Aha - Khoo Teck Puat Hospital

 
Aha - Khoo Teck Puat Hospital
aha                                                                Issue 1: January-february 2019

                                  a journey of mANY STEPS
                                               The road to wellness at Yishun Health is paved with
        MCI (P) 101/04/2018

                                              constant improvements in all areas of a health system

                              What’s     12     “it’s good to know   16    a wealth of   26
                              cooking?          someone cares”             experience

AHA Jan-Feb 19 cover.indd 1                                                                                10/1/19 3:40 PM
Aha - Khoo Teck Puat Hospital
ontents

                                             4    HEALTH HIGHLIGHTS                24 5 THINGS ABOUT…

              18      COVER STORY                 Healthcare news and updates         Radiation and X-rays
                                                                                      A better understanding of
                      A journey of           6    WHAT’S UP                           this important diagnostic
               many steps                         Community events, outreach          tool
               Part two of the Kaizen             efforts, and more
                                                                                   26 LIVE WELL
               series explores the           12 SPOTLIGHT                             A wealth of experience
               many ways — big                  What’s cooking?                       Four veteran
               and small — in                   Step inside Yishun Health’s           anaesthesiologists share
                                                kitchen for a glimpse of how          what keeps them going in
               which clinical care is           safe, healthy, nutritious and         the pursuit of their vocation
               improved at                      tasty meals are prepared
               Yishun Health.                                                      28 MAKAN TIME
                                             16 EVERYDAY HEROES                       Steamed
                                                “It’s good to know                    seabass,
                                                someone cares”                        Teochew
                                                Sally Low shares how                  style
                                                community support has made            Learn to
                                                a difference to alleviate her         prepare this
                                                caregiving struggles                  classic fish dish

                                   The Kaizen mindset — a culture of constant improvement and continuous small
                                   refinements — has shaped the way we enhance our care processes, develop
                                   healthcare programmes, and even locate our services in the community. In this
                      THE KAIZEN   second instalment of The Kaizen Series, we explore what’s been done across our
                        SERIES     institutions at the clinical, process and community levels.

           2 |

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Aha - Khoo Teck Puat Hospital
PUBLISHER
                                                                                                                               Yishun Health is a network of
                                                                                                                         medical institutions and health facilities in
                                                                                                                        the north of Singapore, under the National
                                                                                                                         Healthcare Group. It comprises Admiralty
                                                                                                                         Medical Centre, Khoo Teck Puat Hospital
                                                                                                                           and Yishun Community Hospital. It also

                                                                                                                   16
                                                                                                                          includes community extensions such as
                                                                                                                                    Wellness Kampung.

                                                                                                                                         EDITORIAL TEAM
                                                                                                                                                Hannah Wong
                                                                                                                                                 Sabrina Ng
                                                                                                                                                 Sharon Ng
                                                                                                                                                 Albert Foo
           30 DAILY DOSE
              Snack smart!                                                                                                        EDITORIAL COMMITTEE
              Choosing quality over quantity                                                                                   The editorial committee — made up of
              means you can still indulge a                                                                                   clinical, nursing, allied health, population
              little this festive season                                                                                      health & community transformation, and
                                                                                                                               administrative heads of department —
                                                                                                                                         advises aha’s direction.
           31 MIND & HEALTH
                                                                                                                                           A/Prof Tan Kok Yang
              Healthy habits planner
                                                                                                                                              Angeline Tang
              Set out your intentions for the                                                                                                  Bastari Irwan
              day, week, month or year —                                                                                                      Chia Kwee Lee
                                                                                                                                          Fatimah Moideen Kutty
              and achieve your health goals!
                                                                                                                                               Shirley Heng

                                                                                                                                             ktph.com.sg/aha
                                                                                                                                            aha@ktph.com.sg

                                                                                                                                      PUBLISHING AGENT
                                                                                                                                           THINKFARM PTE LTD

                aha                                                               Issue 1: January-february 2019
                                                                                                                                            www.thinkfarm.sg
                                                                                                                                          M A N AG I N G D I R E C T O R
                                                                                                                                              Christopher Tay
                                                                                                                                          E D I TO R I A L D I R E C TO R
                                                                                                                                               Chua Kim Beng
                                                                                                                                         C O N T R I B U T I N G E D I TO R
                                                                                                                                                 Sheralyn Tay
                                                                                                                                                     E D I TO R
                                          a journey of mANY STEPS
                                                       The road to wellness at Yishun Health is paved with                                      Dang Hui Ling
                MCI (P) 101/04/2018

                                                      constant improvements in all areas of a health system

                                      What’s     12     “it’s good to know   16    a wealth of   26
                                      cooking?          someone cares”             experience
                                                                                                                                                A R T D I R E C TO R
                                                                                                                                                Regina Wong

                                      W
                                                                                                                                                   DESIGNER
                                                                                                                                                Melissa Poon
                                                     hy aha?
                                                                                                                           S E N I O R M A N AG E R , C L I E N T R E L AT I O N S H I P
                                                     The name aha holds much                                                                      Jessie Kek
                                                     significance for us at Yishun Health.                                                     C O N T R I B U TO R S
                                                     In part, it is a nod to our beginnings                                                 Justin Loh, Lee Lily

                                      at Alexandra Hospital; it also stands for ‘Advocates                                aha is the official bi-monthly publication of Khoo Teck Puat Hospital
                                                                                                                        (Co. Reg. No. 200717564H) and is produced by ThinkFarm Pte Ltd. All
                                      for Health in Action’. Through these pages, we hope                               rights to this publication are reserved and no part may be reproduced
                                                                                                                         without the expressed written consent of the publishers. While every

                                      to empower you to take charge of your own health                                  effort has been made to ensure that the information in this newsletter
                                                                                                                         is accurate and up to date, the editorial team will not be responsible
                                                                                                                        for errors due to information received. Opinions expressed are that of
                                      and discover those ‘aha!’ moments that lead to a                                    the writers and do not necessarily represent the views and opinions
                                                                                                                                  of the publishers. Printed by Mainland Press Pte Ltd.
                                      healthier, happier you.                                                                                       MCI (P) 101/04/2018

                                                                                                                                                                                          | 3

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Aha - Khoo Teck Puat Hospital
ealth Highlights

          Better
          Caregiver
          Support
           Being a caregiver can be taxing,
           especially when the population
           is ageing and families are small.
           This is why the Ministry of Health
           recently reviewed the system that
           offers support and relief to people
           providing this critical role.

          T
                    he Ministry of Health (MOH)   size is usually small, there is added      The discussions included
                    conducted a series of         burden on caregivers.                   consultations with caregivers, service
                    focus group discussions          While steps have been taken          providers, and various stakeholders,
                    in December 2018. The         over the past few years towards         all of whom were encouraged to
           aim was to identify opportunities      building up the range and quality of    come together to co-create solutions.
           to strengthen care navigation in       eldercare services, MOH also aims       An enhanced caregiver support
           the community, improve caregiver       to focus on providing more direct       system will also be implemented,
           support services, and find ways to     and holistic assistance to              complementing existing programmes
           empower caregivers.                    caregivers and build a strong           and assistance for caregivers, including
             As Singapore’s population ages,      caregiver support system. This is       tax relief for caring for parents or
           caregivers play an increasingly        critical to ensure that the elderly     handicapped family members, as well
           important role. However, as family     can age well in place.                  as grants to train caregivers.

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MEDISHIELD LIFE EXTENDED TO COVER MORE NEEDS
           In November 2018, national health insurance scheme MediShield Life was extended
           to cover three more groups of patients:

                                                                                                               1
                                                                                                 Patients admitted directly from
                                                                                               emergency departments of public
                                                                                                hospitals to community hospitals
                                                                                                  Eligible patients can claim up to
                                                                                               $350 per day from MediShield Life,
                                                                                             under the prevailing inpatient limit for
                                                                                                              community hospitals.

                                                                                                             2
                               3                                                          Those who need long-term intravenous
                                                                                                  nutrition for intestinal conditions
                                                                                              Eligible patients who need parenteral
                                                                                           nutrition for 90 days or more may claim
           Children born with the rare congenital conditions of trisomy 18                  up to $1,700 a month from MediShield
           and alobar holoprosencephaly and who need surgery                                Life and withdraw up to $200 a month
           Eligible patients may make a claim from MediShield Life for                       from Medisave for items necessary to
           surgical interventions, up to the prevailing surgical claim limits of                      administer parenteral nutrition.
           $200 to $2,000, depending on the complexity of the procedure.

              The broadening of coverage is
           part of MOH’s continuing review of                       Have a question about MediShield Life?
           MediShield Life to ensure that it provides               Log on to the MediShield Life website at
           protection for Singaporeans against
           large hospital bills and selected costly
           outpatient treatments, in keeping with
                                                                                   www.medishieldlife.sg
           developments in medical care.

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hat’s Up

          Kampung Admiralty wins
          Building of the Year Award!

          K     ampung Admiralty, which
                encompasses Admiralty Medical
          Centre, was crowned Building of
          the Year at the World Architecture
          Festival in Amsterdam in December
          2018. The 11-storey complex was
          picked from 535 other projects
          spread across 57 countries.
              As the first integrated kampung
          in the world, the development
          was recognised for its innovative
          infrastructural design and ‘software’,
          both coming together to enhance
          social integration and elder-friendly
          community, while giving easy
          access to amenities. The mixed               Yishun Health’s Admiralty Medical
          development hosts public housing,         Centre occupies levels 3 and 4
          a mix of healthcare, eldercare and        of Kampung Admiralty, giving the
          childcare facilities, as well as retail   community access to a suite of
          and dining outlets.                       specialist outpatient services.

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For All Your Urology Needs

          Dr Molly Eng, Head & Senior Consultant, Urology (third from right), Mrs Chew Kwee Tiang, CEO, KTPH & Yishun Health (middle), with the
          rest of the Urology department at the opening ceremony (below)

          Y      ishun Health officially opened
                 the new KTPH Urology
          Clinic on 29 November 2018. The
                                                        urological procedures in the days of
                                                        Alexandra Hospital.
                                                           Located at Tower C, C44, the
                                                                                                     subspecialties. These include a
                                                                                                     Haematuria Clinic, Ureteric/Colic
                                                                                                     Clinic, Fast Tract Clinic, as well as
          comprehensive clinic is a milestone           Urology Clinic will provide one-             services to address bone health,
          for the service, which has come               stop hassle-free service across              andrology, women’s urology,
          a long way from providing key                 a wide range of conditions and               oncology, endourology and stones.

                                                                                                                                            | 7

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hat’s Up

          Raising Pressure Injury
          Awareness
          T     o raise the level of skill and
                awareness of pressure injury,
          the Pressure Injury Workgroup
          organised an in-depth event for
          staff and community partners. STOP
          Pressure Injury was a full-day event
          held on 29 November 2018.
             Aimed at bolstering the
          proficiency of healthcare workers,
          particularly in the community care
          sector, the event included four
          plenary sessions and three skills      Our community partners participated in the lectures and workshops
          workshops.                             to share the knowledge and skills with their organisations
             There was also a keynote speech
          by Mr Emilio Galea, International
          Medical Director of URGO Medical,      topic and shared useful ideas on            learn wound-dressing methods, and
          who addressed the prevention and       good pressure wound care.                   use a pressure-mapping system to
          management of pressure injuries.          Workshop participants had the            ensure proper seating position to
          Other experts also expanded on the     chance to try pressure injury devices,      lower the risk of pressure wounds.

          Diabetes Management:
          It Takes a Village
          U     nderscoring the importance
                of support, Yishun Health
          commemorated World Diabetes
                                                 diabetes management and reminded
                                                 participants of the far-reaching
                                                 consequences of the chronic disease
                                                                                             diabetes-related eye complications.
                                                                                             Foot and footwear were also
                                                                                             assessed. There was even a cooking
          Day with the theme ‘The Family &       for both patients and their loved ones.     demonstration, which emphasised
          Diabetes’. Held on 3 November 2018        At the booths, participants              that food need not be heavily
          at the Kampung Admiralty Plaza,        were asked to guess their blood             seasoned to be delicious.
          the event involved five interactive    glucose ‘number’, and shown the                Guest calligraphist Mr Jimmy Koh
          multisensory booths. Each covered      consequences of high blood sugar            also presented a scroll of a Chinese
          the multidisciplinary nature of        via illustrations, and the impact of        couplet, which translates to:
                                                                                             “A healthy body makes you feel
                                                                                             strong, so do not wait and worry
                                                                                             about your health in old age.”

                                                                                             Unveiling of Mr Jimmy Koh’s (third from
                                                                                             right) calligraphy couplet by Guest-
                                                                                             of-Honour Mr Amrin Amin and KTPH
                                                                                             & Yishun Health CEO Mrs Chew Kwee
                                                                                             Tiang (fifth and sixth from left)

          8 |

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Aha - Khoo Teck Puat Hospital
‘X’ Marks
                                                                                                       the Spot
                                                                                                       I  n celebration of World
                                                                                                          Radiography Day, which falls
                                                                                                       on 8 November, Yishun Health
                                                                                                       radiographers set up informational
                                                                                                       posters to celebrate the 123rd
                                                                                                       anniversary of the discovery of
                                                                           Learn more                  X-rays. The exhibition showcased the
                                                                        about X-rays and               evolution of medical technologies.
                                                                           radiation in                There were also posters highlighting
                                                                         5 Things About                the different medical imaging
                                                                           on page 24                  methods and interesting trivia aimed
          Participants took the time to read informational posters
                                                                                                       at dispelling myths and fears of
          in order to find answers to a challenging quiz
                                                                                                       radiation exposure from scans.

          Combat
          Sports
          Comes to
          KTPH

                                                                                                                             Our first Combat

          O      n 3 November 2018, Yishun
                 Health’s Sports Medicine
          Centre, together with WAKO
                                                         of diet for optimal performance,
                                                         and tips for physical training
                                                         and rehabilitation.
                                                                                                                                Sports Public
                                                                                                                              Forum brought
                                                                                                                            together medical
          Kickboxing Singapore, held their                   Apart from this, demonstrations                                      and martial
                                                                                                                               arts experts in
          first Combat Sports Public Forum at            added an action-filled edge to the day.
                                                                                                                              an afternoon of
          KTPH. More than 150 people signed              Athletes showed off a range of pugilistic                          educational talks
          up for the event, which included               styles, from kickboxing and Brazilian jiu-                        and action-packed
          enlightening talks from a sports               jitsu to silat and savate (French boxing),                          demonstrations
          doctor, dietitian and physiotherapist          thrilling the audience with their dexterity
          on common sport injuries, the impact           and high-powered moves.

                                                                                                                                          | 9

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hat’s Up

                                                                                                                     Turn to

          Mental Wellness for                                                                                     page 12 to read
                                                                                                                  more about the
                                                                                                                  Food Services

          the Family                                                                                               department

                                                                              I  n collaboration with various community partners,
                                                                                 the Family Mental Wellness Carnival was held on
                                                                              20 October 2018 to cultivate a caring and inclusive
                                                                              community, and promote mental wellness. Community
                                                                              partners organised a range of fun activities designed to
                                                                              highlight the signs and symptoms usually manifested by
                                                                              persons with mental illness, and the effects of ageing on
                                                                              cognitive skills.
                                                                                  These included informative exhibits on the five
                                                                              languages of love, and how to connect with and show
                                                                              appreciation for each other. Families bonded over
                                                                              crafting, skin painting, and balloon sculptures. Chefs
                                                                              from KTPH Food Services also conducted a live cooking
                                                                              demonstration to encourage healthy eating, providing
          Staff from KTPH Food Services giving a live cooking demonstration   recipe cards so that participants can recreate the dishes
                                                                              at home.

          A Nurse Leader
          in the Making
          S     abrina Tan, Staff Nurse, Acute
                & Emergency (A&E), KTPH,
          was conferred the Ngee Ann Kongsi
                                                           Sabrina’s first taste of
                                                       nursing occurred in
                                                       secondary school when
          Gold Award on her graduation on              she joined the St John’s
          19 October 2018. She was recognised          Ambulance Brigade
          by the Singapore Institute of                uniformed group.
          Technology (SIT) not only for her            “You’re there for the
          excellent academic achievements,             patients most of the time,
          but also her active involvement in           especially when they’re
          community projects.                          sick. They can be angry and
              She topped SIT’s inaugural batch         frustrated sometimes, but
          of 52 nursing degree students. The           there is a sense of satisfaction
          Bachelor of Science in Nursing is a          to see them recover and go home, ”
          joint degree awarded by SIT and the          she recalls.
          University of Glasgow. As part of SIT’s          Today, Sabrina continues to show
                                                                                                    Sabrina Tan’s passion for nursing started
          Community Service Club, she led              care for people in the wards as she           when she joined the St John Ambulance
          projects to benefit underprivileged          equips herself with the skills required                   Brigade in secondary school
          children in Laos and Myanmar.                in the rigorous nature of A&E.

          10 |

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Pledging Support
                        for an Inclusive Society

          Y     ishun Health was part of the
                10,000 people who turned up
          for the Purple Parade on 27 October
                                                       Within the Yishun Health campus
                                                   itself, there are efforts to build
                                                   an inclusive workforce through a
          2018. Staff were there to pledge their   partnership with SG Enable, an agency
          support for the movement, which          dedicated to enabling persons with
          seeks equal access to education,         disabilities. Every year, we provide a
          employment, transport and social         batch of students from SG Enable with
          networks for people with special         on-the-job training, equipping them
          needs.                                   with useful skills for the future.

                                                                                            | 11

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potlight

            Ghazali (left) and Chef Simon, Executive Sous Chef,
            lead the KTPH Food Services team behind the scenes

     What’s Cooking? C
                                                                            ooking 2,700 meals a day
                                                                            is quite a feat. But consider
                                                                            that not all these meals are
                                                                            the same and, in fact, can
                                                                  involve anywhere between 80 and
            A complex choreography of planning goes               90 permutations, and the complexity
            into each nutritionally balanced and                  becomes even more apparent.
            carefully plated meal served across Yishun               According to Ghazali bin
                                                                  Mohamad, Head and Manager,
            Health, from inpatient dishes to staff meals.         Food Services, KTPH, putting
            Here’s a look at what it takes.                       together these many variation
                                                                  of meals entails comprehensive
                                                                  planning behind the scenes. Not
                                                                  only does the department provide
                                                                  meal services for patients, it is also

            12 |

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THE KAIZEN
                                                                                                   SERIES
            a supporting department for the                                                          PART 2 OF 3
            whole organisation and caters for

                                                                                       1
            internal and special events as well as
            provides meals for staff. “Our area
            of coverage is wide because we
            cover outpatient clinics, Emergency
            Department patients, and even
            support frontline staff so that they                                       Quality control
            can focus on their jobs in caring for                                      begins at
            patients,” he shares.                                                      the door
                Then there are also fresh fruits,                                      Purchasers do stringent
            coffee and tea provided for patients                                       checks, acting as
            who come for early morning                                                 ‘bouncers’ to ensure
            appointments, and special treats                                           that food items meet
            during festive periods. “We do it                                          minimum quality and
            all,” Ghazali stresses. He emphasises                                      temperature standards.

                                                                                       2
            that the department’s key role is to
            “provide healthy meals and support
            therapeutic eating plans, and also
            ensure that the food we provide is
            safe and good enough for our own
            families”. This means a high level of                                      Safe storage and
            care is exercised to ensure that all                                       organisation
            foods — raw, dried, fresh or cooked                                        After passing inspection,
            — are kept at safe temperatures,                                           food items are stored
            handled with care, and tested                                              in respective areas and
            for quality.                                                               organised under the
                “It all begins at the planning,                                        first-in-first-out and
            purchasing and preparation stages,”                                        first-expiry-first-out
            explains Ghazali, “and takes up                                            principles to reduce
            almost three-quarters of the work.”                                        food waste.

                  AVOIDING THE DANGER ZONE
                                                                                     100oC
                  •   The temperature danger zone is between
                      5oC and 60oC — harmful bacteria grow in
                                                                    Hot food zone
                      food easily at these temperatures
                  •   Minimise the time that food spends at these
                      temperatures in order to keep food safe                        60oC
                  •   Refrigerated food needs to be kept at 5oC
                      or below                                       Temperature     Bacteria grow
                                                                     danger zone     quickly
                  •   Hot food needs to be kept at 60oC or above

                                                                                     5oC
                  Food should be kept out of the danger zone,
                                                                    Cold food zone   0oC
                  i.e. between 5oC and 60oC. The goal of the
                  kitchen’s hot and cold chain is thus to keep
                  food temperatures below or above this zone.        Frozen food     -18oC
                                                                            zone     Bacteria do not
                                                                                     grow

                                                                                                            | 13

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potlight

                                                                                        3       Preparation
                                                                                                To raise productivity and
                                                                                                speed of cooking, various raw
                                                                                                ingredients are cleaned and
                                                                                                prepared in advance. Some
                                                                                                items are given a quick blanch
                                                                                                to par-cook before being
                                                                                                blast-chilled to preserve their
                                                                                                freshness and flavour. Soups,
                                                                                                gravies and base sauces are
                                                                                                also made ahead of time.

                MEALS IN NUMBERS

                                       4
                                            cuisines:
                                            Chinese,
                                            Malay, Indian
                                       and Western

                                       5
                                           meals: breakfast,
                                           lunch, afternoon
                                           tea, dinner and
                                       supper

                                       6
                                             rice options: white
                                             rice, brown rice, mixed
                                             white/brown rice, soft
                                       rice, plain porridge and
                                       pureed porridge

                                                          22
                                                      therapeutic

                250kg                                    diets

                                                            6
                vegetables for 1,800

                                                                       4
                main meals daily                       allergy-
                                                   avoidance diets         Fire it up!
                                                                           Closer to meal times, the burners in the kitchen are
                100kg
                meat for 1,100
                                                            4
                                                       modified
                                                                           fired up and chefs pull out the prepared ingredients
                                                                           to cook up a variety of stir-fries, curries and soups.
                                                     texture diets:
                main meals daily                     regular, soft,        Each day, about 11 meal options are made available.
                                                    minced, pureed         Some of the cooked food may have its texture

                100kg
                rice for 1,450
                                                                           modified — pureed or mashed — in accordance
                                                                           to the speech therapist’s texture guidelines. This
                main meals daily                                           ensures that people with swallowing difficulties can
                                                                           eat safely without choking. To do this, foods may
                                                                           be modified with special thickeners.

            14 |

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THE KAIZEN
                                                                                                                         SERIES
                                                                                                                          PART 2 OF 3

            5         Testing, plating and
                      temperature checks
                      Each meal prepared is developed in

                                                                            6
                      collaboration with Yishun Health’s dietitians and
                      is checked to be low in fat, salt and sugar, but             Load it up!
                      high in nutrition, variety, taste and texture. Once          The plated food is plated according to the
                      a dish is cooked, it is loaded into warmers for              patient’s diet order. It is then loaded into the
                      plating. Taste and temperature tests are done                pre-heated food cart. The food cart will then be
                      before plating to ensure that the food meets all             programmed and transported to the wards via
                      safety (and taste) requirements.                             Automated Guided Vehicles.

            HEALTHY, SAFE, TASTY                                            Even the water used to wash fruits and vegetables is not
            AND SUSTAINABLE                                                 immediately disposed of; rather, it is recycled and used
            Apart from the many considerations to ensure that meals         for the first round of floor washing.
            are balanced, delicious and safe to eat, the department            This underscores the Food Services department’s
            goes the extra mile to be environmentally conscious             holistic approach to food, health and wellness, assures
            through many small process improvements. For example,           Ghazali. “The Food Services team strives to provide
            food waste is reduced at the production level. Vegetable        the best food and care for our patients because we
            and meat scraps are used to make richly flavoured stocks,       believe eating well also plays a pivotal role in their
            and fruit trimmings are used for desserts such as pies.         healing process.”

                                                                                                                                 | 15

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veryday Heroes

                                “It’s good to know
                                 someone cares”
           Life has been hard for Ms Sally Low, 47, who has been a caregiver to both her
             parents and is now in need of some care herself. Recently diagnosed with
            cancer, Sally nevertheless finds joy in the simple pleasures of life and urges
               people in need to open themselves up to self-care and social support.

                                                                                          As a caregiver, Sally receives free hand
                                                                                         massages at the sensory bay. This offers
                                                                                             her relief from the numbness in her
                                                                                                      hands due to chemotherapy

         S
                     ally was only in her 20s       caregiving at home was too much      for her mother, whose condition
                     when her father, then in       for her mum and herself, and made    was quite severe and resulted in a
                     his 70s, was diagnosed         the difficult decision to move her   number of behavioural adjustments.
                     with a brain tumour. As        father to a nursing home.            Back in the role of caregiver —
          the only child of elderly parents,           When he passed away in 2003,      this time on her own — Sally was
          Sally had to shoulder a lot of the        Sally thought that her caregiving    often overwhelmed. She became
          responsibilities as breadwinner           duties were over. But a few years    depressed, stressed and isolated,
          and co-caregiver. She even had to         ago, her mother had a fall and,      constantly worrying about her
          hold down two jobs to support the         during her stay in hospital, was     mother, work and finances. She
          household financially. After some         diagnosed with dementia. Sally       experienced one of her lowest
          time, Sally realised that the strain of   decided to leave her job to care     points when her mother fell and was

          16 |

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warded at Khoo Teck Puat Hospital.         burden of treatment.
              Recognising the immense                Aside from this,
          pressures that Sally was facing,           Sally has benefited
          her mother’s doctor, A/Prof Philip         from receiving
          Yap, Senior Consultant, Geriatric          aromatherapy and
          Medicine, connected her with               massage sessions
          Montfort Care, a network of social         that helped improve
          and community programmes                   her quality of sleep
          committed to improving the lives           (see sidebar). This has
          of individuals, families and the           helped her overcome
          community facing transitional              insomnia and manage
          challenges. It was also during this        her stress levels, so she can
          time that Sally decided to find a          focus on getting better.
          new job as a Student Care Officer to          By opening up about her
          support both her mother and herself.       experiences and illness, Sally hopes to                Over time, Sally found herself
                                                                                                            opening up to Jayne about her
                                                     encourage others to do the same —
                                                                                                                  problems and concerns
          SOMEONE TO LEAN ON                         and know that there is help out there.
          IN DARK TIMES                              Services such as Montfort Care, and
          It was then that Sally met Jayne           social workers such as Jayne, have         will be conducive to helping others
          Leong, Lead Social Worker at               had a huge impact on her life. “I wish     “open up to a circle of social support”
          Montfort Care. “Somehow we                 we had this help when my dad was           and know that there is hope and
          connected,” says Sally, who found          sick. It would have made such a big        care out there. “I want to dedicate
          herself opening up about her               difference to us,” Sally shares.           my life to help whoever comes my
          problems and concerns. Through                 Though she still has her own           way,” she says. “I used to be very
          these chats, Sally made another            battles to fight, Sally wishes to make a   negative, but I have seen the light
          difficult decision to opt for nursing      difference to others, and pay forward      at the end of the tunnel. It’s good to
          home care at All Saints Home in            the good she has received. In fact, she    know someone cares, so I want to
          Yishun, where her mother would have        is looking forward to volunteering at      people to know that there is help out
          more supervision and professional          GoodLife@Yishun, and is training to        there. I have struggled before, but
          care. “I felt very guilty about it but     be a listening ear and friend to others.   now with support, I know I do not
          talking with Jayne helped me to see        She hopes the environment of care          struggle alone.”
          things from a different perspective.”
              Having someone to talk to
          and a support system became
          even more crucial when Sally was              HEALING HANDS, CARING HEARTS
          diagnosed with Stage 4 rectal cancer          GoodLife@Yishun, a one-stop wellness hub and resource centre, was
                                                        launched on 25 November 2018. Run by Montfort Care and supported
          in early 2018. Sally had surgery
                                                        by the Nee Soon South community, the space features a drop-in café
          in April, followed by eight rounds            for residents and a sensory bay that offers free hand massage therapy
          of chemotherapy. Despite this,                and mindful tea drinking sessions for caregivers.
          Sally faces the next phase of her                Apart from conducting wellness activities for seniors, the centre
          treatment with quiet courage. “I am           also runs case management, counselling, caregivers’ support groups,
                                                        dementia and mental health screenings, and active ageing and
          no longer as worried as I used to be
                                                        befriending programmes.
          because I know I have someone I can              For Sally, these hand massages offer some relief as her
          talk to and there is help,” she affirms.      chemotherapy causes numbness in her hands. The sessions are
          Jayne has helped her to apply for             relaxing and help her feel better. Sally encourages caregivers to stop
          subsidies, reducing the financial             by to engage in some self-care and, perhaps, open up to others about
                                                        what they are going through. This is the first step to seeking help, she
                                                        says. “I would like to raise awareness of such spaces and services, and
               GOODLIFE@YISHUN                          my hope is for others to come out of their shell to share their problems
               838 Yishun Street 81                     and seek help. If you do, will find that you are not alone and there are
               Singapore 760838                         many resources and help available.”
               Tel: 6484 8040

                                                                                                                                     | 17

16-17 Everyday Heroes.indd 17                                                                                                          10/1/19 3:30 PM
Cover Story

          A JOURNEY
          OF MANY
          STEPS
           From ground-up approaches that
           engage the community to changing
           behaviours, this article explores
           the novel ways that Yishun Health
           improves the delivery of healthcare.

          T
                     he pursuit of delivering     its various touchpoints and               Over the last three years, some
                     better healthcare can take   institutions. This stems from a      20,000 people — students, retailers,
                     many forms. It could be      mindset that first acknowledges      business-owners, and members of
                     making access to care        challenges.                          religious organisations — have been
           more convenient for patients,                                               trained to spot people with dementia,
           collaborating with partners to         A CARING-VILLAGE                     how to interact with them, and help
           improve efficiency, or educating the   APPROACH TOWARDS                     or refer them to suitable agencies.
           public to raise awareness. In some     DEMENTIA                             This awareness is aimed at better
           cases, it may involve transforming     Recognising that our population is   addressing dementia, de-medicalising
           processes completely.                  ageing rapidly, Yishun Health has    it, and offering greater empathy
              Yishun Health embraces all          made improvements to build a         and support to those with dementia
           these moves as part of an ethos        more aged- and dementia-friendly     as well as their caregivers. Instead
           of constant improvement across         community in northern Singapore.     of treating them as patients, the

           18 |

18-23 Cover Story.indd 18                                                                                                10/1/19 4:09 PM
THE KAIZEN
                                                                                                                      SERIES
                                                                                                                        PART 2 OF 3

                                                                                                     Members of the CARITAS team
                                                                                                         having a discussion led by
                                                                                                      A/Prof Yap (fourth from right)

           dementia-friendly initiative aims to     about the newest GoodLife! eldercare    Yap, Senior Consultant, Geriatric
           help people with dementia to live        centre in Yishun on page 17].           Medicine. When patients are
           at home rather than in hospitals or          Another partnership to improve      discharged from the hospital and
           nursing homes.                           the care for frail older persons with   head home, or to a nursing home or
              Today, there are more than 13         dementia as well as support ageing      a day care centre, the CARITAS team
           dementia go-to points in Yishun. These   in place is CARITAS iCommunity@         continues to be part of the care.
           ‘safe return’ spots are places where     North. Started in 2012, the goals of    “This extends dementia care into the
           members of the public can bring lost     this integrated care model is spelt     community,” explains A/Prof Yap.
           and wandering people with dementia.      out in its name. “CARITAS stands           The transdisciplinary team of
           Yishun Health has also partnered         for Comprehensive, Accessible,          Yishun Health doctors, nurses,
           organisations such as Montfort Care      Responsive, Individualised,             physiotherapists, occupational
           to provide longer-term support for       Transdisciplinary, Accountable and      therapists, speech therapists,
           patients and caregivers [read more       Seamless care,” says A/Prof Philip      psychologists, pharmacists, and

                                                                                                                                | 19

18-23 Cover Story.indd 19                                                                                                          10/1/19 4:09 PM
Cover Story

                                                                                              medical social workers — all dementia
                                                                                              specialists — meet weekly with
               PATIENT-CENTRED DEMENTIA CARE                                                  community partners to discuss
               Within the hospital setting, Yishun Health has made improvements               care plans, provide updates, and
               to the way dementia is cared for. Since 2003, it has run the only              share recommendations to offer
               specialised inpatient dementia care unit in a tertiary acute care setting in
                                                                                              timely and proactive care. This
               Singapore.
                   The 16-bed CAMIE (Care for the Acute Mentally Infirm Elderly) ward         means no patient falls through the
               in KTPH adopts person-centred care that prioritises the needs of each          cracks even after they have left the
               patient. A sister ward in YCH, CARMIE (Comprehensive Assessment                hospital. Patients and their families
               & Rehabilitation of the Mentally Infirm Elder), cares for patients with        are also holistically supported with
               dementia who have less acute medical conditions or who need physical
                                                                                              individualised, person-centred care.
               rehabilitation.
                   As of December 2018, CAMIE and CARMIE have recorded 2,078 and              There is even a patient care manager
               220 restraint-free days respectively.                                          whom caregivers can readily contact
                   According to A/Prof Yap, elderly patients with dementia in hospitals       if they need help. This heightens the
               have been found to have better health outcomes if they are not tied            responsiveness to ad hoc as well as
               down with physical restraints, and if their autonomy is respected.
                                                                                              long-term needs.
                   He leads a study that proves that the restraint-free system is both
               cost-effective and scalable. Instead of using restraints, nurses find other        Today, CARITAS serves more
               ways to gain the cooperation of patients. One way is to build rapport          than 800 patients with dementia
               and gain their trust. Another is to use technology such as pressure-           and differing levels of frailty and co-
               sensor mats so staff are alerted when the patient attempts to get out of       morbidities in the North.
               bed. Compared to conventional care, restraint-free care sees a:
                                                                                                  Dementia awareness is nurtured
               • 32% improvement in well-being
               • 15% improvement in mobility and function                                     through an intervention programme
               • 45% reduction in challenging behaviour                                       called New You. This started in
               • No increase in the rate of falls                                             2007, back in the days of Alexandra
                                                                                              Hospital, and has been based

             Dr Ng Chong Jin, Consultant,
             Geriatric Medicine, works with
             A/Prof Philip Yap in the Dementia
             team to care for their patients

           20 |

18-23 Cover Story.indd 20                                                                                                         10/1/19 4:09 PM
THE KAIZEN
                                                                                                                        SERIES
                                                                                                                          PART 2 OF 3

           All dementia                            this culture of community-led care
                                                   is making its mark. A group of
                                                                                               diabetes nurses, podiatrists and
                                                                                               dietitians work not only on their
           specialists meet                        residents has even begun to use             specific areas, but across specialties

           weekly with                             brochures on dementia as part of
                                                   their hanyu pinyin teaching material!
                                                                                               to ensure well-coordinated patient
                                                                                               care. “We realised our own gaps and
           community partners                      “They are also doing Sudoku                 the need to train ourselves in the

           to discuss care
                                                   puzzles as a group so that they can         specialised knowledge and skill sets
                                                   support one of their friends who            of our colleagues to move towards
           plans, provide                          was recently diagnosed with early           transdisciplinary care [see diagram
                                                   dementia,” shares Evon.                     on page 23],” he explains.
           updates, and share                                                                     While state-of-the-art research

           recommendations                         EMPOWERING
                                                   DIABETES SELF-CARE
                                                                                               plays an important role in treating
                                                                                               disease, it is just as essential to go
           to offer timely and                     Yishun Health has adapted its care          back to the basics, emphasises

           proactive care. This                    platforms to make care more integrated
                                                   as well as improve patient compliance.
                                                                                               A/Prof Tavintharan, who researches
                                                                                               in the area of diabetes and other
           means no patient                            One of these is in the ongoing          metabolic diseases. “We have good
                                                   improvements to diabetes                    drugs, surgical advancements, and
           falls through the                       management. The disease is not only         high-tech equipment, but as medical

           cracks, even after                      about managing blood sugar through
                                                   medication, but also through long-
                                                                                               professionals, we must not neglect
                                                                                               bread-and-butter issues,” he notes.
           they have left the                      term lifestyle and dietary changes.         “Lifestyle choices and daily habits

           hospital.                               And because the disease can lead to
                                                   many other complications, such as
                                                                                               make a big — if not more important —
                                                                                               difference in sustaining good health
                                                   heart disease, foot problems, poor          and managing disease.”
           A/PROF PHILIP YAP                       wound healing, and eye conditions,              So, while he researches
           SENIOR CONSULTANT,                      many specialists need to be involved.       extensively in the field, A/Prof
           GERIATRIC MEDICINE, KTPH                This can result in confusion, frustration   Tavintharan is just as involved in
                                                   and inconvenience for patients.             ‘simpler’ innovations on the ground,
           in KTPH’s Geriatric Clinic. The             According to A/Prof Subramaniam         particularly in novel ways to move
           programme has been implemented          Tavintharan, Director and Senior            care away from the hospital and
           in the Wellness Kampungs since          Consultant, Diabetes Centre,                into the community, and manage
           2017, and more than 50 sessions         Admiralty Medical Centre (AdMC),            diabetes in the earlier stages of the
           have been held. It combines exercise,   Yishun Health has been building and         disease pathway. “We are
           cognitive training and stimulation,     refining its diabetes care model since      enhancing our collaborations
           and social interaction for patients     its days as Alexandra Hospital. “The        with general practitioners (GPs),
           with early dementia. This programme     Diabetes Centre has been around             polyclinics, and our own
           for early dementia patients combines    for some time, but care has evolved         community nurses to influence
           exercise, cognitive training and        to better treat patients beyond             diabetes care and improve
           stimulation, and social interaction.    their medical well-being,” he shares.       outcomes,” he reveals.
               This programme is                   “First, we tackled the many facets of           For instance, patients coming to
           complemented with other ground-         care by developing multidisciplinary        the Diabetes Centre are greeted by a
           up initiatives from the community,      services around the patient.” The           large installation highlighting the Five
           such as Age Well Everyday, where        approach shifted the idea of ‘illness       Pillars of Diabetes Care:
           residents are trained to conduct        care’ to ‘holistic healthcare’, viewing     • Diet
           programmes on health education,         each patient as a whole rather than         • Exercise
           exercise and mindfulness. According     a combination of body parts or              • Support
           to Evon Chua, Manager, Population       medical conditions.                         • Monitoring
           Health & Community Transformation,          Together as a team, doctors,            • Medication

                                                                                                                                  | 21

18-23 Cover Story.indd 21                                                                                                           10/1/19 4:09 PM
Cover Story

               The DESMM message is
           reinforced throughout the clinic in
                                                 autonomy and agency improves
                                                 care compliance. “It is well known
                                                                                           Lifestyle choices
           the form of visible cues, such as     that patients who are more involved       and daily habits
           posters and self-monitoring booths.
           “In every corner, the patient is
                                                 in decision-making regarding their
                                                 healthcare are more motivated.
                                                                                           make a big — if not
           made aware of the steps they          This translates to better outcomes.”      more important
                                                                                           — difference
           can take in their own self-care,”         To drive patients to participate
           A/Prof Tavintharan highlights.        in their own care, his department
                                                 developed a mobile app for patients       in sustaining
           CO-CREATING                           to do their own eye tests at home.
           A CULTURE OF                          Regular eye checks at the hospital can    good health and
           COMMUNITY CARE
           A/Prof Yip Chee Chew, Medical
                                                 be inconvenient for patients, and could
                                                 lead to missed appointments that
                                                                                           managing disease.
           Director, AdMC, and Head and          result in eye problems going unnoticed.
           Senior Consultant, Ophthalmology      To improve the rate of eye screening,     A/PROF SUBRAMANIAM TAVINTHARAN
           and Visual Sciences Department,       the Macular Amsler Testing Application    DIRECTOR & SENIOR CONSULTANT,
           echoes the point about self-          (MATA) mobile app was developed.          DIABETES CENTRE, ADMC
           management as a way to improve        This allows patients to easily screen
           patient outcomes in the long          themselves at home to accurately
           term, and notes that a sense of       monitor their eye conditions. It also

           22 |

18-23 Cover Story.indd 22                                                                                                   10/1/19 4:09 PM
THE KAIZEN
                                                                                                                              SERIES
                                                                                                                                PART 2 OF 3

                                                         how they interact, their needs, and        participants in their own care, creating
                                                         how the community can play a role.         a more conducive place that supports
                                                             In some ways, AdMC, located            the idea of self-care.
                                                         within Kampung Admiralty, moves                Reflecting on these moves,
                                                         management of diabetes and eye             which enormously widens the idea
                                                         conditions away from hospital-based        of medical care from curing illness
                                                         treatment and shifts the perception        to caring for the whole patient,
                                                         of care, he notes. “The environment is     his family and even his community,
                                                         friendly and more community-based.”        A/Prof Tavintharan points to his own
                                                         The specialist centre offers the range     care motto, which is premised on
                                                         of services in a more convenient           a foundation of “caring and learning”.
                                                         location that integrates both the          He stresses, “While these innovations,
                                                         medical and social aspects of health.      improvements and realignment of care
                                                            Apart from changing the place           take more time and effort to put into
                                                         where care is delivered, AdMC also         place, it is worth it if we really want to
                                                         shapes its spaces to encourage             achieve integrated, hassle-free and
                                                         patients to be more active                 patient-centred care.”

                                                            The transdisciplinary approach sees the team coming together from the
                                                            beginning to jointly communicate, exchange ideas, and work together to
                                                            develop a holistic care plan. A multidisciplinary team involves individual
                                                            experts who come together with individually developed ideas to
                                                            formulate a solution. At Yishun Health, the medical teams explore ways
                                                            to move upstream to address the diseases in the early stages, so that
                       At the AdMC Diabetes Centre,         complications can be prevented, delayed or reduced in severity.
                           patients are treated by the
                 transdisciplinary team led by A/Prof
                       Tavintharan (third from right)                       TRANSDISCIPLINARY CARE

           enables them to spot any changes so
           that they can seek help early.
               But beyond the individual,
           healthcare engagement and
           education should also be widened.
           A/Prof Yip believes that involving
                                                                                                  PATIENT
           the community will play an important
           role in the management of not just
           eye disease and diabetes but also
           other lifestyle-related diseases,
           which he terms ‘medical social                                    MULTIDISCIPLINARY CARE
           conditions’. “Medical treatment
           cannot be as effective if the social or
           familial setting does not permit
           a change in lifestyle,” he explains.
           After all, he adds, “what one person
           does is a habit, what many people do
           is a culture”. To truly manage health
           holistically, healthcare innovations                                                                         PATIENT
           must consider where people live,

                                                                                                                                        | 23

18-23 Cover Story.indd 23                                                                                                                  10/1/19 4:09 PM
Things About...

                                       5 Things About
                                       RADIATION
                                       AND X-RAYS
                                       You may undergo an X-ray as part of a regular
                                       health screening or receive radiation therapy as
                                       a form of medical treatment, but what exactly
                                       are these ‘rays’ and how safe are they?
                                       In consultation with Muhammad Azhar bin Samsudin and Jasmine Lee,
                                       Senior Radiographers, Diagnostic Radiology, KTPH

           24 |

24-25 5 Things About....indd 24                                                                            10/1/19 3:35 PM
1
                 RADIATION IS ALL
                 AROUND US
                We often think of radiation
           as a man-made phenomenon,
           but low-dose radiation is natural.
           We are surrounded by naturally
           occurring radioactive elements in
           the environment, and cosmic rays
           are constantly penetrating the
           atmosphere from space. We have
           radioactive elements (Potassium 40,
           Carbon 14, Radium 226) in our blood
           and bones, while man-made devices,
           such as wrist watches and ionisation
           smoke detectors, emit small amounts
           of radiation. However, according to
           studies done by the United Nations
           Scientific Committee, the risk
           associated with low-dose radiation
           from natural and man-made sources
           is extremely small.

          2
                     RADIATION HAS ITS

                                                      3                                        4
                     PROS AND CONS                           SAFETY COMES                             X-RAYS ARE NOT
                   The use of radiation and                  FIRST UNDER THE                          ONLY USED FOR
           nuclear imaging techniques in                     ALARA PRINCIPLE                          MEDICAL PURPOSES
           medicine is one of the most important      ALARA stands for As Low As               While X-rays are used for diagnostic
           ways we diagnose and treat disease         Reasonably Achievable, and is            or treatment purposes, they are
           and injury. Small amounts of radiation     how patients and professionals           also very useful for security, and
           are used to obtain X-ray images and        working with radiation are protected.    are extensively deployed in air
           larger amounts are used to treat           It consists of three principles: time,   and sea ports as part of screening
           cancers and tumours. Certainly,            distance and shielding. The idea         procedures. The usefulness of seeing
           prolonged exposure can be harmful          is to minimise the amount of time        through the surface also means
           and, in rare cases, lethal. This is why    one is exposed to radiation, keep        X-rays are used to analyse fossils
           the risks and benefits are all weighed     a distance of at least 2m from the       and even artworks. In fact, historians
           carefully by medical professionals         radiation source, and use shielding      have used X-rays to examine
           and explained to patients who are          to reduce unnecessary exposure           underpaintings in ancient artefacts
           undergoing medical procedures              of body parts that are not being         and famous works of art.

                                                                                               5
           involving radiation.                       examined or treated.
                                                                                                      THE ‘X’ IN X-RAY
                                                                                                      MEANS ‘UNKNOWN’
                TAKING CLEAR X-RAYS                                                                    X-rays were discovered by
                X-rays can be taken in a                                                       Wilhelm Röntgen, a German physicist
                hospital’s radiology department,      be asked to lie or sit on a plate,       and mechanical engineer, in 1895
                a clinic specialising in diagnostic   while a camera on an arm is moved
                                                                                               during an experiment with electrical
                procedures, or even while you’re      over your body.
                seated in a dentist’s chair!                                                   conduction through low-pressure
                                                      As with any kind of photography,         gases. He named them ‘X-strahlen’.
                Usually, you stand in front of a      you need to remain still while the       ‘Strahlen’ means ‘beams’ or ‘ray’
                plate containing X-ray film or        X-rays are emitted so that clear         in German, while the ‘X’ was pulled
                detectors. Sometimes, you may         images can be obtained.
                                                                                               from algebra’s use of the letter as an
                                                                                               unknown quantity in an equation.

                                                                                                                                 | 25

24-25 5 Things About....indd 25                                                                                                    10/1/19 3:35 PM
ive Well

           A Wealth of
           Experience
           With a combined experience spanning
           more than 150 years, these four veteran
           anaesthesiologists aged 70 and above are still
           passionately pursuing their vocation, which
           helps them keep active in mind, body and spirit.

          T
                        here is more to                to see patients from across the age
                        anaesthesiology than           spectrum and medical conditions.”
                        putting people to sleep.           Another attractive aspect of the
                           For Dr Low Tut Choon,       job, adds Dr Low, is that the work
           Dr Lim Kim Seong, Dr Subhashini d/o         can span the surgical, intensive care,
           Anandan and Prof Chandra Mohan              emergency, and pain management              (L–R, standing): Dr Subhashini d/o
           Kumar, it is about making challenging       fields, which gives doctors many            Anandan, Dr Lim Kim Seong,
                                                                                                   Prof Chandra Mohan Kumar
           medical conditions easier to bear,          avenues to choose from. “There are          (Seated): Dr Low Tut Choon
           surgeries safer and more effective,         various modes of anaesthesia, from
           and giving patients a better quality        general to regional, as well as mild
           of life. After all, says Dr Subhashini,     sedation. The work also involves
           better known as Dr Subha, “Any              airway and pain management,”              BETTER WITH AGE
           illness is tolerable if there is no pain.   Dr Lim explains.                          With their breadth of experience,
           And there is a lot of satisfaction in           This variety keeps the job            these four physicians are also
           helping to alleviate pain and reassure      interesting and offers many paths         respected educators and mentors.
           patients when they are afraid.”             for professional development.             “It feels good to be able to still be an
                                                       Prof Chandra, in particular, has          active and appreciated member of
           THE VARIETY WITHIN                          embraced this wholeheartedly:             the medical profession,” says Dr Lim.
           While they have each spent more             he even has a Masters in Computing,           They have continued to learn,
           than 40 years in anaesthesiology,           in addition to his medical                grow and adapt with the profession,
           they readily admit that it was              qualifications. “I love this work!” he    attending weekly lectures and poring
           not their first choice as a medical         enthuses. “Doing anaesthesiology          over journals. One of the biggest
           specialty, and never thought that           — whether in the operating theatre,       changes has been the incredible
           it would become a lifelong career.          writing papers, or as an educator —       advancements in technology.
           Most of them joined for practical           keeps me mentally active.”                Dr Low recalls that much of the
           reasons — they were posted to the               Just as active is Dr Subha. “I will   management of patients was done
           department during their houseman            keep on working for as long as I am       manually in the early days. “We had
           rotation. But the year-long training        able; it is something I really enjoy,”    to take blood pressure with our hands
           grew on them, so they stayed. Says          she says with a laugh. “Working in the    while ventilating the patient with our
           Dr Lim, “It is a specialty that requires    operating room keeps me active, and       knees,” he shares. “Electrocardiograms
           lots of focus, precision, and keeping       I am known to move very fast — but        were recorded not using electrodes
           up with technology. You also get            only in short bursts.”                    but with needles inserted under

           26 |

26-27 Live Well.indd 26                                                                                                                 10/1/19 3:36 PM
the skin.” Digital technologies, less            This mindset of learning, and           He frequently conducts lectures on
           invasive methods, and automation             embracing change and challenges is          the role of anaesthesiology in eye
           have changed the practice of medicine        a common characteristic among the           surgery for the elderly.
           tremendously. “Anaesthesia drugs             other members of this quartet.                  While Dr Low has spent several
           and technology are now safer, more               Dr Lim believes this is essential as    years heading the Anaesthesia
           precise, and the outcomes are better,”       patient profiles change; illnesses are      department, one of his areas of
           assures Prof Chandra.                        getting more complex and doctors            interest these days is chronic pain
               It has not always been easy to           have to account for complications           management. Beyond just treating
           keep up with technology, especially          such as chronic illness, obesity and an     the pain, he believes in supporting
           when it comes to computers, admits           ageing population. Dr Lim, who has an       patients. “Some patients suffer for
           Dr Subha. “But we just need to keep          interest in bariatric surgery, works with   a long time with chronic pain but
           learning and not be afraid to ask for        his peers to ensure that overweight         may not be taken seriously by their
           help.” It is all part of the collaborative   patients optimise their health status       family and friends,” he reveals.
           aspect of medicine, she surmises.            before surgery.                             He finds that listening to his
           “I enjoy working with my team very               Prof Chandra is an advocate             patients supports them more
           much. We need and support each               for making eye surgeries safer              holistically. “It is therapeutic
           other.” For this reason, she is keen         for elderly patients with dementia          somehow to simply be there for
           to work in the operating theatre,            through regional rather than general        them,” he shares. “All medicine is
           where there is a strong sense                anaesthesia. This, he advises, limits       fulfilling; being able to be there to
           of teamwork and camaraderie,                 the risks of respiratory, liver and         ensure that patients are safe and
           especially under pressure.                   kidney issues, and cognitive decline.       taken care of is what matters.”

                                                                                                                                      | 27

26-27 Live Well.indd 27                                                                                                                 10/1/19 3:36 PM
akan Time

          Steamed Seabass,
                                                                                           cut
                                                                                         & keep

          Teochew Style
          Fresh fish, best served steamed, is a deliciously
          simple addition to the dinner table. It’s high in
          protein and omega-3, and low in fat.
          Recipe contributed by Chef Terry Wan Sau Ann, Food Services, KTPH,
          and in consultation with Nutrition and Dietetics, KTPH

          INGREDIENTS
          Serves 4
          • 500g seabass, whole
          • 20g tomato, thinly sliced
          • 15g red chilli, thinly sliced
          • 10g salted vegetable, thinly sliced
          • 20g dried Chinese mushroom, soaked
            and thinly sliced                           NUTRITIONAL
          • 10g ginger, thinly sliced                   INFORMATION (1 SERVING)
          • 30g silken tofu, cut into strips
                                                        Energy                 128kcal
          • 10g salted plum, seed removed
                                                        Carbohydrates          2g
          METHOD                                        Protein                25g
          1. Wash and clean the seabass with water,
                                                        Fat                    2g
             pat dry, then place on a steaming plate
          2. In a bowl, combine all other ingredients   • Saturated            1g
             and spoon on top of the fish               • Polyunsaturated      0.5g
          3. Pour ¼ bowl of water over the fish
                                                        • Monounsaturated      0.4g
          4. Bring the water in your steamer to a
             rolling boil                               Cholesterol            68mg
          5. Steam the fish for 8 minutes               Fibre                  1g
          6. Remove from steamer
                                                        Sodium                 229mg
          7. Add salt and pepper to taste; serve hot

          28
          28 |

28-29 Recipe.indd 28                                                                              10/1/19 3:37 PM
| 29

28-29 Recipe.indd 29    10/1/19 3:37 PM
aily Dose

           Snack smart!
           Ring in the new year with a healthier
           approach to traditional snacks and dishes of
           festive occasions. Enjoy in moderation, and
           exercise a little extra to burn off the excess.
           In consultation with Chow Pek Yee, Principal Dietitian,
           Nutrition and Dietetics, KTPH

         E
                     ating healthily does not mean      to sodas, packet drinks (even the
                     depriving yourself of all things   ‘less sweet’ varieties), and fruit juices,   that have lower sugar content.
                     delicious. It simply means         all of which contain lots of sugar. Go           Fat should form no more than
                     making informed choices and        for water, Chinese tea, or sugar-free        25–30% of your daily caloric intake;
           eating in moderation. It also means          green tea instead. You can then              this translates to 14–16 teaspoons
           choosing quality over quantity, and          allocate your sugar quota (the Health        of fat (55–65g). To achieve this, try
           mindfully enjoying each mouthful.            Promotion Board recommends no                forgoing items that are deep fried,
               One simple way to reduce your            more than 8–11 teaspoons a day;              and be mindful of any hidden fat and
           intake of extra calories is to say “no”      that’s 40–55g) on cookies and snacks         gravy served with dishes.

           SUGAR

                                   Soda (330ml): 7tsp sugar, 133kcal                                    Chinese tea,
                                                                                                        Green tea, Water
                                   ‘Less Sweet’ Chrysanthemum tea
                                                                                                        0tsp sugar, 0kcal
                                   (330ml): 4tsp sugar, 70kcal

                                   Pineapple tart (1 piece)                                             Love letter (1 piece)
                                   3tsp sugar, 93kcal                                                   1tsp sugar, 17kcal

           FAT

                                   Deep-fried nian gao (35g)                                            Steamed nian gao (20g)
                                   2tsp fat, 160kcal                                                    1tsp fat, 46kcal

                                                                                                        Traditional yu sheng with half
                                   Traditional yu sheng (387g)                                          the amount of oil dressing and
                                   8.5tsp fat, 561kcal                                                  deep fried items (450g)
                                                                                                        5tsp fat, 354kcal

                                   Deep-fried chicken breast                                            Deep-fried chicken breast
                                   (with skin)                                                          (without skin)
                                   4tsp fat, 364kcal                                                    1tsp fat, 224kcal

           30 |

30 Daily Dose.indd 30                                                                                                                    11/1/19 5:27 PM
ind & Health

                       Healthy Habits Planner
                                    Set out your intentions for the day, week,
                                  month or year — and achieve your health goals!

                                EXERCISE REGULARLY:                                           EAT HEALTHILY:
                     A weekly exercise routine I would like to try out                    Cups of water I would
                                                                                            like to drink daily

             MONDAY                                                                1           2         3         4

             TUESDAY                                                               5           6         7         8
                                                                                   Fruits and vegetables that I
             WEDNESDAY                                                           would like to include in my meals

             THURSDAY

             FRIDAY
                                                                                       How many times a week
                                                                                         I would like to include
             SATURDAY                                                                  brown rice into my meals

                                                                                   1      2     3   4    5    6    7
             SUNDAY
                                                                                   8      9    10   11   12   13   14

                           BE HAPPY:                      PRACTISE
                   3 things I am grateful                                                 HEALTHY HABITS:
                                                      PERSONAL HYGIENE:                    2 bad habits I would
                 for in 2018 and 3 things             Good hygiene practices
                I look forward to in 2019                                                    like to overcome
                                                      I would like to maintain

            1                                                                      1
            2                                                                      2
            3
                                                                                                                       | 31

31 Mind & Health.indd 31                                                                                                10/1/19 3:40 PM
Community
                                                                                          Nurse Post

             Wellness Kampung
             Wellness Kampung is an initiative comprising three wellness and care centres for residents in the north. They
             provide a suite of health and social programmes, creating a support network for residents to inspire each other to
             adopt healthier lifestyles in a close-knit 'kampung' setting.

             Opening hours: Mondays to Fridays, 8.30am to 5.30pm (closed on Saturdays, Sundays and all Public Holidays)

             115 Chong Pang                           260 Nee Soon East                        765 Nee Soon
                 Blk 115 Yishun Ring Road                Blk 260 Yishun Street 22                      Blk 765 Yishun Street 72
                 #01-495, Singapore 760115               #01-87, Singapore 760260                      #01-366, Singapore 760765
                 6257 4702                               6257 4802                                     6257 4842
 C

 M

 Y

CM

MY

CY

CMY

 K

      Admiralty Medical                            Khoo Teck Puat                                      Yishun Community
      Centre (AdMC)                                Hospital (KTPH)                                     Hospital (YCH)
      AdMC is a one-stop medical centre for        KTPH is a 659-bed general and acute                 YCH provides intermediate care for
      specialist outpatient consultation, day      care hospital serving more than 800,000             recuperating patients who do not require
      surgery, rehabilitation and diagnostic       people living in the north of Singapore.            the intensive services of an acute care
      services, as well as community health        It combines medical expertise with high             hospital. Situated beside KTPH, the two
      outreach activities.                         standards of personalised care in a                 hospitals provide an integrated care
                                                   healing environment, to provide care                experience for patients.
                                                   good enough for our own loved ones.

         676 Woodlands Drive 71, #03-01                90 Yishun Central                                   2 Yishun Central 2
         Kampung Admiralty, Singapore 730676           Singapore 768828                                    Singapore 768024
         6807 8000                                     6555 8000                                           6807 8800
         www.admiraltymedicalcentre.com.sg             www.ktph.com.sg                                     www.yishuncommunityhospital.com.sg
         www.fb.com/admiraltymedicalcentre             www.fb.com/khooteckpuathospital                     www.fb.com/yishuncommunityhospital
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