 47,329 43,526 3,803 9%

Total NHG 11,767 12,309 11,622 11,631 47,329 43,526 3,803 9%

No

. of

Day

Su

rger

ies

Per

form

ed

11,767 12,309 11,622 11,631

April 09 - June 09 Jul 09 - Sep 09 Oct - Dec 09 Jan 10 - Mar 10

43 | Statistics 09/10 Statistics 09/10 | 44

Above information is obtained from MOH Bulletin as at 31st March 2010, except Johns Hopkins

Apr 09 - Jun 09 Jul 09 - Sep 09 Oct 09 - Dec 09 Jan 10 - Mar 10 FY 2009 FY 2008 Change Change%

TTSH 139,296 144,161 141,442 143,803 568,702 550,741 17,961 3%

TTSH-CDC 8,386 8,286 7,914 7,827 32,413 33,554 (1,141) -3%

IMH 41,691 42,554 40,853 39,144 164,242 169,101 (4,859) -3%

NSC 75,218 78,516 73,010 76,569 303,313 297,535 5,778 2%

Johns Hopkins

1,681 1,884 1,668 1,807 7,040 6,636 404 6%

Total NHG 266,272 275,401 264,887 269,150 1,075,710 1,057,567 18,143 2%

Trend in SOC Attendance

No

. of

Att

end

ance

s

41,691

Apr 09 - Jun 09

139,296 75,218 1,6818,386

No

. of

Att

end

ance

s

42,554

Jul 09 - Sep 09

144,161 78,516 1,8848,286

No

. of

Att

end

ance

s

40,853

Oct 09 - Dec 09

141,442 73,010 1,6687,914

No

. of

Att

end

ance

s

39,144

Jan 10 - Mar 10

143,803 76,569 1,8077,827

Trend in A&E Attendance

Above information is obtained from MOH Bulletin as at 31st March 2010.

Apr 09 - Jun 09 Jul 09 - Sep 09 Oct 09 - Dec 09 Jan 10 - Mar 10 FY 2009 FY 2008 Change Change%

TTSH 43,742 45,239 41,459 42,022 172,462 162,162 10,300 6%

Total NHG 43,742 45,239 41,459 42,022 172,462 162,162 10,300 6%

No

. of

Att

end

ance

s

43,742 45,239 41,459 42,022

April 09 - June 09 Jul 09 - Sep 09 Oct - Dec 09 Jan 10 - Mar 10

45 | Statistics 09/10 Statistics 09/10 | 46

Above information is obtained from MOH Bulletin as at 31st March 2010, except Johns Hopkins

Apr 09 - Jun 09 Jul 09 - Sep 09 Oct 09 - Dec 09 Jan 10 - Mar 10 FY 2009 FY 2008 Change Change%

Acute 214,695 251,114 217,334 228,630 911,773 837,509 74,264 9%

Chronic 235,029 234,738 241,952 238,031 949,750 955,752 (6,002) -1%

Non- Morbid 164,045 172,814 195,169 178,636 710,664 633,378 77,286 12%

Total NHG 613,769 658,666 654,455 645,297 2,572,187 2,426,639 145,548 6%

Trend in Polyclinics Attendance

Apr 09 - Jun 09

No

. of

Att

end

ance

s

235,029214,695 164,045

Jul 09 - Sep 09N

o. o

f A

tten

dan

ces

234,738251,114 172,814

Oct 09 - Dec 09

No

. of

Att

end

ance

s

241,952217,334 195,169

Jan 10 - Mar 10

No

. of

Att

end

ance

s

238,031228,630 178,636

FY 2009 FY 2008

Doctors 718 958

Nurses 3,729 3,526

Allied Health 1,397 1,238

Ancillary 2,299 2,231

Administration 1,132 1,035

Total 9,275 8,988

Distribution of Staff as at 31 March 2010

Doctors

8%

Adminstration

12%

Ancillary

25%

Nurses

40%

Allied Health

15%

47 | Statistics 09/10 Statistics 09/10 | 48

FY 2009 FY 2008

S$’M S$’M

ASSETS BY MAJOR CATEGORIES

Properties, Plant and Equipment 274 221

Trade and Other Receivables 162 190

Cash and Cash Equivalents 705 573

Other Assets 84 116

TOTAL 1,225 1,100

LIABILITIES BY MAJOR CATEGORIES

Trade and Other Payables 594 507

Other Liabilities 102 69

TOTAL 696 576

CAPITAL AND RESERVES BY MAJOR CATEGORIES

Share Capital 217 217

Reserves and Retained Surplus 312 312

TOTAL 529 524

REVENUE BY MAJOR CATEGORIES

Patient and Patient Related Revenue

442 407

Government Subvention 596 539

Other Revenue 159 169

TOTAL 1,197 1,115

EXPENDITURE BY MAJOR CATEGORIES

Manpower Costs 671 614

Supplies and Consumables 179 159

Depreciation and Amortisation 60 54

Other Operating Expenses 281 276

TOTAL 1,191 1,103

Key Financial Information

49 | Statistics 09/10 Statistics 09/10 | 50

At NHG, we are committed to keeping costs down,

and in 2009, our Group Purchasing Office

succeeded in achieving savings worth S$9.8 million

for the hospitals participating through NHG.

This monumental effort was accomplished through

volume aggregation and product standardisation.

Caring it Forward | 52

“I was morbidly obese at 80kg on my 1.5m frame. I didn’t want this to lead to serious health issues so I decided to find an effective weight management regime. aI am Caring it Forward by motivating others to adopt a healthy lifestyle and educating them on good health practices. “ Dee Dee promotes health awareness through seminars and workshops where she hopes to motivate and inspire others to adopt healthy lifestyles. She also conducts fitness classes and is featured regularly in mainstream media as a health consultant You don’t have to be a fitness guru to help your family and friends get healthier. Start today by encouraging them to go for a walk after dinner instead of sitting in front of the TV. Walking briskly just three times a week for 30 minutes does wonders for the heart and lungs.

MS DEE DEE MAHMOOD, Exercise physiologist, nutritionist and television presenter

51 | Caring it Forward

“I have written a number of books to chronicle my journey with schizophrenia. These books have since been translated into Mandarin, Malay and Korean. When people tell me how my books have inspired them, I feel comforted that I have helped them in some way. “ Harris improved after taking long-term medication for schizophrenia so he decided to be a champion for mental health. Besides his writing, he has also given talks at nursing seminars, conducted school visits at IMH and run support group sessions to reassure others that they are not alone in battling schizophrenia. Signs of depression include constant irritability, anxiety and social withdrawal. If you see a family member or friend displaying these symptoms, gently suggest to him or her that he/she should seek help from a counsellor or psychiatrist.

MR HARRIS NG, Author and Volunteer at IMH

The National Healthcare Group turned 10 this year. Together with our institutions, NHG has enjoyed a rich legacy of more than 340 years of caring for our community. We celebrate this milestone in our 2009-2010 Annual Report – by showcasing the gifts of care from our colleagues to our patients and caregivers. These patients and caregivers in turn share the good health practices with their families and friends. By Caring it Forward, we strive to build a community of empowered individuals, capable of taking charge of their own well-being as well as those around them. Every patient we nurture back to health is a testimony of how care and compassion can transform lives. This is what they in turn share with family, friends and our community.

Meet two Caring it Forward Ambassadors who have made a difference with

their special brand of care. We hope that by reading their stories, you too will be

inspired to do the same for your family and friends

As we take stock of what we have achieved over the

last decade, it is even more important to ensure that

we move forward in the right direction so that NHG

can remain a relevant pillar of healthcare in Singapore

and the region.

www.nhg.com.sg