As a continuation of the initiative for medical technology development in Singapore, SGH has become an integral part of the national landscape, where every crisis is the instigator of innovation.
In the early months of the COVID-19 pandemic, hospitals were swamped by a tide of patients needing screening tests. An SGH anaesthesiologist team swiftly developed a foldable swab screen system that can double the number of tests performed without putting healthcare workers at risk. They did so within a week in March, naming their system "Swab Assurance For Everyone" or SG SAFE in short. They used industrial-grade chemical resistant materials. It is now being used at SGH's emergency department and extended facilities to assess patients for COVID-19.
Wearing just an N95 mask, the healthcare worker steps into the U-shaped transparent booth and puts his hands into a pair of biosafety level 3 gloves built into the panel to take swabs from the patient standing or sitting on the other side. The booth is then disinfected, ready for the next patient. The entire process takes about two-and-a-half minutes.
In wards and clinics where SG SAFE is not available or cannot be placed due to space constraints, healthcare workers can bring in SG SHIELD. As the name implies, it is a shield that blocks healthcare workers from droplet deposition that patients may cough out during throat swabs.
Conceptualised by a multidisciplinary team of doctors from SGH Departments of Otolaryngology - Head and Neck Surgery, Urology, and clinical innovation engineers from Medical Technology Office (MTO) SingHealth, they drew inspiration for the design by observing a throat swab procedure simulation.
The mobile swab station (MSS) integrates a booth system developed by SGH called SG Safe into a Singapore Armed Forces cross country ambulance. The joint project by the Singapore Army, Defence Science and Technology Agency (DSTA), and ST Engineering helped to test all 323,000 foreign workers in dorms. The MSS was deployed on Monday (11 May 2020) to do swabbing operations at places outside of purpose-built dorms.
Drawing inspiration from the innovation SG Safe, SGH's Department of Diagnostic Radiology designed a mobile x-ray unit, SG SafeR, that can be deployed off-site with lower exposure risk for radiographers performing the x-ray. As a result of the protective isolation elements included in the design, the mobile x-ray unit can be operated by one, instead of the usual two radiographers, who wears just an N95 mask instead of full personal protective equipment.
In 2003, SARS-hit SGH constructed two wards of 40 single-room cabins to nurse patients with a fever of unknown cause. It was located at the site of the current National Heart Centre Singapore. In 2020, during the fight against COVID-19, SGH constructed an isolation facility occupying a total space of 3200 sqm, comprising 50 purpose-built isolation units and the necessary requisites needed in a ward.
Each isolation unit is a negative pressure single room with en suite toilet and shower facilities for patients with infectious diseases. Located in the car parks immediately adjacent to the Bowyer Block, the facility is aptly named Ward@Bowyer. SGH leveraged technology to develop better tools and systems, many of which were introduced in this new facility.
Since January 2020, the Isolation Ward nurses had been caring for suspected and confirmed COVID-19 patients, while the Molecular Laboratory staff processed up to 500 samples a day after the outbreak. In a short span of four months, the Lab processed more than 10,000 samples, the preceding year's workload.
The Emergency Department and the Fever Screening Area (FSA) frontline teams organised Mobile Swab Teams to test migrant worker dormitories and elderly care homes. Compared to the 100 swabs they conducted a day during the initial phase of the outbreak, they swabbed around 1,600 tests a day for the virus, both at SGH and its many off-site tents at Singapore Expo and foreign worker dormitories.
Logistical challenges of supporting infected patients' unprecedented inflows meant endless daily challenges in ensuring staff testing safety protocols, creating new beds and ad hoc isolation wards. SGH care reached beyond its physical structure.
New wards were temporarily opened in the newly completed Outram Community Hospital to house patients with non-COVID conditions.