New Simei facility to help patients help themselves

SINGAPORE - A new health facility that will try out a model of care that encourages patients to be more self-reliant will open its doors in Simei in December.

Jointly managed by Changi General Hospital (CGH) and St Andrew's Community Hospital (SACH), the 280-bed Integrated Building (IB) is located next to the two institutions. It will provide geriatric, psychology and rehabilitation services, among other things.

Staff will apply a new model of care that discourages reliance on health-care staff and encourages more independence among patients. For example, this can mean encouraging a patient to walk to the toilet, assisted by a nurse, instead of giving him a bedpan.

A recovering stroke patient may walk to a communal dining room for dinner instead of eating in bed, or even practise making a drink for himself in the kitchen of a mock three-room HDB flat.

Such rehab is important as patients, especially the elderly, increasingly live alone or with caregivers who are out at work."The longer a patient stays inactive, the more his muscles will deteriorate and recovery takes a longer time," said CGH chief executive officer Lee Chien Earn. "So rehabilitation may also begin earlier, even when a patient is in the acute stage."

In the current model of care, patients often enter a "twilight zone" when they go to hospital. "You lie in bed nearly 23 hours a day and you have a magic button called the nurse call button. When you press it, everything is sent to you, but you don't have that at home," he said.

But in the new model of care, patients will be trained in "activities of daily living" as soon as possible to smoothen the process of adapting back home.

CGH will run 180 beds in the new IB and SACH will run about 100 of them. Wards will open progressively starting December.

These beds will also ease a national bed crunch which saw hospitals resorting to measures like putting patients on beds lined along corridors, shielded by privacy curtains. Currently, CGH beds are almost 90 per cent full. SACH's occupancy rate is about 93 per cent.

SACH's Day Rehabilitation Centre (DRC) services will also be moved to the IB and doubled in capacity to cope with rising demand. The new facility can handle about 120 DRC patients.

And to prepare staff for this new model, more than 1,000 nurses, doctors and allied health professionals are being trained to motivate patients to be independent.

Trainers foresee challenges.

"Hospital nurses are used to doing everything for patients, but at the IB, they have to be mentors and guides to facilitate independent living. We need to shift mindsets," said CGH senior manager for care transformation Lim Shwu Juin, 41. Some caregivers, who expect their loved ones to be spoon-fed, may resist the idea.

"But physiotherapists assess a patient's ability before making him do certain activities," said nurse manager Jamilah Kamis, 49. "Safety is key."

Whether the new care model works better remains to be seen, but SACH patient Chew Teow Boei is looking forward to more space in the new facility. "Hopefully the new building can benefit more patients like me," the 59-year-old stroke patient said.

kashc@sph.com.sg

This article was first published on July 8, 2014.
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