New rehab facility aims to push patients towards independence

SINGAPORE: Changi General Hospital and St Andrew’s Community Hospital are introducing a new model of care to help the ageing population cope with injuries and illnesses.

This will be rolled out at a new eight—storey facility called The Integrated Building located between the two hospitals in Simei.

The new Integrated Building is part of the government’s plans for healthcare delivery and services in the east and also part of the two hospitals’ Simei Campus Vision.

A key concept will be "cluster housing" — where patients learn to be independent.

CEO of Changi General Hospital, Dr Lee Chien Earn, said: "We cluster our traditional B2 and C class beds, the 10 beds, within and try to make it as home—like and homely as possible. By having a living room, by having ensuite toilets, within the cluster itself.

"And for every three clusters in a ward, there’ll be common—shared dining area as well as a living area. The intent is so that the patients’ time that they’re actively involved in mobilisation, actively involved in therapy, is not just limited to the time the therapist spends with them, but in terms of the activities that they do — when they walk to the toilets, when they eat with their families, when they get a cup of water — we want all these to also contribute to the patients’ getting, being more actively involved, in their recovery."

Housing 280 beds, the building will also integrate a suite of rehabilitation facilities.

They include the Geriatric Day Hospital and Neuro and Trauma Rehabilitation — to prepare patients for life back home.

Doctors said all these are important as Singapore’s population is aging rapidly and the number of people with conditions like hip fractures and stroke, increases.

Other reasons cited — shrinking family sizes and caregivers getting older.

Research has also shown that physical and mental decline is a side effect of hospitalisation, especially for elderly patients.

Dr Lee said: "These need not be due to prolonged hospitalisation, but just staying two to three days in hospital for older patients, the decline has already started."

So the hospitals set up the new building with three goals in mind.

They are — to increase capacity as set out in the Health Ministry’s 2020 Plan, optimise functional capability of patients and to achieve this in the most cost—effective manner.

"In terms of cost—savings, I think we want to move beyond looking at cost—savings from just a particular episode, but looking at cost—savings from the whole life cycle, so if a patient is able to return to productive work, if the patient is able to return home, be less dependent on other caregivers, and is able to continue on being independent in community rather than being re—admitted again," Dr Lee explained.

CEO of St Andrew’s Community Hospital, Dr Loh Yik Hin, said: "The success will be in terms of whether we can bring them to their best functional state upon discharge and if they are brought to that state, they will have a better quality of life, there will be less caregiver stress for the family, there will be a lesser risk of them having to come back to the acute hospital, and also lesser use of healthcare resources in the community."

Over the next 15 months, the two hospitals will build five different mock—ups of wards, each lasting about three months. The mock—ups will allow them to identify potential kinks and hopefully reduce teething problems.

The S$200 million project is expected to be completed by 2014 and will require an additional 850 workers.

— CNA/ck