Board Member and past CEO on the ‘step-up care’ concept, and why the hospital is integrated with a medical centre and hotel.
Farrer Park Hospital is a private 220-bed hospital in downtown Singapore, and is the first fully-integrated complex for both healthcare and hospitality. Board member and immediate past CEO, Dr Timothy Low, shares with Hospital Insights Asia how step-up care works; the hospital’s smart nursing initiative; and what it means to be corridor-less.
How are you innovating in your hospital to transform care?
We have what we call step-up care. You have heard of step-down care for government hospitals – because they are so full after treating acute episodes, they need to make sure the patient ‘steps down’ or moves to recuperating care in a community hospital. So now all the new hospitals you see always have a community hospital beside them.
But for us, it is step-up care. We have a unique infrastructure, where we have a five-star hotel integrated with the hospital and medical centre in one building. It is integrated in terms of IT platforms and quick medical access.
When patients are ready to be discharged from hospital, but they still need some kind of recuperation where they don’t need daily or 24-hour nursing care, we move them to the Vertex suite in the hotel. This suite, they can have access to the doctors and specialists through their own private lift, within about a two-minute walk. They can reach their specialist internally.
Should anything happen that they need emergency care or attention, we have our 24 hour emergency clinic with staff to get to wherever they are within the complex within three to four minutes – even in the hotel. It is similar to an A&E.
So why do I say step-up care? Because they are going to a comfortable hotel environment, their caregivers can stay with them, speak with them, care for them. And our nurses and staff can go and look after their wounds or dressings should they need it. They don’t need to lie on a hospital bed.
If a person is lying down the hospital bed, it is more expensive because we need to pay for 24 hour nursing care and all the other ancillaries. But a hotel bed, that is so much cheaper. So it is step-up and cheaper; it costs 20 to 30% less for the patients. Whereas in a community hospital, it is step-down and cheaper. So that is how we try to reduce healthcare costs for patients.
How are you using technology to help your clinicians and staff become more efficient?
An example that comes to mind is our Virtual Desktop Infrastructure, a platform that we have put in place since we launched in 2016. Doctors can get their patients lab reports or scans immediately on their mobile devices in real-time. Even if they are not in the hospital and are away attending a conference, they can view these reports. Then they can make decisions faster.
I’d also like to mention smart nursing, a system we launched last year to align care across our nursing teams as our nurses can come from many different hospitals and countries. The platform uses machine learning to prompt nurses on the kinds of questions they need to ask to ensure they get all the important information from their patients, and gives advice on care.
Patients may mention certain conditions that they have and complain that they are prone to falls, for instance. So the system will pull up the best care methods and suggest to the nurses, maybe you can do this or maybe this.
And as they monitor the patient’s recovery, the system will pull out statistics of wound care, and previous cases of patients who healed a lot faster because nurses monitored them every few hours perhaps.
The system is meant to aid and assist the nurses in case they forgot to ask a question the first time. It is constantly changing as data goes in, because they will choose the best method, it will choose the best questions that you need to ask.
Hospital Insights Asia understands that the hospital layout was designed for a better patient experience. Tell us more.
This whole facility is built for efficiency. You go to where you need to go, and we don’t want to have bottlenecks. Since we started, we wanted to make sure that there was minimal walking, so that we are known as a corridor-less hospital. The corridors are only to bring you from one ward to the next, or for you to walk to the destination.
Patients input all of their healthcare details beforehand and the data flows through to the ward. They can go directly to the ward, and admission is done at the bedside. If they need to go to operating theatre or get a scan, they go through the lift within the ward without having to go outside. They then go back to their bed, and discharged from the bedside as well. So they don’t have to walk all over the place.
At the end of the day, technology doesn’t ‘front’. It is actually embedded. Patients don’t really see the technology; it is meant to facilitate our staff to provide a high-tech, high-touch ambiance.
Skills transformation is crucial in healthcare. How are you ensuring that your staff receive continuous training and upskilling?
It is very important that our staff have a unified mindset for patient treatment and care. The culture of caring and sharing, which I started when I was CEO, has continued on because when the staff care for one another, and care enough to share, automatically it will be transmitted down to patients and practice in terms of service mindset. We have a lot of team bonding and team building workshops to make sure that we inculcate that mindset and behavior to our staff.
The other thing we do is workplace learning, which is at the forefront of training. A lot of companies cannot release staff for classroom training or lectures because they are short-staffed. They cannot release staff for classroom training, lectures.
Instead of doing that, we do minimal classroom training but a lot of on-site training, which is one of the government’s latest drives. I think we are one of the first private hospitals to embark on this kind of training. So that is operationally trying to make sure that we bring service training to the staff.