Some drills to test
systems and processes are smaller scale, like this one known as a tabletop
exercise that Chee Woei conducted with her AMW team.
SNM Lee Chee Woei discusses her role in preparing to set up the Acute Medical Wards in the new SGH Emergency/National Neuroscience Institute building.
Fast-tracking care
When Lee Chee Woei was posted to Ward 73 as a young nurse in 2008, she could hardly have anticipated the big role she would play in the future Acute Medical Ward (AMW). She is now one of two Senior Nurse Managers (SNM) who lead the charge of setting up four floors of the AMW in the new SGH Emergency/National Neuroscience Institute (SGH EM/NNI) building. Two of the wards began operations in December 2024.
Chee Woei was there when SGH first converted one of its existing wards to an AMW in 2015 under the care of the Department of Internal Medicine. It was a move to improve patient care for individuals being admitted from the Emergency Department (ED), to meet growing demands of an ageing population. This first AMW served as a pilot, to prepare for the day when it will have more beds in the new building.
“I’ve been involved in the AMW’s development since it first started operations, working closely with various stakeholders to shape and improve our care model. Since then, I’ve been given the opportunity to lead multiple quality improvement projects to streamline the work processes there,” says the 42-year-old.
The AMW, a short-stay facility for SGH patients, delivers early assessments, treatment and rehab interventions. Nurses lead the discussion of cases by the multi-discipline team, comprising doctors, nurses, pharmacists, physio and occupational therapists, medical social workers and dieticians. The nurses are able to play this leading role because they are most familiar with the patients’ conditions, being the ones constantly monitoring their vital signs and aware of any changes. They are the key person to coordinate the care for patients and lead the discharge process.
This way, treatment is intensified at the start of the patients’ admission, boosting their recovery and facilitating earlier patient discharge. Typically, patients stay for three to five days at the AMW, thanks to this care model.
Patients will be admitted to AMW if the doctor assesses their conditions to benefit from the care model. These patients are not critically ill and do not need prolonged stay in hospital, yet are not well enough to go home.
From the AMW, such patients may be discharged home, to the community hospital, or to the SGH@Home programme where they continue to receive care from SGH colleagues and community partners in the comfort of their home, lowering their hospitalisation bills and freeing up much needed beds for patients needing acute and critical care.
To ensure patients receive the same care when they are discharged for home, engagement of patients, families and domestic helpers starts from admission. Having caregivers by the bedside also comforts patients in an unfamiliar hospital environment. “Because we have dedicated physiotherapists, occupational therapists, patient navigators, medical social workers and pharmacists stationed in the ward, they are able to work with the patients daily, which reduces the patient’s length of stay significantly. We also offer caregiver training upfront, so patients are more confident when discharged,” says Chee Woei.
Her challenge was scaling up the efficiency of the AMW to the expanded facility, which has 152 beds across four levels. She arranged comprehensive training programmes for the staff to help them understand the new workflows and protocols for the expanded facility. For instance, nurses had to learn to manage isolation rooms as well as run peritoneal dialysis and haemodialysis as these services are now offered within the AMW at the new building.
Coordinating care and ensuring seamless communication between teams on different levels is challenging. Thus, the multidisciplinary teams met regularly so that they are aligned in the care plan of patients. “We also made sure the nurses are familiar with the layout of the bigger space. They need to know the fastest routes to the patients for resuscitation cases, or the safest way to move patients in case of fire and so on,” said Chee Woei. About 200 nurses underwent training, and went on recce trips to the new AMW for orientation to “empower the nurses and make them more equipped”.
Chee Woei enjoyed being part of this major project, especially as she knows that her efforts directly improve patient care. She has led and coached multiple Quality Improvement Projects which directly impact patient’s care and received recognition from the hospital. “Personally, I found the constant need to adapt and improve to be both challenging and exciting. Coordinating with multiple stakeholders and ensuring smooth communication across different teams were sometimes tough, but it was a great learning experience.”
Chee Woei finds joy in watching her nursing colleagues grow, develop their skills, and become more confident in their roles. “I truly enjoy listening to them and creating a family-like atmosphere in the workplace. It’s important to me that they feel supported and cared for, just as we care for our patients.”
During the COVID-19 pandemic, she made use of skills picked up from her seamstress mum to sew masks for kids using fabric printed with colourful cartoon characters. “It turned into a little venture of its own, as colleagues came back to me for repeat orders! It was rewarding to see them excited about wearing something I created,” she said. Her greatest fulfillment, however, is in the impact she makes on patients’ lives. “Being there for them during their most vulnerable moments, whether they’re recovering or facing difficult challenges, reinforces why I chose this profession.”
We love mail! Drop us a note at [email protected] to tell us what you like or didn’t like about this story, and what you would like to see more of in LighterNotes.
Tags:
;
;
;
;
Internal;
;
Singapore General Hospital;
;
LighterNotes (SGH);
;
;
;
;
Lighternotes
