KTPH’s geriatric ward coordinates care, support to get patients discharged earlier

SINGAPORE – Medical centres often face a dilemma when caring for elderly patients: Discharging them too early may endanger their recovery, while prolonged hospitalisation can lead to a loss of independence.

Hospitals tend to take the latter choice, opting to err on the side of caution. However, Khoo Teck Puat Hospital (KTPH) has reorganised its systems so that patients who can be safely discharged earlier are placed in a dedicated ward instead.

Known as the Geriatric Short Stay Ward (GSSW), it allows patients to be evaluated as soon as possible after admission – such as when they are still in the emergency department (ED) – rather than only after being transferred to a ward.

The hospital has also digitalised the evaluation process, making it easier for caregivers to give their input.

The medical care team, the patient and the caregivers set goals early to determine an anticipated discharge timing. This gives the caregivers, who are often working adults, more time to plan and prepare for the discharge. Under the conventional system, caregivers were often informed only on the eve or day of discharge.

The ward places strong emphasis on coordinated care, with doctors and nurses holding daily multidisciplinary “team huddles” to stay updated on patients’ needs across areas ranging from physiotherapy to independence levels.

It also coordinates community services and support for caregivers early to prepare them for the discharge.

According to a study conducted by KTPH from December 2022 to December 2024, patients in the GSSW recorded a 28 per cent reduction in their length of stay compared with those in conventional care, with the average length of stay falling from 7.3 days to 5.4 days. This correlated with a 25 per cent reduction in hospitalisation costs, from $6,557 to $5,051.

The GSSW also reported a lower mortality rate while maintaining a readmission rate comparable with that of conventional care.

Patients admitted to geriatric wards are typically 78 years old and above. Those suited for short stays in the GSSW have normal circulatory function and steady blood pressure, are not in critical condition, and are likely to recover well after treatment. They constitute about 10 per cent of the elderly patients admitted from the ED.

Since its pilot in December 2022, the GSSW has cared for more than 1,800 patients. It expanded in January 2025 to a full 16-bed ward operated by KTPH within Yishun Community Hospital.

Dr Rachel Cheong, a senior consultant geriatrician and programme lead for the GSSW, said: “Older adults often tell us they want to get well and go home as soon as possible.

“With the right approach, we’ve demonstrated that even frail elderly patients can benefit from a shorter hospital stay when their needs are understood early and addressed as a team. It’s about delivering care that is both efficient and deeply respectful of the vulnerabilities of ageing.”

Mr Chua Meng Chong, 90, has been a regular patient at KTPH due to conditions such as hypertension, diabetes and recurrent gout.

Mr Chua said he has been admitted about 10 times, most recently to the GSSW before being transferred to Yishun Community Hospital. He found the discharge process “very fast”, unlike his previous experiences.

Dr Calvin Loh, a senior resident physician at KTPH who attended to Mr Chua during his hospitalisation, said that during a previous admission, he stayed for about 10 days.

“We managed to shorten it to half of that,” he added.

Dr Cheong said that KTPH plans to expand the ward, but is still assessing the needs of its patients.