AMK-THKH Newsletter Issue 2 of 2011 - Thye Hua Kwan Hospital

ServingwithPassionWe managed to catch up and findout more about Ms Carolina Png,the new Deputy Director of AlliedHealth at AMK-THKH, as she settledinto her new role.She joins AMK-THKH from TanTock Seng Hospital, where she ledthe Cardiopulmonary PhysiotherapyUnit.She has always believed in hope inrehabilitation, sharing an anecdotefrom her past work experienceabout a patient who requiredmaximum support initially uponadmission to the hospital.Looking back at her career, shesingles out one particular mentor, aprevious supervisor, who gave hermuch support and opportunities togrow. “She was an open-mindedleader who welcomes contributionof ideas and opinions, whileencouraging us to be independent inmaking our own decisions.”As the Deputy Director of AlliedHealth in AMK-THKH, Ms Png aimsto integrate the various disciplinesunder her purview to providetheir best care in making sure thepatients’ transition from hospital tocommunity is a seamless one."My goal is toprovide a platformfor our patientsto receive the bestrehabilitation careand a chance for abetter qualityof life."Ms Carolina Png,Deputy Director,Allied HealthDedicating her Heartto theStudying Biology during herSecondary education sparked off DrJocelyn Koh’s passion to further studythe mystery of the human body. Thisbudding passion eventually led herto pursue Medicine at the NationalUniversity of Singapore.Nine years on, Dr Koh, who has beenseeing patients at polyclinics sinceshe completed her medical training,continues to care for the ill in thecommunity. This time, she decidedto take up the challenging task ofcaring for geriatric patients, joining theHospital as a Registrar.ElderlyDr Koh identified Geriatrics asa core national need. With ourpatients getting more sophisticated,Dr Koh defined managingpatients’ higher expectations andaddressing their needs as areas ofchallenge.Apart from carrying out her routinerounds in the wards, Dr Koh believesin empowering her patients byeducating them on their medicalconditions and taking control of theirmedication intake.“The ultimate goal is to ensure patientsknow how to take their medicine aftertheir discharge and to monitor theirown medical conditions. This willhelp patients to be more independentwhen they integrate back into thesociety” said Dr Koh.“Many felt that that this patientposed limited rehabilitativepotential but I was not deterred. Amonth later, he walked out of thecentre on his own with a walkingstick after much-invested efforts ingetting him up and about.”In particular, she has a clear focuson the aging population, withits attendant implications. “Mygoal is to provide a platform forour patients to receive the bestrehabilitation care and a chancefor a better quality of life.”Dr Koh attendingto a patientMs Png with herphysiotherapistduring a therapysessionDr Jocelyn Koh,Registrar, AMK-THKHAMK - THKH REACHING OUT 5

Ms Amy Chan,Serving our patients with a warm smileA Chat withMs Amy ChanAMK-THKH warmly welcomes MsAmy Chan to its senior leadership asAssistant Director of Pharmacy. MsChan brings with her more than adecade of professional experience inthe Pharmacy field. She has workedin various sectors of the healthcareindustry ranging from primary totertiary healthcare institutions both inthe public and private sectors.I decided to become a pharmacistbecause…I have always wanted to care for thesick since young and this passion isstill burning bright within me.The most rewarding aspect of mywork is…When I am able to educate andempower my patients to consumetheir medication safely. This isimportant because an overdose canresult in serious consequences inpatients’ health.Patients and their caregivers mustunderstand how and when themedicine must be taken to optimiseresults.My day begins every morning at8.30am. Together with my team, Ireview the Inpatient Medical Records(IMR) after our doctors complete theirward rounds. This will be followed bystock-taking of patients’ medicationbefore lunchtime.In the afternoon, I conduct medicationscreening for patients who havejust been admitted to our Hospital.This involves reviewing patients’medication and ensuring that theirprescribed medicine is continued.Medication consultation is alsoprovided for patients who are due fordischarge the same day.My day ends with preparingmedications for patients who will bedischarged the next day.Working in a CommunityHospital…Our patients typically spend about30 days with us. This allows me toeducate and counsel my patients in arelatively unhurried manner which isideal in a Community Hospital setting.This is especially true for patientswho are on various medications formultiple chronic conditions.I see joining AMK-THKH as…An opportunity to explore and learnabout step-down care in Singapore.Together with the multi-disciplinaryteam at AMK-THKH, we aim to nurseour patients back to good healthand return home equipped with bothknowledge and medical supplies totake care of their health.First HealthcarePerformance OfficeCouncil Meetingheld at AMK-THKHThe Ministry of Health (MOH)Healthcare Performance Group hasinitiated the set-up of the HealthcarePerformance Offices (HPOs) inCommunity Hospitals (CHs). TheHPOs serve as the centre for collationand analysis of CHs’ performanceindicators.On 13 July 2011, AMK-THKH hostedthe first Healthcare Performance Office(HPO) Council Meeting. The HPOCouncil Meeting provided a platformfor HPOs of various CHs to share andreview their methodology of collatingand analysing performance indicators.Our Patientssay itBestDear Doctors, Nurses and Staffat Ward 3 (East Wing),Thank you very much for yourcare and concern during my stayat the Hospital. Even though yourworkload was heavy; having to takecare of many patients at all times,you are always prompt and kindin providing me all the help that Ineeded.To all Staff of the Hospital,Thank you for taking such great careof Mr Edward Semily during his2-week stay. Your dedicated servicehas enabled us to manage and survivethrough our difficult situation.Best RegardsFrom the family of Mr EdwardSemilyI will always remember your kindnessand your spirit of giving! Thank youand best wishes to all.RegardsMdm Chong See MoiAMK - THKH REACHING OUT 7

Our participants engaging in a friendly chatCaring for ourCaregiversBringingComfortProvidingSupportAmputation can be a distressingprocedure for many patients,especially the elderly. Many amputeeshave to adjust to their new lifestylesafter amputation as well as cope withemotional and physical struggles.Hence, to help patients cope withthe trauma of losing their limbs, theHospital’s Care and Counselling Teamstarted the Amputee Support Group.The monthly sessions provideopportunities for patients to sharetheir experiences and provide supportfor one another.Mr Tong, 53, who suffers from diabetes,has found these sessions very uplifting.He said “After sharing with the otherparticipants on the frustrations andcommon difficulties faced, I feel morecomfortable about being wheelchairbound.We have learnt to support andmotivate one other to overcome ourfears and difficulties. Mr Tong leadsan independent life with the help of hiswheelchair.Besides the sharing sessions, theCare and Counselling Team alsoorganises activities to preparepatients to integrate safely back tosociety. Patients learn to preparesimple and healthy meals, as well asseed planting which can be carriedout at home. These activities aim tohelp them realise that there are manythings they can do in their lives despitetheir medical conditions.The Care and Counselling team alsoworks with the Hospital’s therapistsand dieticians to educate thesepatients’ on simple home exercises aswell as tips on healthy eating.With more than 97% of our patientsaged 50 years and above, care-givinghas become a fact of life for manyfamily members of our patients whooften require continuous care after theirdischarge.Madam Ah Lek is the primary caregiverfor her godmother who suffered a fall inearly 2011. “I was very worried aboutcaring for her after her discharge.Although I learnt from the nurseshow to provide for her everyday needssuch as bathing and feeding, I was notsure if I was ready to be a caregiver.Even during her stay at the Hospital,I realised how stressful it is to be acaregiver.”To allay the fears and concerns offamily members such as Mdm Ah Lek,the Care and Counselling Team at theHospital launched a Caregivers SupportGroup for our patients’ caregivers.The four-week programme is designedto prepare them on their journey ofbeing caregivers. Split into hour-longsessions, caregivers are provided withan avenue to share their experienceswith fellow caregivers. The sessionsalso provide them with opportunitiesto gain a better understanding of whattheir loved ones are going through.Participants are also provided valuabletips on emergency care planning aswell as practical techniques on angerand stress management.“Care-giving over a prolonged periodcan take its toll on a caregiver emotionallyand physically. It is importantthat they take care of themselves andminimise the effects of stress and angerthey may feel,” explained Ms Fan LooChing, Principal Medical Social Worker.For Mdm Ah Lek, although her journeyas a caregiver is just beginning, shenow feels ready to care for her godmother. “Thanks to the programme, Ihave gained a better understanding ofwhat to expect as a caregiver. I can facethe future with greater confidence.”Our Medical Social Worker.Ms Tan Ying Yan, sharingstress managementtechniques with caregiversAMK - THKH REACHING OUT9

At AMK-THKH, about three quartersof our elderly patients are at risk ofdysphasia and may develop the needfor special blended diets during theirstay with us.proposed and implemented severalsolutions in their CPIP. The project,titled, Compliance of Diet Orders ispart of the Hospital’s efforts to enhancework efficiency.Team members participatingin this project: (from left)Dr Kelvin Phua, Assistant Director,Medical Services;Ms Tan-Chwee Say Moi, Ward Manager;Ms Stephanie Ho, Senior Dietician;Ms Thelma Melya Bautista,Senior Staff Nurse andMs Zar Ni Myint, Ward AssistantWith this in mind, Ms Tan-Chwee SayMoi, Ward Manager and her ClinicalPractice Improvement Project (CPIP)team members conducted a reviewof the Hospital’s patient diet orderingsystem over a period of six months.From the review, team membersfound that new meal orders were nottransmitted to the kitchen on time ona few occasions. These were due tothe complexity of the meal orderingsystem as well as human errors such asoversight by staff who were attendingto concurrent duties.To ensure that all revised meal ordersare sent to the kitchen in time, the teamExplained Ms Tan, “We worked withour Management Information Systemteam to enhance the patient dietordering system. Quick updates arenow made possible by usage of largericons and text in the selection menu.We also instituted a ‘buddy system’whereby staffs are encouraged to gothrough a checklist in pairs to ensurethat all required updates are loggedinto the system on time.”A four-month long post-project reviewrevealed that there were no missedupdates in the conveyance of revisedmeal orders.Right DietRight on TimeMr Zhu performing upper arm cyclingexercise with our Principal OccupationalTherapist, Tim Xu (right)Perseveranceon the CardsA condition that seemed to haveworsened, that’s how Mr Tony Zhufelt since he first met with a caraccident in 2009. Barely a year later,Mr Zhu suffered another accidentalfall in his bathroom. The two mishapsworsened his Spinal Muscular Atrophy,a degenerative condition which he hasbeen suffering from for a few years,leaving him paralysed from the lowerpart of his body.After his inpatient treatment at theSingapore General Hospital (SGH), MrZhu was transferred to AMK-THKH forrehabilitation.Mr Zhu was dependent on nurses in hisdaily routine during his hospitalisationstay. The once sprightly and energeticperson found his career prospectsaffected, especially since it requiredhim to travel frequently.To help him regain his independence, ourtherapy team designed a personalisedrehabilitation programme for him.With Mr Zhu depending heavily onhis arms to navigate his wheelchair,the physiotherapists focused onstrengthening his arm muscles. Intandem, our occupational therapists alsotrained him on the use of wheelchairsto navigate in the community afterdischarge.Mr Zhu was also provided with self-caretraining by our occupational therapists.Mr Zhu learnt how assistive devices likethe transfer board and grab bar canhelp him regain more independence inhis daily activities.“This illness did not deter me frommoving on with my life. In fact, itmade me stronger than before as Irealised I have to take control of myown life.” asserted Mr Zhu.Mr Zhu, who also suffers from diabetes,shared that his condition has been keptunder control ever since he startedwatching his diet. He is determined tomaintain his independence by doingthe therapy exercises as advised by histherapists.Mr Zhu has returned to work afterhis discharge from AMK-THKH. Withthe help of his motorised wheelchairto navigate around and a self-madefoldable device that enables him tomove items to within his reach, Mr Zhuis leading an independent life. Mr Zhuis continuing his rehabilitation sessionsat the Singapore Cheshire Home oncea week."From all of us atAMK-THKH, keep upthe spirit Mr Zhu!!"AMK - THKH REACHING OUT 11

Engaging theCommunityin ActiveAgeingAMK-THKH, together withYio Chu Kang CommunityClub’s (YCK CC) Active AgeingCommittee recently embarkedon a new initiative to engage andeducate the community on activeliving.The partnership started with a LiveCooking Demonstration as well asa Seminar on Footcare for Diabeticsheld at YCK CC earlier this year.Said Ms Beh Siang Yeang, a housewife residing in Yio Chu Kang, “Thedishes were easy to prepare and tasted really good. I will cook thesedishes for my family soon.”The demonstration was followed by a talk on Foot Care for Diabetics,conducted by Mr Zechariah Yeo, a Nursing Officer with the Hospital. Theseminar taught participants the importance of taking care of their feet,especially when they have diabetes. It also provided them with usefultips on what to look out for when purchasing new shoes.Another workshop on Falls Prevention was recently concluded where theHospital’s therapists gave a live exercise demonstration with practicaland effective exercise techniques for senior citizens to keep fit.The workshop attracted more than 40 participants, who also wentthrough a Falls Assessment to analyse their risk of falls.Said Ms Natalie Koh, the Constituency Manager for Wellness at YCKCC, “The senior citizens found the sessions very interactive. We hopeto continue this working relationship with AMK-THKH to provideinnovative workshops and activities to our elderly residents.”Health Bites:Living Well,Eating WellStarting this issue, we will be sharingtips on staying healthy and keepingfit. For a start, we would like to sharewith you the following recipes whichare suitable for diabetic patients.POPIAH BASAH SEMARANGIngredientsPopiah SkinBamboo Shoot (sliced thinly)Carrot (julienned)Bean SproutsCabbageOyster sauceGarlic Chili SauceSesame OilGarlic, choppedSaltPepperMethod of Preparation10 pieces50 grams50 grams25 grams25 grams1 tablespoon2 tablespoons1 tablespoon1 tablespoon¼ tablespoon¼ tablespoonSlice cabbages into stripes.Heat sesame oil and add garlic. Fry until fragrant and then addvegetables as well as oyster sauce.Set aside to cool.Layer the popiah skin on the plate, spread cooked vegetablesin the middle of the popiah skin and roll.Serve popiah with chili sauce.During the live cooking demonstration,participants were treated to a spreadof healthy dishes selected by theHospital’s dieticians. Local favouritessuch as ‘popiah’ and vegetablesandwiches using vegetables andtofu, which substituted meat patty,were on the menu.Khoo Kim Hoe, one of the participants said, “The exercise demonstrationwas very helpful. The steps were simple and easy. I am confident that ifI continue these exercises, my sense of balance will improve.”VEGETABLE STACKSIngredientsMultigrain Bread SlicesTaukwa (cut into 8 slices)CucumberRed Bell Pepper (whole)Tomatoes (slices)Pepper (according to tasteOlive OilBalsamic VinegarMustard Dijon8 slices80 grams200 grams120 grams80 grams5 tablespoons2 tablespoons1 tablespoonMethod of PreparationPat taukwa dry with paper towels.Combine balsamic vinegar, olive oil, salt, pepper and mustard.Mix with taukwa and keep in refrigerator.Meantime, slice cucumber into thin slices and sear in non-stick pan.Roast bell pepper in oven for 15minutes at 220°C. Cool the bellpepper, remove its skin, and slice to strips.Place the bell pepper, cucumber, tomato and tofu slices on a sliceof multigrain bread. Proceed to make 8 portions.Toast quickly in oven at 180°C for 5 minutes.Our Therapy team (in red) leading participants inthe exercise demonstrationOur dietician, Ms Stephanie Ho (in red shirt) explaining thebenefits of multi grain bread*These recipes are reproduced with permission from the HealthPromotion Board.AMK - THKH REACHING OUT13

Bringing theclassroom intoourWardsAnderson Primary School students at the HospitalAs part of its efforts to educate theyoung on healthcare, AMK-THKHhosts Primary Two students fromAnderson Primary School (APS) whovisited the Hospital early this year.The students were given a funintroduction to the Hospital. Besidesthe familiar team of doctors and nurses,students were also introduced to ourtherapy team and the work they do.They were able to observe how thetherapists conduct their rehabilitationexercises for the elderly patients. Theyalso learnt how assistive devices suchas long reacher and walking frame helppatients adjust to life in their homes.The enthusiastic students raised manyquestions during the Dialogue Session,such as how patients call for nursingassistance and the importance ofinfection control.This annual visit by students of APSis part of their Learning Journeycurriculum, which educates thestudents on the community aroundtheir school.One of the students, Ong Gilaineshared, “I finally get to see doctors andnurses at work. I believe that nursesare caring people who take good careof the patients.”Clare Drummond,3rd year nursing student in Adult DiplomaNursing Course, King’s College, LondonIn Appreciation of ourOccupational TherapistsIn partnership with our colleagues fromTan Tock Seng Hospital RehabilitationCentre, the Hospital markedOccupational Therapist (OT) Dayearlier this year with an exhibition andworkshops scheduled over two days.Tim Xu, our Principal OT (left) explaining to a visitoron the use of a Tilt-in-space lightweight wheelchairThe exhibition which aimed to raisepublic awareness of the roles of OTssaw the latter explaining to visitors howthey help patients regain their functionalabilities. Booths showcasing the variousassistive devices that OTs utilise to helppatients in their rehabilitative exerciseswere also set-up.An interested visitor at our exhibition boothAs Mr Xu Tianma, a PrincipalOccupational Therapist of AMK-THKHcommented “Our ultimate goal isto guide our patients towards selfindependenceand instill in them theconfidence to return to play active rolesin the community.”Learning at AMK-THKH…This cross-border attachment providedme with better understanding ofhealthcare delivery in Singapore. I feelthat AMK-THKH patients benefitfrom having their rehabilitationtreatment in a community hospitalsetting. This equips them with thementality that they are on the road torecovery, motivating them to performtheir rehabilitation exercises. Also,the wards are run in an open concept,enabling patients to make friends withtheir neighbours. Henceforth, this isbeneficial for patients’ physical andpsychological wellbeing.Clare Drummond,3rd year nursing student in AdultDiploma Nursing Course, King’sCollege, LondonAMK-THKH provides good trainingground for students majoringin Gerontology. My short-termattachment with this Hospital exposedme to a range of rehabilitationtreatment available. I have learntto perform initial assessments onpatients suspected of suffering fromspeech and swallowing problems.I have also learnt how therapistsprovide rehabilitation treatment forpatients suffering from conditions suchas Parkinson’s Disease and Stroke.Rozainah Mohamed,Advanced Diploma student fromNanyang Polytechnic.AMK - THKH REACHING OUT15

Participants at the seminar on wound managementContinuing Medical Education SeminarsWound Management:Getting it rightA simple procedure such as wounddressing may be challenging for nursesand attaining the right technique isimportant to avoid any deterioration inthe healing of patients’ wounds. Thisformed the focus of the ContinuingMedical Education Seminar on WoundManagement and Therapeutics byAssoc. Prof Edward Poon, Director ofNursing, AMK-THKH.The 110 participants at the seminarlearnt about the different types ofcommon wounds as well as variouswound management methods.Besides sharing his expertise onwound management, Assoc. Prof Poonalso shared on bed and oral woundmanagement of patients.“It was an interesting session wherebywe learnt wound identification andmanagement techniques. The segment onmanaging frequent bed sores in particularprovided useful insights into how wecan better care for our patients,” saidMs Erlyn M Bugaoan, one of our staffnurses at the talk.Prescribing Medicinefor the ElderlyDr David Yong, Senior Aged CarePhysician for Geriatric Medicine,Changi General Hospital spoke onPrescribing Medication for the Elderlyat the Hospital’s Continuing MedicalEducation (CME) Seminar recently.Dr Yong described potentially high risksituations whereby medication maybe wrongly prescribed to the elderly.He then moved on to focus on theprinciples that medical officers as wellas nurses must take into considerationwhen prescribing and administeringdrugs to elderly patients.His use of thought-provoking casestudies and statistics engaged theaudience throughout the talk. Thetalk not only attracted doctors andnurses, but also therapists, medicalsocial workers as well as the Hospital’sadministrative staff.Said Dr Gilbert Er, one of the participantsat the seminar, “It was an interesting talkthat reminded us about the importanceof checking patients’ medical history toascertain that the drugs we prescribe arecompatible with those that our patients arealready taking.”Speaker, Assoc. Prof Edward Poon, Director of Nursing at AMK-THKHParticipants listening attentively to Dr David YongAMK - THKH REACHING OUT16