Singapore’s first new public hospital has been officially opened by Lee Kuan Yew, the country’s Minister Mentor, last week.
The 550 bed Khoo Teck Puat Hopsital, which cost the government S$700 million (US$540 million) to build, started operations in March, and is currently serving 20,000 outpatients and 2000 inpatients a month.
Not only expected to bring significant relief to other public hospitals through the hospital’s opening, KTPH’s leadership was also challenged by Health Minister Khaw Boon Wan to build a ‘hassle-free hospital’.
To act on this challenge, the KTPH management consulted stakeholders including patients, visitors, staff as well as experts from hotel/retail industry.
Architects were briefed to design the hospital in a way that patients would have easy access to whatever they need – and the walking distance from the main entrance to clinics/wards should be less than 100 metres. Also, facilities were arranged such that patients going for tests/examinations do not have to walk unnecessary distances.
“I have visited KTPH several times. I have spoken to many patients there. I am pleased with what I saw and what I heard,” wrote Khaw, who is confident that KTPH will become a hassle-free hospital.
The government is building another general hospital – Jurong General Hosptial – which will be co-located with a community hospital. This is catered to the shifting disease patterns where more patients need continuous care rather than emergency care.
“The traditional model of healthcare delivery has typically not ensured good coordination between the hospital and the community care providers,” said Khaw. “Patients are left to navigate between these providers, with very unsatisfactory outcomes.”
One of the key issues here was the information gaps – patients treated by different doctors often have to repeat tests and/or medications.
Khaw said JGH, and the subsequent new public hospitals, must outperform all existing ones, including the newly-opened KTPH.
For example, tests get repeated unnecessarily because of information gaps. And the lack of a commonly agreed protocle for smooth handover of patients means that patients often have to experience unnecessary waiting,
Thus, Khaw sets out a vision of a “hassle-free health service” - where providers coordinate and integrate their care for their patients in a seamless manner, even though they work for different employers and may not even know one another.
To achieve this, JGH management will have to work closely with care providers in the community, including GPs, polyclinics, community hospitals, nursing homes, home care providers and social support groups.
Khaw also realised that older hospitals have a slight disadvantage while trying to deliver the vision, as they have to deal with old traditions and legacies. “For example, some hospitals in Korea have already gone “4-less”: paperless, filmless, script-less and chart-less, while we are still struggling to go “paperless”,” he explained. “Although we are better than some countries, we can do more, but legacies have prevented us from moving forward.”
But Khaw expects the new hospitals, which do not have the challenge of legacy, to achieve much faster. “Building the community hospital and the general hospital as one project should allow you to push integration and coordination to the maximum,” he wrote. “It will enable you to achieve multiple physical connections between both entities, not just for smooth movement for patients and families, but also to encourage mingling of doctors and care staff and sharing of information and services, while observing patient privacy.”
Services such as the pharmacy, kitchen, medical records and purchasing systems as well as training facilities like the auditorium could be shared between the tertiary hospital and the community hospital. IT connectivity and Digital Imaging would also be shared to reduce operational cost and facilitate patients to move seamlessly between the two when their medical conditions change.
The government has pledged to invest S$1 billion (US$771 million) in the Jurong project, excluding the cost of land. “It reflects our commitment to raising the healthcare service standard for Singaporeans, especially for those in the lower income group,” said Khaw, wo added that 75 per cent of JGH’s 700 beds will be in the heavily subsidised Class B2/C wards.
Two new subsidised nursing homes are also being built for patients who need to go through rehabilitation before going home; and the government is also pushing existing nursing homes to upgrade in order to meet new challenges.
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