ISSUE
coming together as one
SHOWCASE
ILTC Night 2016 PAGE 6
National Seminar on Productivity in Healthcare 2016 PAGE 8
SPOTLIGHT
A Day In the Life of ... PAGE 4
27 REFLECTIONS Compassion and Care: Venerable Sik Kwang Sheng PAGE 10
AND MORE
JAN 2017
A Publication for Community Care Partners by the Agency for Integrated Care
EDITOR’S NOTE
2
January 2017
WELCOME TO mosAIC... Happy 2017! In this new year, we bring you another issue packed with exciting news for the Community Care sector. In Bulletin, join us in congratulating exemplary staff from 23 outstanding Community Care organisations who were honoured at the ILTC Excellence Awards 2016, organised by AIC. In the ever-popular section, Spotlight, find out what drives two young talents – Staff Nurses Andrea Hia from Yong-en Care Centre and Mirza Abdul Halim from Dover Park Hospice – to do their best for their clients. Then, relive the highlights of 2016’s ILTC Night and the National Seminar on Productivity in Healthcare in our specially upsized Showcase section. No matter what your role is in the sector, care and compassion are qualities that bind us together. In Reflections, Venerable Sik Kwang Sheng, Abbot, Kong Meng San Phor Kark See Monastery and Chairman, Bright Hill Evergreen Home, shares some wisdom from his experiences and approaches that can help us all age better. Do consider incorporating these approaches and the 10 tips offered in Improvements into your new year’s resolutions. In Newsbytes, we share the many accolades received by Community Care staff in the second half of 2016 – a testament to their dedication in advancing care. Beyond these individual efforts, greater strides have also been made to co-create a shared vision for the sector’s enhanced quality of care. Find out more about the “House of Quality” framework which was discussed at the Quality Retreat and how you too may contribute to it.
About Agency for Integrated Care (AIC)
AIC seeks to create a vibrant Care Community enabling people to live well and age gracefully. AIC coordinates and facilitates efforts in care integration to achieve the best care outcomes for our clients. We do this by empowering them with health and social care information and arranging for their care when they are discharged from hospitals. We enable stakeholders to raise the quality of care, and also enhance collaboration by working with health and social care partners to increase services to support the ageing population. Our work in the community brings care services and information closer to those in need. For more information, visit http://www.aic.sg.
About mosAIC
mosAIC shares happenings within AIC and in the Community Care sector. For more information, visit http://www.aic.sg/mosaic.
Publisher
Designer
Editorial Team
Printer
Agency for Integrated Care Lynda Soong, Chief Editor Charmaine Tan, Second Editor Thiru Gunasegaran
Cubiz Pte Ltd Spectrum Zone International Pte Ltd
MCI (P) 160/03/2016
For updates on good practices, go to Sector’s Sharing and read about two award-winning projects in skin care and exercise. In other pages, read about initiatives to better support caregivers, persons living with mental health conditions, and the general public so as to enable everyone to live well and age gracefully in our community.
mosAIC is a publication by the Agency for Integrated Care (AIC). The views and opinions expressed or implied in mosAIC do not necessarily reflect those of AIC, its directors or editorial staff. All information is correct at time of printing. Articles may only be reproduced with AIC’s permission.
Is your organisation already using the National ILTC IT Enablement Programme (NI-IELP)? Discover some of the benefits of the recently launched medication management module. For other innovative practices, get tips on how to start a Community Café for people living with dementia in Regular Reads.
For editorial queries, feedback and subscription*, please email
[email protected].
Thank you for the valuable comments you shared with us during the last feedback exercise. Do keep a look out for some exciting changes which we will be bringing to you progressively in future issues. Happy working!
Lynda Soong
Lynda Soong Chief Editor
[email protected]
mosAIC is the recipient of four APEX Awards for Publication Excellence – “Print Newsletter” category (2015 & 2016), “Most Improved Newsletter” category (2014) and “Newsletter – Electronic and Web” category (2013).
*FREE subscription for Health and Social Care Staff! Scan mosAIC’s Quick Response (QR) code with your smart devices to easily access online content (flipzine, photo/video gallery and additional journal articles).
This new cover series illustrates that through the joining of hands, supportive environments can be fostered to enable seniors to live well and age gracefully.
In support of a sustainable planet, this publication is printed on environmentally friendly paper.
BULLETIN
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HONOURING EXEMPLARY STAFF: ILTC EXCELLENCE AWARDS 2016 What does receiving an ILTC Excellence Award mean to you? “This award is a combined effort of many unsung heroes who go beyond their call of duty every day. This is a sector where we can constantly push frontiers to improve the quality of care. We can only do this if we have the heart for our patients.” – Benjamin Lim Wei Ming, Senior Occupational Therapist, Kwong Wai Shiu Hospital, Service Quality – Gold award recipient.
2016’s ILTC Excellence Awards recipients together with Dr Amy Khor (in striped dress), Senior Minister of State, Ministry of the Environment and Water Resources and Ministry of Health, and Dr Jennifer Lee (in orange top), Chairman, AIC.
On 28 September 2016, 320 Community Care staff came together for the much-awaited ILTC Excellence Awards. The AIC-organised biennial event, solely dedicated to the Community Care sector, recognises staffs’ exemplary efforts in delivering quality care and services. The Awards are given to outstanding individuals who have shown service excellence and given valuable suggestions which have improved care in their organisations. It also acknowledges exceptional quality improvement initiatives that have been implemented. During her speech, Guest of Honour Dr Amy Khor, Senior Minister of State, Ministry of the Environment and Water Resources and Ministry of Health, said, “By 2030, we will have over 900,000 seniors aged 65 and over. We need to ensure that existing and new services are delivered with a high quality of care… I hope recipients will continue your good work and inspire others to do the same. I also want to encourage organisations to continue to build cultures of excellence and continuously improve.” A total of 209 awards (175 Individual Awards and 34 Team Awards) were given to 23 winning organisations. Our heartiest congratulations to: • All Saints Home • Ang Mo Kio – Thye Hua Kwan Hospital • Bright Vision Hospital • Dover Park Hospice • ECON Healthcare Group • HCA Hospice Care • Jurong Community Hospital • Kwong Wai Shiu Hospital • Ling Kwang Home for Senior Citizens • National Kidney Foundation • Orange Valley Nursing Homes • Ren Ci Hospital
• Society for the Aged Sick • The Salvation Army Peacehaven Nursing Home • Society for the Physically Disabled • Singapore Cancer Society • Sree Narayana Mission Home for the Aged Sick • St. Andrew’s Community Hospital • St. Andrew’s Nursing Home • St Luke’s ElderCare • St Luke’s Hospital • TOUCH Community Services • Villa Francis Home for the Aged
“It is satisfying working in the Community Care sector as it provides opportunities for us to provide holistic care for patients, [so they can] achieve their best premorbid status and reintegrate back into the community.” – The team from St. Andrew’s Community Hospital. Project: “Preventing Medication Omission Error in a Community Hospital”, Clinical Quality Improvement – Team award recipient. The project has ensured that there have been no medication omission cases since January 2015. Fast Facts • The first ILTC Excellence Awards was held in 2014. • There are two award categories: Individual (Service Quality [Gold and Silver], Good Suggestion) and Team (Areas: Clinical Quality Improvement, Service Quality Improvement, and Productivity and Innovation). • Nominations were assessed by an evaluation panel comprising 15 members from the Community Care sector and AIC.
FOR MORE INFORMATION!
Contact the ILTC Excellence Awards secretariat at
[email protected].
More photos at: http://www.aic.sg/mosaic/gallery/jan17
SPOTLIGHT
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January 2017
A DAY IN THE LIFE OF ... In this section, we catch up with Community Care staff – Andrea Hia, Staff Nurse, Yong-en Care Centre (Yong-en) and Mirza Abdul Halim, Staff Nurse, Dover Park Hospice (DPH) – to find out more about their work. Working with Andrea is a breeze because she works from her heart! It is always energising to see such passion in a young nurse. She has been such an inspiration to the people around her. – Gerald Tan, Manager, Elderly Services, Yong-en
Andrea shows genuine care and concern and looks after us very well. She treats us equally and is kind and helpful. She shows great patience, listening to our needs and doing her best to meet them in any way she can. – Mdm L, a Yong-en Client
12.00pm Lunch is served! It can be a challenge to balance paperwork and contact time with clients but somehow, we find a way. Afternoons are spent making referrals and completing nursing reports. We also conduct orientation for new clients and volunteers and trial sessions for those who may wish to attend dementia day care with us. I need to constantly multitask but this means that work is never mundane.
Activities like role-playing in skits help clients hone their independent living skills such as ordering drinks in a coffee shop. (Photo credit: Yong-en Care Centre)
8.00am This job keeps me continuously on the go so the day begins with hydration – a cup of tea. As a nurse in our Dementia Day Care Centre, I look into care aspects that bring about physical, mental, and social wellbeing for my clients. Mornings are spent coordinating care plans with their families and other healthcare professionals; administering medication; checking vital signs; and planning activities.
At Yong-en, we conduct a wide range of activities. In the afternoon, clients may be involved in reminiscence sessions, “food bingo”, karaoke, and pet-related activities. Spending time getting to know clients is integral to providing good care. This is especially important for clients with a dementia diagnosis as they may have difficulty verbalising their needs. There is such a fine line between a client feeling unwell and needing medical attention so being familiar with their personality and range of behaviours helps determine if they require medical attention. I am particularly heartened when my clients recognise and remember me enough to seek help. Seeing them at ease and feeling cheerful after I have assisted them makes my day.
3.00pm During interactions with clients, they constantly surprise us with their wit and
Name: Andrea Hia Organisation: Yong-en Care Centre Designation: Staff Nurse Years in Service: 1.5 (Photo credit: Yong-en Care Centre)
puns. This keeps work interesting as I am always learning new things. Once, during a game forfeit, we cued the favourite song of a client, passed him a ukulele and he started to sing and dance! His spirit was so ignited that he forgot that his legs are weak; he performed the whole song! This episode taught me the importance of knowing what clients like and facilitating their independence so they can express themselves freely and meaningfully.
5.00pm It is a good day when activities have been well planned and clients feel safe, engaged, and happy. My days can be long but my family knows that I enjoy my work. My experiences have also been helpful now that my grandmother has been diagnosed with Alzheimer’s disease. If you are considering working in this field, I would say, take this leap of faith and step out of your comfort zone. It also helps if you have patience, critical thinking, and a sense of humour. Although being a nurse in dementia care is not easy, my clients never fail to leave a smile on my face.
http://www.aic.sg/mosaic
Mirza attending to one of his patients during mealtime. (Photo credit: Dover Park Hospice)
6.30AM At DPH, we have three rotating shifts and practise a team-based nursing approach. My team comprises a Registered Nurse (RN), an Enrolled Nurse, and Nursing Aides. As the RN, I manage patients’ pain and symptoms; conduct spiritual, emotional, and psychosocial baseline assessments; manage controlled drugs; review care plans; work with our multidisciplinary team to manage patients holistically; and implement interventions to provide comfort care. Shifts can be physically demanding, so I always ensure I exercise regularly and rest adequately. During morning duties, after a team handover, we prepare and administer medication; follow up on issues; and receive new admissions. We always have to think on our feet in palliative care. As our clients are terminally ill, they may deteriorate or have multiple symptoms all at once. We must then assess and reassess their condition to intervene promptly and appropriately.
11.00am When I first started, I was an “energizer bunny”, moving quickly through my tasks. These days, I move as quickly, but choose to spend more time interacting with patients. In the early afternoon, we administer medication, assist with mealtimes, and catch up with patients and their families. Communicating with a patient’s family requires a lot of tact. During this difficult period, watching a loved one’s condition
worsen can upset and sometimes make them request unsuitable or unrealistic interventions. Thankfully, training and experience have enabled me to better manage these situations.
1.00pm I am grateful for my accidental introduction to this sector. Assigned as an agency nurse to DPH, I saw the hospice’s commitment to its patients and felt it would be meaningful to assist people in this phase of their lives. My patients are a source of wisdom. I remember a well-educated elderly patient who disliked inarticulate people. Usually, such patients would speak to a senior nurse or doctor for the smallest of things. Somehow, he chose to ask me about his treatments. This experience made me realise the importance of knowledge and self-confidence in earning the trust of patients and their families.
2.30pm Before leaving, I finish all my tasks so that my colleagues in the next shift do not need to complete them and can focus on providing direct care to patients. A great day involves spending time with alert patients, even if they are not able to communicate. Whenever appropriate, I also crack jokes to lighten the mood. The healthcare sector needs to be more aware that palliative care has more applications beyond caring for a dying person. I hope it will be better integrated into all aspects of care in the future.
5
Name: Mirza Abdul Halim Organisation: Dover Park Hospice Designation: Staff Nurse Awards Received: SHMDP-ILTC* 2016 recipient (Specialist Diploma in Palliative Nursing Care, Ngee Ann Polytechnic) Years in Service: 5 (Photo credit: Dover Park Hospice)
*Social & Health Manpower Development Programme – Intermediate and Long-Term Care.
Mirza is gentle and very patient when caring for his patients. He also demonstrates a good understanding of patients with end-of-life care issues and their family members who may be experiencing anticipatory loss, grief, and bereavement. – Chin Soh Mun, Head of Nursing Services, DPH Mirza is very patient and takes good care of his patients. He has been able to coax my husband to eat when he refuses. – Tang Ah Muay, wife of Lim Pa Tang (Mr Lim is a DPH patient)
More photos at: http://www.aic.sg/mosaic/gallery/jan17
SHOWCASE
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January 2017
“YESTERDAY, TODAY, TOMORROW”: ILTC NIGHT 2016 ILTC Night Talent Competition In February 2016, 16 contestants (competing in the solo and group categories), took part in auditions as a lead-up to the ILTC Night Talent Competition. mosAIC caught up with the eight finalists to find out about their experiences being part of the talent segment. Solo category
1st
Prize
Community Care partners, as well as MOH and AIC staff, came together for an evening to remember during ILTC Night 2016.
Beverly Bautista (Ling Kwang Home for Senior Citizens) She sang a mash-up of “Go The Distance” and “Home”.
On 16 September 2016, some 1,400 staff from the Community Care sector came together and bonded over the theme, “Yesterday, Today, Tomorrow”. Held at Raffles City Convention Centre, it was the evening of ILTC Night, the much-awaited signature event organised by AIC. Held biennially and known affectionately as the entire sector’s “Dinner and Dance”, it was a time of coming together to celebrate the sector’s achievements.
“It’s overwhelming! I feel really blessed and thankful that I can share this talent with others. I [have] practised more [with] every competition as I know that the other participants are getting better. I also usually pray before I go onstage. Taking part in ILTC Night is an experience that I will hold in my memory and a story that I will share with my loved ones.”
Graced for the first time by three senior leaders from the Ministry of Health (MOH) – Senior Minister of State, Dr Amy Khor, Ministry of the Environment and Water Resources and MOH; Ministers of State, Dr Lam Pin Min, MOH and Chee Hong Tat, Ministry of Communications and Information and MOH – it was an evening of great camaraderie, good food, and fun. One of the key highlights of the Night has always been its performances. The evening started on a high note with a first-time combined choir performance, Seasons of Love, by senior leaders from the Community Care sector, MOH, and AIC. AIC staff also presented various performances, including a traditional Chinese Opera song and an electrifying rhythmic percussion item using recycled materials. The eagerly-anticipated ILTC Night Talent Competition saw eight contestants from various Community Care organisations showcasing their creativity and talents. The memorable evening ended with leaders from the Community Care sector, MOH, and AIC singing modified versions of two songs by popular music group Coldplay to thank staff for making a difference in the lives of their clients. Some of the lyrics included “With commitment we care for you/ We always long to improve/ To deliver our best to you/ Our mission here is to work hand in hand” which were sung to the tune of Viva La Vida.
(This was the third time Beverly has taken part in the ILTC Night Talent Competition and her second time clinching the first prize). Merit Prizes Amit Choudhury, Ang Mo Kio – Thye Hua Kwan Hospital (AMK – THKH) who performed a self-composed song in Bengali titled “Toke Mone Porche Tai” (I’ll Be Missing You). “It was a great opportunity to present myself as a composer and performer to the judges and audience. I was also proud to share the song as it reflected my personality and feelings.” Odessa Milanio, Sunshine Welfare Action Mission (SWAMI) Home for her rendition of “Better Days”. “Being the chosen one to represent SWAMI Home and as a finalist of ILTC Night was a wonderful experience. What struck me most was the heartfelt moments of making new friends. It also served as an eye opener for how much support I have from SWAMI Home. I feel blessed to be part of the team.”
http://www.aic.sg/mosaic
Group category
1st
Prize
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understand our dance, we wore three different costumes. The team’s hard work and great support from the SAS family contributed to our success.” – Marantan Ace Adanza, Enrolled Nurse, Group spokesperson (This was the first time that SAS took part in the ILTC Night Talent Competition).
3rd
Prize
Sunlove Abode for Intellectually-Infirmed (Sunlove) Their dance incorporated elements from various cultures in Singapore.
Ling Kwang Home for Senior Citizens (LKH) Through a musical movement of hands and colours, they depicted the story of an elderly woman who remembers her past and struggles in her present life. Eventually, she finds her ‘future light’, giving her hope, meaning, and happiness.
“Our residents were our inspiration; seeing them and listening to their stories gave us the idea for our item, Mime. We had some difficulty scheduling practice sessions and these sometimes went on till late at night because of our conflicting shifts. Also, as some members were doing mime for the first time, we started from scratch but together, we learned and finished our piece! We are glad that the audience and judges appreciated our hard work. We wanted to show that we should not take our loved ones who have grown old for granted. We should cherish them while they are still around and remember how they brought us up when we were young and helpless. Now is the time to repay them for their love.” – Beverly Bautista, Enrolled Nurse, Group spokesperson (This was the third time that LKH has taken part in the ILTC Night Talent Competition and the first time that they clinched the top spot).
2nd
Prize
Society for the Aged Sick (SAS) Their performance comprised three separate dance numbers to mark the past, present, and future.
“[In line with the theme], we decided to do a dance routine featuring choreography from the 1960s (yesterday), hip hop (today), and a “futuristic” one (tomorrow). To help the audience and judges further
“At first, we felt disheartened as we had, in previous years, not been selected for the finals. However, with motivation and support from our management, the team this time took on the challenge to do something unique. We made the effort to embed our values within the dance, such as loving and caring for our patients and portraying harmony and unity across the races, which are the core values of our nursing home and Singapore.” – Charles Lingham, Director of Nursing, Group spokesperson (This was the fourth time that Sunlove has taken part in the ILTC Night Talent Competition, this win was their best placed position). Merit Prizes AMK – THKH for their performance of three love songs from the 1960s, 1980s, and 1990s. “Our team, SWaBs (South Wing Ang Mo Kio Band) was formed two years ago when our south wing first opened. We started playing songs inside the ward during patients’ birthdays and subsequently, during various AMK – THKH events. [To prepare for ILTC Night], we practised during our off days and even during our breaks.” National Kidney Foundation for their youthful and energetic dance number. “We were very happy to be able to participate at ILTC Night. We are delighted and honoured to have won and it was a great team effort as everyone did their best at the performance.” More photos at: http://www.aic.sg/mosaic/gallery/jan17
SHOWCASE
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January 2017
DRIVING VALUE IN HEALTHCARE: NATIONAL SEMINAR ON PRODUCTIVITY IN HEALTHCARE 2016 to drive excellence such as through affiliate programmes. Highlights from the plenary sessions included those by Robert Chew, Göran Henriks, and Professor Jonathon Gray. In his presentation, “Why Computers Get Better and Health Care Should”, Robert shared that there are benefits to bringing in new medical innovations but it may not provide labour or cost saving productivity improvements. He put forth that the healthcare sector should leverage technology to develop “moonshot” projects (i.e., ambitious and groundbreaking projects that could potentially create major changes). During his session on “Driving Value Development and Productivity as a Key Pillar in Organisational Culture”, Göran shared that when it comes to patient involvement, instead of placing them in the centre, the patient should be included as part of the care team, with their needs and preferences placed at the centre. He also added that value is increased when we can meet the changing needs of different groups of patients over the course of their life cycle.
(Clockwise, from top left) Some of the Seminar speakers included Robert Chew1; Göran Henriks2, Professor Michael Porter3, Professor Hum Sin Hoon4, and Professor Jonathon Gray5.
Over 1,200 participants from the healthcare sector came together for the biennial National Seminar on Productivity in Healthcare 2016 (20-21 October) held at the Marina Bay Sands Expo and Convention Centre, Singapore. The Seminar’s theme was “Driving Value in Healthcare” and focused on three tracks: • Care Redesign; • Automation, Information Technology (IT) and Robotics Innovation; and • Workforce Transformation. More than 30 renowned local and international thought leaders shared their insights on over 20 topics related to these tracks. In his keynote address, “Value-Based
Healthcare Delivery: Strategy for Healthcare Leaders”, Professor Michael Porter explained that it is necessary to restructure healthcare delivery with the fundamental goal of maximising value for patients as incremental solutions (e.g., introducing LEAN process improvements, eliminating errors, etc.) have limited impact. He added that the single most powerful lever for reducing cost is improving outcomes. He also shared strategies6 that can be employed to create a value-based healthcare delivery organisation. These include organising care around patients’ medical conditions and segments such as through Integrated Practice Units7 (IPUs); moving to value-based reimbursement models; and expanding geographic reach
Elaborating on new leadership approaches in “Extraordinary: How Do We Equip Ourselves to Climb the Truly Big Mountains of Healthcare?”, Professor Gray shared that “momentous leadership” is required to realise the vision of providing “great care everywhere”. He noted that qualities of such leadership turns failing into learning; does not exhaust people but instead inspires resilience; leads by visible improvement; and recognises the community as the main source of wisdom. Sharing her thoughts on the Seminar, Zeng Mei Lian, Head of Finance, Home Nursing Foundation, shared, “[We gained] plenty of valuable knowledge and principles which we can learn and apply in our continuing efforts to improve the overall productivity of our organisation. Thank you to all the speakers for sharing their enriching and insightful experiences on their improvement journeys with us.”
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SLH and NUH partnership receives a National Healthcare Innovation and Productivity Medal The inaugural National Healthcare Innovation and Productivity (HIP) Medals award ceremony held during the Seminar celebrates excellence in healthcare innovation and productivity. A total of 56 submissions from over 20 organisations were received for the categories: Care Redesign; Automation, IT and Robotics Innovation; and Workforce Transformation. Five organisations received their awards from Dr Amy Khor, Senior Minister of State, Ministry of the Environment and Water Resources and Ministry of Health.
Our heartiest congratulations to St Luke’s Hospital (SLH) and National University Hospital (NUH) for clinching a Best Practice Medal in Care Redesign for their partnership on the “Integrated Care Path” project. The project helped to better integrate care for patients recovering from total knee replacement and total hip replacement, reducing the length of hospital stay and estimated cost avoidance of about $1.6 million for 295 patients over two years. Dr Chia Tee Hien, Assistant Medical Director, SLH, shared, “Major challenges [we faced] were the intentional tweaks in current processes – for NUH to provide early counselling on the NUH-SLH care path and estimated bill-size of the NUH-SLH journey, as well as for SLH to ring-fence beds to accommodate patients’ timely discharge from NUH. With both parties’ equal commitment towards delivering better care for our patients, this project has turned out to be a success.” (L-R) Tan Teck Chong, Director, Head, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster (UOHC) Operations and Administration, NUH; Associate Professor Tan Boon Yeow, CEO, SLH; Senior Minister of State Dr Amy Khor; Associate Professor Wilson Wang, Senior Consultant, NUH; Grace Tan, Assistant Manager, Project and Partnership, SLH; and Kan Hong Qing, Senior Manager, NUH, at the HIP Medals award ceremony.
Launch of the “2020 Healthcare Manpower Plan” The Seminar also saw the launch of the “2020 Healthcare Manpower Plan” by Guest of Honour, Minister for Health, Gan Kim Yong. The Plan outlines key strategies to develop our future healthcare workforce including: • Building future skills such as placing more emphasis on Primary and Community Care in pre-employment clinical training; • Training more doctors in broad-based specialty disciplines (i.e., Family, Geriatric, and Internal Medicine); and • Deepening the skills of nurses through initiatives such as the “SkillsFuture Earn and Learn Programme” in Gerontology Nursing. Download the “2020 Healthcare Manpower Plan” at: http://www.moh.gov.sg/content/moh_web/home/pressRoom/highlights/2016/2020-healthcare-manpower-plan.html Fast Facts • The first National Seminar on Productivity in Healthcare was organised in 2014. • Submissions for the HIP Medals were assessed on the following criteria: Problem definition; Project definition and scope; Quality of project idea/concept; Innovation; Impact; Sustainability; Learning Value; and Presentation. Robert Chew is Chairman, Silver Industry Standards Committee, SPRING Singapore. Göran Henriks is Chief Executive Officer (CEO), Learning and Innovation, Qulturum, Jönköping County Council, Sweden. 3 Professor Michael Porter is Bishop William Lawrence University Professor, Harvard Business School, United States of America. 4 Professor Hum Sin Hoon is Deputy Dean, Department of Decision Sciences, National University of Singapore Business School. 5 Professor Jonathon Gray is Director, Ko Awatea, Counties Manukau Health, New Zealand. 6 To read about the six strategies Professor Porter shared, download his presentation slides in the link at the end of the article. 7 An IPU brings together the full range of providers and support staff who address a specific disease or clinical condition. 1 2
FOR MORE INFORMATION!
Visit http://www.aic.sg/nsph2016 to download the speakers’ presentations. More photos at: http://www.aic.sg/mosaic/gallery/jan17
REFLECTIONS
10
January 2017
COMPASSION AND CARE: VENERABLE SIK KWANG SHENG In this section, we speak with pioneers and leaders in the Community Care sector. For this issue, we caught up with Venerable Sik Kwang Sheng, Abbot, Kong Meng San Phor Kark See Monastery (KMSPKS); Vice President, Singapore Buddhist Federation; Founder, Buddhist College of Singapore; and Chairman, Bright Hill Evergreen Home (BHEH). He shares about the beginnings of BHEH and his vision for the Community Care sector.
Venerable Kwang Sheng has been the Abbot of KMSPKS since 2004 and has been integral in the development of BHEH’s services as Chairman of its Board. (Photo credit: Bright Hill Evergreen Home)
Can you please share about why KMSPKS started BHEH and about some of the Monastery’s current involvement in the Home? My late Master, Venerable Seck Hong Choon, the former Abbot of KMSPKS, was far-sighted and anticipated Singapore’s ageing population. In 1983, BHEH was constructed within the Monastery’s premises to care for retired workers with no family members in Singapore (i.e., Samsui women and Amahs). The 68-bed Home initially provided vegetarian meals. However, my Master was compassionate and appreciated the fact that not all residents would be able to accept a full vegetarian diet and hence, decided not to have this restriction. When it was decided that there would be a need to build a Buddhist College in the Monastery, the nursing home was relocated to its current site in Punggol with the government’s help. Although the Home is no longer in the Monastery, we are still very involved in it. Our staff serve on its Board and we also help with fundraising and volunteer support. In November 2015, over $900,000 was raised in just one event. Whenever I visit and see happy residents and staff, it makes all the effort worth it. With manpower posing a challenge to the sector, one strategy Community Care partners can adopt is growing a volunteer pool to augment activities for clients. What strategies can be used to keep volunteers engaged? We have two types of volunteers – Board Members who enhance BHEH’s management practices and community volunteers. We are
constantly in touch with them, even when they are not actively volunteering. We share our challenges, never hesitating to ask for help. They can see for themselves the differences they make, which motivates them. How do you envision Singapore’s future Community Care sector? The Community Care sector has come a long way, with improvements achieved through dedication and hard work. With a more educated and affluent society, it’s a matter of time before we explore developing retirement and assisted living village models such as those in Japan and Australia. However, we need to strike a balance as we have limited funds and resources. To improve our care, we need to be open to feedback and change for the better. Our biggest rewards are the happy faces of the elderly and seeing them reintegrate well back into the community. Could you please share some personal philosophies that you think will help us age well? We need to build a compassionate and caring society. Singapore grows and prospers because our citizens love and care for each other regardless of race and religion. Live a good and healthy life. At a certain age, let go of the burdens of your past and start afresh. Keep an active mind; helping others can also help us better take care of ourselves. In life, there will be ups and downs, so take challenges as a learning process and remember to always look for the silver lining in every cloud.
IMPROVEMENTS
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FOLLOW YOUR HEART: FINDING PURPOSE IN YOUR LIFE AND WORK
In Follow Your Heart: Finding Purpose in Your Life and Work, bestselling author Andrew Matthews offers 10 practical tips to change your outlook on life and how you relate to the world.
1.
Learn from Every Challenge
Challenges can offer some of life’s biggest lessons. Benefit from them by asking what you can learn from each situation. 2.
Make the Effort
Every effort, coupled with patience, can lead to better results (e.g., being tenacious when facing obstacles can lead to a project’s success). Be systematic and self-disciplined in your approach. 3.
Change Your Beliefs
Go beyond your personal limits by: • Looking at things from a different perspective; • Not letting yourself be defined by a category (e.g., your age); and • Believing that every cloud has a silver lining. 4.
Be Detached but Determined
When you are trying to attain something, be in control of your emotions and don’t take things personally. Instead, be determined – if you have not yet achieved it, move forward and try again.
5.
Think Positively
When challenges occur, examine what other opportunities they may offer. Reflect on what you have in life, and be thankful. Additionally, focus on the positive aspects of people rather than looking for their faults. 6.
Do What You Love
Find meaning and excitement in your work by: • Doing what gives you fulfilment; • Giving your best; and • Finding joy in helping and connecting with people (e.g., by teaching others). 7.
Stop Thinking and Start Doing
Starting on a task can help you feel even more motivated. Step out of your comfort zone and meet people who will challenge you. To perform better, live in the present moment and don’t overthink situations. 8.
Find Inner Peace
Achieve inner peace by: • Making relaxation a daily habit (e.g., meditate every day); • Giving your fullest attention to each task; and • Visiting relaxing places.
9.
Love Yourself and Others
Aim for improvement rather than perfection, and let every obstacle make you stronger. Accept people for who they are by first accepting yourself. Forgive others and appreciate and support your loved ones. 10.
Change from Within
Focus on changing yourself by transforming your perspective rather than trying to change those around you. Consequently, you will see that life is not a struggle but a challenge that enables you to grow. Listen to Andrew Matthews’ tips on achieving success and peace of mind at http://goo.gl/pQWjpl.
Watch a short video on framing your attitude positively at http://goo.gl/qtuCLr.
More photos at: http://www.aic.sg/mosaic/gallery/jan17
NEWSBYTES
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January 2017
CELEBRATING EXCELLENCE Our heartiest congratulations to outstanding Community Care staff and organisations who were recognised at award ceremonies between July to November 2016. ILTC Manpower Development Awards (25 August 2016)
100 nurses from the healthcare sector were recognised at the Nurses’ Merit Award ceremony. (Photo credit: Ministry of Health)
Nurses’ Merit Award (19 July 2016) The Nurses’ Merit Award is presented annually by the Ministry of Health to nurses who have demonstrated consistent and outstanding performance, participated in professional development, and made contributions to promote the nursing profession. 15 Community Care nurses were recognised: Jasmine Tan Siew Ngoh Senior Staff Nurse/Clinical Instructor, St Luke’s Hospital
Pamela Koh Wen Xin Staff Nurse, Dover Park Hospice
Kimberly Lim Sze Cheng Senior Staff Nurse, Yishun Community Hospital
Rodona Dela Paz Labuanan Infection Control Nurse (Nursing Officer), Bright Vision Hospital
Lai Mee Horng Senior Nurse Clinician, Assisi Hospice Lai Siew Fung Senior Staff Nurse, National Kidney Foundation (NKF) Lew Sow Peng Senior Staff Nurse, St. Andrew’s Community Hospital
Seah Baojuan Nurse Manager, Kwong Wai Shiu Hospital Siong Meei Jeng Nurse Manager, HCA Hospice Care
Lu Meihua Lucy Advanced Clinical Nurse, NKF
Stephen Tan Teck Kwang Senior Nurse Manager, Ang Mo Kio – Thye Hua Kwan Hospital
Mah Sui Har Bernadette Nurse Clinician, All Saints Home
Tang Yip Chong Principal Staff Nurse, Bright Hill Evergreen Home
Manisah Bte Marseety Principal Enrolled Nurse, Jurong Community Hospital
Zhang Danyang Staff Nurse, Ling Kwang Home for Senior Citizens (LKH)
(L-R) Dr Do Su Ern, HCA Hospice Care (Community Care – GP Partnership Training Award) and Noor Kesuma Binte Manap, St. Andrew’s Community Hospital (ILTC – Upgrading Programme), were among the recipients presented their awards by Dr Amy Khor, Senior Minister of State, Ministry of the Environment and Water Resources and Ministry of Health.
The annual ILTC Manpower Development Awards Ceremony recognises recipients who received study awards to upgrade their skills and knowledge. In 2016, 98 awardees were recognised: For Students Award
Details
Balaji Sadasivan Study Award
For students pursuing Nursing or Allied Health careers in Community Care.
Mid-Term Scholarship for Medical Social Work
For students pursuing careers as Medical Social Workers in Community Care.
No. of Recipients 15
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For Healthcare Staff Award
Details
Community Care – GP Partnership Training Award
For doctors pursuing additional training to better serve elderly in Community Care.
ILTC – Upgrading Programme
For Community Care professionals pursuing a Nursing or Allied Health degree.
For staff pursuing advanced Social & Health Manpower Development skills training in elderly and continuing care. Programme – ILTC (SHMDP-ILTC)
No. of Recipients 13
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50 staff from 21 organisations
FOR MORE INFORMATION! Contact Kelvin Liew at
[email protected].
http://www.aic.sg/mosaic
This was the first year that LKH received SHMDP-ILTC awards. mosAIC caught up with the team to find out what motivated them to put in their application and how they plan to put their new knowledge into practice.
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Singapore Health Age-Friendly Awards 2016 (8 November 2016) Organised by SingHealth, the Singapore Health Age-Friendly Awards annually recognises healthcare professionals for their efforts in making their institutions more age-friendly in terms of processes, people, policies, and infrastructure. Six Community Care organisations received 15 awards for their outstanding projects: Service Improvement and Experience
Patient Safety
Ang Mo Kio – Thye Hua Kwan Hospital
Man Fut Tong Nursing Home
Bright Vision Hospital
Orange Valley Nursing Homes
National Kidney Foundation
Ren Ci Hospital
Ren Ci Hospital
Honouring a Pioneer in Geriatric Medicine
(L-R) Goh Yiqing, Social Work Assistant; Belina Lee, Director of Nursing; Chew Jee Eng, Nurse Manager; Llego Cecilia Macayaon, Physiotherapist; and Dennis Tan, CEO.
Our heartiest congratulations to Associate Professor Pang Weng Sun1!
On 17 August 2016, Associate Professor Pang was conferred the National Outstanding Clinician Educator Award at the National Medical Excellence Awards.
“After working in Community Care for several years, I realised that passion is not enough to make a difference. Since my degree was from a different field, I wanted to learn technical skills to better equip myself. I hope to bring social work theories and best practices of other organisations back to LKH so that residents are able to age well and we can focus on partnering families and caregivers for care provision.”
The Award recognises individuals who have contributed substantially to the training of clinicians and/or clinician scientists through mentorship or academic positions.
– Goh Yiqing, Social Work Assistant (Commenced her Masters in Social Work at UniSIM in 2016). “We applied for an attachment to help us better understand our elderly’s needs and to develop a dementia model of care in LKH. The experience showed us how as a learning organisation, BaptistCare* implemented a customised and consistent dementia model of care across their different centres. Their perspectives towards dementia was refreshing — residents are not seen as difficult but rather, having unmet needs. One paradigm shift for our staff is to recognise that LKH is a home for our residents and we have to help them function as independently as possible. We also saw a clear focus on quality of care, quality of life, and person-centred care, which we aim to translate into practice at ward level for both our clients and staff.” – Belina Lee, Director of Nursing; Chew Jee Eng, Nurse Manager; LIego Cecilia Macayaon, Physiotherapist; and Dennis Tan, CEO (Participated in a Dementia Care Clinical Attachment at BaptistCare, Australia in 2016). *BaptistCare is a not-for-profit Christian-based care organisation in Australia that has been serving the aged and people living with disadvantage for over 70 years. (Source: http://baptistcare.org.au/about-baptistcare)
Associate Professor Pang Weng Sun (right) received the National Outstanding Clinician Educator Award from Gan Kim Yong, Minister for Health. (Photo credit: National Healthcare Group) Associate Professor Pang Weng Sun is Chairman, Medical Board, Yishun Community Hospital and Vice-Dean, Clinical Affairs, Lee Kong Chian School of Medicine, Nanyang Technological University.
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More photos at: http://www.aic.sg/mosaic/gallery/jan17
NEWSBYTES
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January 2017
DEVELOPING A SHARED VISION OF QUALITY: COMMUNITY CARE RETREAT ON QUALITY 2016 Insights from the Retreat Leveraging the “House of Quality” approach, four main themes to improve quality of care emerged. They include: Theme
Participants discussed various key areas to embark on for their quality improvement initiatives.
Some 100 leaders from 60 Community Care partner organisations gathered for the Community Care Retreat on Quality on 4 August 2016. A culmination to quality improvement (QI) focus group discussions held earlier in the year, the Retreat explored key areas to better support and sustain quality care and discussed how the sector can more cohesively undertake the QI journey together.
The “House of Quality” framework identifies six key areas which Community Care partners can work on to improve quality of care.
“House of Quality” Framework For the first time, participants discussed and generated suggestions to key areas (or “building blocks”) using the “House of Quality” framework. The framework identifies six building blocks (People, Learning and Innovation, Customer Experience, Processes, Strategy and Knowledge, Leadership and Governance) to improve the sector’s quality of care. It was developed by service partners, with advice from the Strategic Advisory Committee for Quality Improvement for ILTC (SAC-QI)1. The SAC-QI advises AIC on the adequacy and efficacy of its efforts to bring about QI in the Community Care sector. The Committee comprises senior management from various healthcare organisations and is currently chaired by Chua Song Khim, CEO, NTUC Health.
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Arising from Building Blocks
Culture: • Building a strong safety and quality culture within organisations, with deep QI expertise, leadership support, and ways to recognise quality care.
• People • Leadership and Governance • Learning and innovation
Measurement and Planning: • Cultivating an open and learning mindset in measuring quality, and having guidance on how to use data from quality indicators for planning, improvement, and engagement.
• People • Strategy and Knowledge • Learning and Innovation
Continuous Improvement, Diffusion, and Sustainment: • Sharing and learning from one another’s successes and areas for improvement in QI, and to better spread and sustain QI efforts.
• People • Learning and Innovation • Processes
Customer Experience: • Improving clients’ and caregivers’ experiences, particularly during care transition across different services and facilities.
• People • Processes • Customer Experience
Following the Retreat, focus groups have been formed to co-develop and implement solutions. Sharing about their experience at the Retreat, one participant said, “Breaking the “House of Quality” up into smaller blocks help[ed] everyone understand the direction we are heading.” Another added, “[It was] a well-orchestrated retreat to align the sector. AIC is taking a step in the right direction and we hope the platform [i.e., the taskforce to drive improvement efforts in the four main themes] discussed will be implemented.”
FOR MORE INFORMATION!
Contact the ILTC Quality, Innovation & Productivity Division at
[email protected].
http://www.aic.sg/mosaic
HIRING ELDERCARE TRAINED HELPERS
CARERS CORNER
Rusmini (right) attended the Basic Eldercare Course and now feels more confident caring for 74-year-old Madam Lee Ah Moy. (Source: The Straits Times© Singapore Press Holdings Ltd. Reproduced with permission.)
Families who require eldercare trained helpers can now hire them in a week. Launched on 1 November 2016, the “Eldercarer Foreign Domestic Worker (FDW) Scheme”, provides families with access to helpers who have undergone a basic eldercare course in topics such as: • Understanding ageing and chronic diseases; • Communicating with seniors; and • Providing care (monitoring and understanding vital signs, transferring, grooming, providing appropriate nutrition, serving medication, etc.) Upon placement, helpers receive three hours of onsite training at the care recipient’s home. Families may tap on the “Caregivers Training Grant1” (CTG) to offset up to $200 of the training fees under the Eldercarer FDW Scheme (fees range between $200-$500). Eldercare-trained helpers can be employed from: • • • •
Active Global Specialised Caregivers (Tel: 6536 0086); Homekeeper International (Tel: 6462 6315); Hon Employment Services (Tel: 6445 2587); and Patience Employment Agency (Tel: 6458 3313).
Those with existing helpers may also enrol them in the basic eldercare course by contacting the following providers directly: • Ang Mo Kio – Thye Hua Kwan Hospital (Tel: 6450 6129); • Centre for Seniors (Tel: 6478 5476); and • The Salvation Army Peacehaven Nursing Home (Tel: 6384 2180). To be eligible for the CTG, care recipients must be Singaporeans or Permanent Residents, be above the age of 65 or have a disability as certified through a doctor/valid functional assessment report. Participants must also complete the course.
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FOR MORE INFORMATION!
Contact the Singapore Silver Line at 1800 650 6060.
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PARTNERING GPs FOR DIABETES PREVENTION
As part of the STOP Diabetes screening programme, Dr Theresa Yap provides early screening and diabetes intervention for her patients’ next of kin. (Photo credit: SingHealth)
Today, one in three Singaporeans aged 60 and above live with diabetes1. If left unchecked, nearly a million Singaporeans could be affected by the disease in 2050. To enable early detection and intervention of diabetes, since April 2016, SingHealth Regional Health System has partnered General Practitioners (GPs) across Singapore to offer health screening2 for the next of kin of individuals with Type 2 diabetes. Known as STOP Diabetes, it aims to enable relatives of patients with diabetes to embark on preventive healthcare to keep them healthy. “My late father had diabetes so getting screened regularly is important for our family. Screening is just the first step though; I also exercise at least three times a week and watch what I eat,” shared 64-year-old Tan Swee Lin. Dr Theresa Yap, one of the 91 GPs who is part of the Programme, said, “I’m a strong advocate of early screening. If an individual knows that he is at risk of developing diabetes, he would be spurred to do something to help himself and comply with the recommended lifestyle changes.” Winning the “War on Diabetes” was one of the strategies identified by the Ministry of Health to create a more sustainable healthcare system. For more information, visit http://goo.gl/rsmTq9. 2 Screening is open to those aged 30 and above who do not have pre-diabetes or diabetes mellitus. They will be screened for diabetes, high blood pressure, high cholesterol, and obesity. 1
FOR MORE INFORMATION!
To sign up for screening, contact 6702 5485/5486/ 5487 or
[email protected]. GPs keen to join the programme can also get in touch via the above contact details.
More photos at: http://www.aic.sg/mosaic/gallery/jan17
NEWSBYTES WE WANT YOUR SUBMISSIONS!
16
January 2017
Share your initiatives and stories with mosAIC readers! Contact us at
[email protected].
A FLAIR FOR SKIN CARE Contributed by Villa Francis Home for the Aged Winner, ILTC Excellence Awards 2016 – Clinical Quality Improvement category Physiological changes, together with reduced mobility and multiple co-morbidities increase the risk of the elderly developing skin problems such as pruritus, dermatitis, fungal infections, scabies, and shingles. These often require review by a medical practitioner or dermatologist. In 2013, we noted that we were making an average of 21 dermatologist-related referrals monthly (15% of our total number of residents). To address this, we initiated a project in collaboration with our volunteer doctor, Dr Martin Chio, Senior Consultant, National Skin Centre.
SECTOR’S SHARING
FOOD, FUN AND FRIENDSHIP! Contributed by Sister Marjorie Almodiel, Centre Manager, Apex Day Rehabilitation Centre For Elderly Clients at Apex Day Rehabilitation Centre For Elderly (ADRC) had a fun time on 10 October 2016. It was Carnival Day! This was the ninth time that the ADRC management, staff and volunteers have organised this annual event. Each client was provided $20 worth of coupons to spend on food and games.
Nursing staff discussing treatment options to alleviate residents’ skin problems. (Photo credit: Villa Francis Home for the Aged)
We assessed and analysed the issue according to the Plan-Do-Check-Act1 (PDCA) cycle. Thereafter, we: • Conducted training to better equip nurses with knowledge and expertise on skin problem management; • Evaluated and revised existing treatment and workflows for common skin problems; and • Added four types of skin creams2 to the ward inventory to better address the skin issues. As a result of the project, the total number of dermatologist referrals reduced from 254 cases in 2013 to 225 (11.4% reduction) in 2014. In 2015, there was further reduction of cases by 13%. “The training provided to nurses has also helped with early identification and intervention to provide better skin care to residents. Besides teleconsultations, messaging services like Whatsapp are also used to expedite referrals, when necessary,” shared Susan Gui, Nursing Director. The PDCA (also known as the Plan-Do-Study-Act) cycle is shorthand for testing a change by developing a plan to test the change, carrying out the test, observing and learning from the consequences, and determining what modifications should be made to the test. (Source: http://www.ihi.org/resources/pages/tools/plandostudyactworksheet.aspx). 2 The four skin creams included Betamethasone 0.025%, 0.05%; Betamethasone 0.025% + Clioquinol 3.0%; 2% Miconazole Cream; and Malathion lotion. 1
At the games booths, clients showed their competitive streak, eagerly collecting points to exchange for prizes. Even so, one client helped a friend who had spent all his coupons on games by treating him to lunch. Aside from the joyous atmosphere, the Carnival aimed to provide clients the opportunity to practise their decision making skills and how to budget, a form of fun cognitive therapy. “I always look forward to the in-house carnival. Due to my disability, I had to be careful in selecting the games so that I would not waste money,” shared Tan Soh
http://www.aic.sg/mosaic
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MAKING WISHES KNOWN Contributed by NTUC Health
Clients could choose from a wide array of delicious treats and snacks available that day. (Photo credit: Apex Day Rehabilitation Centre For Elderly)
Nobody knows what the future holds. We cannot predict what might become of our health, but we can always plan ahead so that our wishes can be known. This was the objective when NTUC Health Nursing Home (Jurong West) began the Advance Care Planning (ACP) programme1 with our residents between December 2015 and May 2016. Over a course of five sessions, 11 residents were guided through ACP-related discussions, led by AIC’s ACP team together with our home’s nurses and therapists. Sessions included activities like arts and craft to enable residents to express themselves through drawing. Topics explored included their personal values, goals, and preferences in life, and who they might want as their Nominated Healthcare Spokesperson (NHS) in the event of a healthcare crisis. This information, together with their stories and wishes, were then penned in a journal which residents kept. For some elderly, discussions about end-of-life care and wishes can be sensitive. However, such information is essential, for their loved ones and healthcare staff to ensure that the provided care is based on their wishes.
66-year-old Tookiat Too trying her hand at a hoop-throwing game. (Photo credit: Apex Day Rehabilitation Centre For Elderly)
Leng, 75. Another client, Quan Sook Ching, 92, added, “It was very fun… $20 worth of coupons was more than enough for me. I spent the money mostly on food.” A lucky draw with attractive prizes to be won capped off the day. Clients attentively listened as the winning numbers were called. “They amazed us when they remembered their numbers, some of which were at least four-digits long… It made our day to see clients enjoying themselves, counting their coupons as they played games,” shared Nellie Goh, Administrative Assistant.
NTUC Health Nursing Home (Jurong West) residents shared their values and wishes in life through activities like arts and craft. (Photo credit: NTUC Health) For more information about Advance Care Planning, visit http://www.livingmatters.sg.
Ng Chor Keng, a resident, shared, “I really enjoyed the arts and craft activities as I felt that they were very meaningful. I think that it was a good initiative by NTUC Health, as it is important for people to prepare their end-of-life wishes and preferences for care in advance. I am glad that I was able to participate.”
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More photos at: http://www.aic.sg/mosaic/gallery/jan17
NEWSBYTES WE WANT YOUR SUBMISSIONS!
18
January 2017
Share your initiatives and stories with mosAIC readers! Contact us at
[email protected].
A WORTHY EXERCISE Contributed by National Kidney Foundation Winner, ILTC Excellence Awards 2016 – Productivity and Innovation category
SECTOR’S SHARING
WHETTING APPETITES Contributed by The Salvation Army Peacehaven Nursing Home Dysphagia, or swallowing difficulties, is a severe condition that occurs as a result of ageing-related diseases. It can cause complications such as choking, dehydration, malnutrition, unintentional weight loss, aspiration, and aspiration pneumonia. Often, puréed diets are recommended for dysphagic clients. However, as liquid is added to achieve the needed consistency, it reduces nutrient density in the food. With the elderly generally experiencing a decrease in appetite and food consumption, clients who require such diets may hence be at risk of malnutrition.
Participating in NKF’s various exercise opportunities has enhanced patients’ overall wellbeing. (Photo credit: National Kidney Foundation)
When Eu Aik Wah was diagnosed with chronic kidney disease five years ago, he felt very depressed. Fortunately, after joining National Kidney Foundation’s (NKF) “Exercise Platform” programme, his health improved and his spirits were lifted. “Now, I can easily do 20 squats at a go. I feel empowered each time the Exercise Specialist teaches me new exercises to strengthen my lower limbs,” he said.
To address this, in February 2016, we carried out a one-month trial to assess the impact of ready-to-eat functional foods1 on weight improvement. Selected residents on puréed diets were provided functional foods to replace their three main meals and two snacks. Their weight and body mass index (BMI) before and after the trial were then compared.
This exercise programme was introduced in 2014 to address our patients’ physical inactivity, resulting from their reduced physical capacity, treatment, and general sedentary lifestyle. It complements treatment, medication, and diet to help them better care for themselves. We provide various opportunities for patients to exercise regularly. These include: • Customised home-based exercise programmes; • Supervised group exercise classes where patients from different centres come together to bond and interact; • Dialysis centre exercise corners and video screenings so patients can exercise before and after dialysis; and • Outdoor exercise events. Findings from our pilot study comprising 33 patients showed significant improvement – 68% felt happier and 73% saw improvement in daily functional activities. Desmond Ang, Manager, Exercise and Fitness department, shared, “Although it was not easy to promote physical exercise to dialysis patients, seeing them benefit from the programmes keeps me going.” Life these days is different for Aik Wah. Employed now as a Patient Exercise Assistant at NKF, he helps other patients better benefit from exercise. The programme has also provided him with a stepping stone to a new healthcare career – he will soon be enrolling in a Therapy Assistant course.
Functional foods deliver enhanced benefits above their basic nutritional value. Food fortifications may include more energy/protein per serving (as compared to a serving of regular food), which may be effective in combating weight loss.
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http://www.aic.sg/mosaic
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HONING LEGAL KNOWLEDGE Contributed by All Saints Home
Some of the functional food offered by the Home include four types of Vegetable Pudding and Smooth Porridge. (Photo credit: The Salvation Army Peacehaven Nursing Home)
Results of the Trial: • More than 70% of residents averaged 1 kg of weight gain; • Residents were generally satisfied with the texture, colour, and flavour of these meals; and • Our nurses found that residents also ate better, especially with the inclusion of new and different flavours. Marsha Tan, Dietitian, shared, “With nutrient-dense food, our residents expend less effort to finish their meals. They are now eating better and it’s very encouraging to see them enjoying their meals!”
Seminar attendees enjoying a light-hearted moment while learning about legal matters relevant to the Community Care sector. (Photo credit: Pro Bono Services Office)
With nursing homes (NHs) facing increasingly complex cases, having a good grounding in legal matters and where to seek further legal assistance is of utmost importance. On 14 October 2016, our Tampines branch hosted the inaugural “Seminar on Legal Issues in Nursing Homes”, which was attended by 150 representatives from NHs, Ministry of Health, and AIC. During the seminar, areas covered included an overview of the: • • • • •
Mental Capacity Act1 and its recent changes; Vulnerable Adults Bill2; Lasting Power of Attorney3; Maintenance of Parents Act4; and Services provided by the Law Society of Singapore’s Pro Bono Services Office (PBSO) and the Legal Aid Bureau (LAB).
The seminar concluded with a lively panel discussion, where NH representatives shared about some of the cases they have encountered and sought advice from the panel on possible next steps. On hand to share their knowledge were representatives from the PBSO, LAB, and Office of the Public Guardian.
Mr Ng, 63, enjoying a bowl of Smooth Porridge as part of the initiative to provide nutrient-dense functional foods to dysphagic residents. (Photo credit: The Salvation Army Peacehaven Nursing Home)
“[The seminar offered] a good overview of issues and challenges that we can possibly face. It was useful and relevant to the Community Care sector,” shared Hudson Teh, Senior Finance Manager, Ling Kwang Home for Senior Citizens. Most attendees also echoed this sentiment, with some requesting for focus group discussions on legal matters to be formed. Download a copy of the Mental Capacity Act at http://goo.gl/12EDnx. Download a copy of the Vulnerable Adults Bill at http://goo.gl/zb1RuY. 3 For more information on the Lasting Power of Attorney, visit http://goo.gl/uKHryD. 4 Download a copy of the Maintenance of Parents Act at http://goo.gl/2HtCiX. 1 2
More photos at: http://www.aic.sg/mosaic/gallery/jan17
NEWSBYTES WE WANT YOUR SUBMISSIONS!
Contact
[email protected] to announce new appointments to key leadership positions in your organisation.
KEY APPOINTMENTS IN THE SECTOR Find out how leaders holding new positions hope to contribute to the Community Care sector. Dr Chan Kay Fei, Chief Executive Officer Orange Valley (OV) (September 2016) “My earliest exposure to the Community Care sector was in the 1970s when my grandmother had a serious stroke. Seeing how a fiercely independent lady became bedridden was life-changing for me.
(Photo credit: Orange Valley)
Before joining OV, I was the [immediate past] Head of Tan Tock Seng Hospital’s Rehabilitation Medicine Department and Co-Director of the Rehabilitation Research Institute of Singapore. I continue to serve today as medical advisor to St Luke’s Hospital and Kwong Wai Shiu Hospital. My aim for OV is to be more responsive and dynamic to better address the sector’s changing needs. I am also interested in the prevention and management of pre-frailty and providing more transitional and home-based care.” Linda Auyong, Director Community for Successful Ageing (ComSA) Tsao Foundation (September 2016) “Most of my career has been in the Social Services. I have had the privilege of serving beneficiaries in varied settings, including as Head of Social Work, Movement for the Intellectually Disabled of Singapore (MINDS) and Director of Social and Community Services, The Salvation Army. I am excited to be part of ComSA1 and look forward to engaging the community to co-develop it as a replicable model of successful ageing.”
(Photo credit: Tsao Foundation)
Ling Bee Sian, Director of Nursing Pearl’s Hill Care Home (PHCH) (September 2016) “Having cared for the elderly as a nurse since 1974, I have a soft spot for them and it was this love that has spurred me on until today. It warms my heart to see their smiles and knowing my hard work has paid off. Currently, we have many projects at PHCH focusing on engaging youths and I hope that more young people will join us in fostering a loving environment for the elderly. My vision is to build a great team that serves with joy and loves and respects the elderly.” (Photo credit: Ling Bee Sian) ComSA is a community-wide initiative that promotes health and wellbeing over the life course, and enables ageing in place. For more information, visit http://www.tsaofoundation.org/what-we-do/comsa/about-comsa.
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January 2017
TEST YOUR KNOWLEDGE! Take part and win up to $30 worth of NTUC vouchers! Questions: $10 vouchers to be won!
1) Which of the following study awards in the ILTC Manpower Development Awards are intended for students? a. Mid-Term Scholarship for Medical Social Work b. ILTC – Upgrading Programme c. All of the above 2) How many building blocks are there in the “House of Quality” framework? a. Four
b. Five
c. Six
3) “Exercise Platform” by National Kidney Foundation includes exercise corners and video screenings at dialysis centres. a. True
b. False
Bonus Activity:
One lucky winner will win an additional $20 worth of vouchers!
Step 1: Capture a group photo with this issue of mosAIC. Step 2: Tell us what you liked and what can be improved about this issue.
Send your entries to
[email protected] with the subject header “mosAIC #27 Quiz”, together with your name, designation, organisation, and mobile number. Winners will be notified by email!
http://www.aic.sg/mosaic
STAMPING OUT STIGMA To commemorate World Mental Health Day (10 October 2016), a series of events – including a mass walk (“Walk With Us · Stamp Out Stigma”), a carnival, and talks – were organised. These aimed to raise awareness on the importance of mental health at three levels: • Self: Being aware and mindful of one’s mental wellbeing; • Family and Friends: Being able to identify signs and symptoms of others’
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CARE IN MIND mental health conditions; and • Community: Knowing that mental health resources and services are available within neighbourhoods. The walk, held on 8 October, was led by Guest of Honour Mdm Halimah Yacob, Speaker of Parliament and Member of Parliament for Marsiling-Yew Tee GRC. She was joined by over 1,000 participants, many of whom are living with mental health conditions. Their participation aimed to
draw attention to the importance of mental health awareness and to destigmatise mental health conditions. Facilitated by AIC, these events were the first ground-up coordinated collaboration among multiple agencies, restructured hospitals, and community partners, signifying closer partnerships to raise mental health awareness and provide better support for clients, caregivers, and the community.
Launch of the new “Mental Health Awareness” logo
Guest of Honour Mdm Halimah Yacob (second from the right), Speaker of Parliament and Member of Parliament for Marsiling-Yew Tee GRC, leading the mass walk down Orchard Road.
The logo, launched as part of the festivities, will provide an overarching identity for all mental health publicity and awareness raising events in Singapore.
MENTAL HEALTH KNOWLEDGE FOR COMMUNITY PHARMACISTS Pharmacists have been partnering the Community Care sector since 2014 through the Pharmaceutical Care Programme1. In 2016, this collaboration was furthered through an initiative with the Pharmaceutical Society of Singapore to equip community pharmacists with mental health knowledge and skills to: • Recognise clients’ mental health needs; and • Support them and their caregivers by providing resources and linkage to appropriate services. Guardian is collaborating with AIC on this pilot and has also been linked to Alzheimer’s Disease Association (ADA). ADA will provide opportunities for pharmacists to participate in their activities to further learn how to engage people living with dementia and provide medication management services. 1 The Pharmaceutical Care Programme (PCP) aims to enhance medication management in nursing homes and centre-based facilities through consultations with registered pharmacists. Services offered under the PCP include helping to standardise work processes such as preparation and administration of medication and conducting medication reconciliation to minimise polypharmacy.
FOR MORE INFORMATION! Contact Sudha Selvam at
[email protected].
Guardian’s pharmacists undergoing awareness training to better attend to clients with mental health conditions living in the community.
More photos at: http://www.aic.sg/mosaic/gallery/jan17
NEWSBYTES
22
January 2017
NEW NI-IELP MEDICATION MODULE LAUNCHED!
QUICK BYTES
APPLY TODAY! Tote Board Community Healthcare Fund (TBCHF) Application Closing Dates
Project Commencement
• 31 Mar 2017, 5pm • 31 Jul 2017, 5pm • 30 Nov 2017, 5pm
• From 1 Aug 2017 • From 1 Dec 2017 • From 1 Apr 2018
FOR MORE INFORMATION!
Visit http://www.aic.sg/tbchf or contact the TBCHF Secretariat at
[email protected].
Input from the sector was important to ensure the module could meet the needs of nursing homes.
The National ILTC IT Enablement Programme1 (NI-IELP) launched its latest module – medication management – at NTUC Health Nursing Home (Jurong West) [NTUC Health] and Jamiyah Nursing Home (JNH) in November 2016.
OFFICIAL OPENINGS Pearl’s Hill Care Home – 28 September 2016
Beginning with NTUC Health on 14 November, some of the immediate benefits shared by staff include: • The ability to see clearly what medication is due as it is displayed on the screen during medication administration rounds; and • Easy identification of overdue medication with the aid of colour coding, so that Registered Nurses can promptly follow up with residents. The electronic platform also offers other advantages. Dr James Cheong, NTUC Health, shared, “Electronic input ensures legibility of prescriptions and reduces risks of medical errors. [In addition], displaying residents’ details in the prescription page provides ease in verifying correct and appropriate prescriptions.” Staff from the soon-to-be launched NTUC Health Nursing Home (Chai Chee) were also present to observe the medication module implementation as they will be using it when their operations commence in mid-January 2017. Watch this space to find out about JNH staffs’ experiences in implementing the medication module in the next issue of mosAIC! NI-IELP is a national Information Technology platform launched in August 2014 to enhance care provision and boost operational efficiency in nursing homes.
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FOR MORE INFORMATION!
Contact James Kuan at
[email protected] or Ash Ang at
[email protected].
(Photo credit: Vanguard Healthcare)
The 130-bed home is the first nursing home operated by Vanguard Healthcare, which was set up by the Ministry of Health (MOH) and MOH Holdings in 2015. More information at http://www.carehome.com.sg.
Yishun Community Hospital – 28 November 2016
(Photo credit: Yishun Community Hospital)
The 428-bed hospital provides rehabilitative, sub-acute, dementia, and palliative care to help patients rehabilitate and ease their transition back home. More information at http://www.yishuncommunityhospit al.com.sg.
THIRD MEMORANDUM OF UNDERSTANDING (MOU) AIC signed the third MOU with the Pharmaceutical Society of Singapore (PSS) on 30 September 2016 for PSS to provide pharmaceutical care and advisory support to nursing homes. Contact Doris Yeo at
[email protected] for more information.
REGULAR READS*
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COMMUNITY CAFÉ TOOLKIT: YOUR MANUAL AND TOOLS FOR ESTABLISHING A CAFÉ FOR PEOPLE LIVING WITH DEMENTIA by Alzheimer’s Australia, New South Wales. (2016) (Accessed: 1 December 2016) Read the full article at: http://www.fightdementia.org.au This toolkit was developed as part of Alzheimer’s Australia’s Dementia-Friendly Communities Initiative and is based on the experiences of Community Cafés across Australia and related literature review from Australia and internationally. It offers a guide on establishing/running a Community Café for persons with dementia (PWDs) and their carers and provides helpful resources such as checklists. What are Community Cafés? Community Cafés provide organised, regular get-togethers in relaxing public spaces to assist PWDs and their carers combat feelings of isolation through increased connections and social support. Considerations Before Beginning Need Ascertain if a Café is needed; if PWDs and their carers would attend it; if there are sufficient participants; and possible language barriers. Begin with at least eight participants (i.e., four pairs of PWDs and their carers). This number may increase in time as a result of word of mouth. Frequency In Australia, Cafés are typically held on the same time and day monthly, for 90 minutes to two hours on weekday mornings as it is a more convenient time for seniors. Choose less busy periods in public spaces and schedule at least six months ahead to give participants plenty of notice. Format Whether fixed or informal, enable participants to lead the activity agenda (e.g., formal emotional support, talks by health professionals, and information exchange). Participants It is best to target early to moderate-stage PWDs and their carers. The group size also depends on factors such as available volunteers, finances, and venue capacity. Venue Cafés, clubs, and community spaces are recommended, with
sessions usually held at the same location. Consider aspects such as the preferred day and time, disability access, transport options, and environment (i.e., layout, lighting, and ambience). Cost There may be costs for the venue, food and beverages, facilitator, speaker, and publicity (e.g., flyers). Facilitator He/she could be a paid or volunteer facilitator and should be equipped with the necessary skills. Sustainability To keep the Café ongoing, establish a working group, have a few healthcare professionals take on facilitator roles, recruit and train a few facilitators, and encourage regular meetings. Running a Community Café • Before the first Café of the year, book the venue for the first few months; establish a participant contact list; allocate tasks; prepare a “Welcome Kit” to help participants understand the purpose of the Café and know what to expect; and share a newsletter with key information. • Before each Café, send reminders to participants via email/call, organise materials, and confirm the volunteers. • During the Café, facilitators should welcome each participant individually; introduce new participants; organise the food and drink orders; encourage and provide time for participants to talk; and look out for those who may feel “left out” or isolated. • After the Café, conduct a debrief with facilitators and volunteers to identify any issues. Every year, hand out a simple evaluation form at the last two sessions.
*mosAIC’s Regular Reads aims to provide relevant, useful information to Community Care partners for the improvement of their operations. This section features journal articles that highlight latest research findings as well as good, evidence-based and innovative practices. While the articles aim to keep Community Care partners informed of current developments in the sector, the views and opinions expressed or implied do not necessarily reflect those of AIC, its directors or editorial staff.
More Regular Reads at: http://www.aic.sg/mosaic/ regular-reads
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