Alexandra Hospital provides patients with one-stop services under new care model

Mr Max Lim, 28, Senior Occupational Therapist, trains Mr Cheng Yam Kwang, 66, to perform daily activities in a simulated home environment at Rehabilitation Centre of Alexandra Hospital on Dec 14, 2018.
Mr Max Lim, 28, Senior Occupational Therapist, trains Mr Cheng Yam Kwang, 66, to perform daily activities in a simulated home environment at Rehabilitation Centre of Alexandra Hospital on Dec 14, 2018.ST PHOTO: LIM YAOHUI
At Alexandra Hospital, patients are cared for by the same team, led by a principal doctor, throughout their admission, treatment, rehabilitation and discharge.
At Alexandra Hospital, patients are cared for by the same team, led by a principal doctor, throughout their admission, treatment, rehabilitation and discharge.ST PHOTO: LIM YAOHUI

SINGAPORE -  Patients who get admitted to Alexandra Hospital will be under the care of the same healthcare team from admission to discharge, under a new model of care being piloted in Singapore for the first time.

Called the integrated general hospital model, it aims to better meet the needs of a growing group of elderly patients, many of whom have multiple medical conditions, announced Alexandra Hospital and the Ministry of Health’s Office for Healthcare Transformation (MOHT) on Friday (Dec 14).

If successful, the model could be implemented at other hospitals in the future.

Since June this year, 2,500 patients have experienced the new model, which integrates acute, sub-acute, rehabilitative, and community care.

It is the result of a collaboration between Alexandra Hospital, which is part of the National University Health System (NUHS), MOHT and Queenstown residents.

Queenstown has one of the highest concentrations of elderly people in the western part of Singapore – 19 per cent of its nearly 100,000 residents are aged 65 and above.

At Alexandra Hospital, patient are cared for by the same team led by a principal doctor, throughout their admission, treatment, rehabilitation and discharge.

The rest of the team is made up of nurses, pharmacists, therapists, dietitians, medical social workers, care managers and administrators.

 
 
 

“We hear this a lot from our patients – there’s quite a bit of camaraderie and trust is strengthened,” said Associate Professor Jason Phua, the hospital’s chief executive.

Caring for the patient has also become more proactive, as the team meets twice a week to discuss how best to care for the patient, instead of waiting for one another’s reports.

The principal doctor also consolidates care plans for those with multiple chronic conditions and coordinates patients’ specialist outpatient appointments into one appointment.

Patients are rehabilitated at the acute hospital instead of the community hospital, and do not need to be transferred between these hospitals. The plan is for acute and rehabilitative care to eventually take place in the very same ward even.

Over time, it is hoped that more patients who require acute hospital care but not complex tertiary specialist treatment can be managed through the integrated general hospital model.

“The lessons we are getting from Alexandra Hospital – we are bringing them back to the National University Hospital (NUH) and Ng Teng Fong General Hospital,” said Professor John Eu-Li Wong, chief executive of NUHS.

He added that Ng Teng Fong General Hospital and Jurong Community Hospital could be managed next time as one integrated hospital, while NUH – which is scheduled to be rebuilt – will also take into account the lessons from Alexandra Hospital.

Professor Tan Chorh Chuan, MOHT’s executive director, said that even with the new integrated general hospital model, the current system of acute and community hospitals is still needed.

“Hospital bed demand is still rising and the current system of acute and community hospitals is serving a current need because without it, we’re going to have very congested acute hospitals and possibly, people may not get the rehabilitation we have that they need,” he added.

And with acute and community hospitals increasingly located next to each other, it provides options for the integrated general hospital model to be implemented in the future.

MOHT was set up in January this year to address fundamental and longer-term issues critical for healthcare transformation.

Besides this project, the office is also developing ways to make care more patient-centric and optimise the use of Internet Technology (IT).

As part of the integrated general hospital model, Alexandra Hospital is also testing out an app that makes it faster for nurses to write reports, as well as redesigning two wards by the middle of next year to feature technology such as robotics and artificial intelligence.