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TWO public hospitals are working to keep the old and chronically ill patients out - for their own good.
Older patients are more susceptible to the bugs that hospitals house, and also tend to stay longer than others once admitted, and the hospitals - Tan Tock Seng (TTSH) and Changi General (CGH) - are working on ways to address the problem.
The hospitals have identified patients in their 70s and 80s and those with chronic illnesses as their target group. At TTSH, for example, doctors now go to nursing homes to attend to patients in need of urgent help, rather than the other way around, as was the case in the past.
A team of four doctors, five nurses and two social workers from the hospital does daily rounds of the homes to attend to patients. If one gets seriously ill, the team, which is on call round-the-clock, rushes over to treat him. To help with emergency treatment, supplies of medicine, equipment and other necessities like oxygen are kept at the homes.
CGH, meanwhile, is pairing up elderly patients with chronic problems like diabetes, heart disease or asthma with general practitioners in the east. The hospital had studied elderly patients who were warded and found that many had medical problems that had been on the boil for several days before flaring up.
If they had seen their general practitioners (GPs) when symptoms first appeared, many could have avoided hospitalisation, CGH's chief executive officer, Mr T. K. Udairam, said. With regular doctors near their homes looking after them, the patients are more likely to approach them whenever they feel ill, rather than put off treatment.
More than 300 patients are now on the scheme, and they are being cared for by 57 GPs of their choice. To help with costs, these patients are allowed to get medicine prescribed by their GPs from the hospital at a subsidised price. The schemes are meant to mitigate a problem brought on by an ageing population.
Mr Udairam said a third of the very sick patients who are admitted through CGH's Accident and Emergency Department (A&E) are more than 80 years old. Just three years ago, only one in five such patients were of that age.
Such patients, said TTSH geriatric specialist Ian Leong, are 'frail' and 'sitting targets' for the bugs that all hospitals house. If they are warded in hospital for one problem, many end up catching an infection there and are warded for three to four weeks.
As it is, patients in their 80s and 90s already stay twice as long in hospital - about two weeks - compared to younger people. The programmes started by the hospitals are starting to bear fruit. St Theresa's Home, one of seven that TTSH doctors and nurses work with, now sends only one or two patients a week to be warded at the hospital.
Before it started on the scheme last September, the number was five or six a day, said the home's administrator, Mr Victor Seng. Many family members of those warded at the homes also prefer to have their loved ones treated in-house. Mrs Maureen Leong, 74, whose paralysed husband Stewart is a resident of St Theresa's, says being treated at the home is 'better than if he was in hospital and surrounded by doctors'.
At the home, she said, there is always a priest present, and she can be with him till 'the end', something that would be difficult at a hospital. For Madam Woon Sam Mui, 64, being put on CGH's programme has been a godsend - she has not been warded since she began seeing Dr Jeff Tay, whose clinic is a five-minute walk from her home, in 2008.
Previously, the diabetic with heart problems had to shuttle between the hospital's specialist outpatient clinic and Tampines Polyclinic. Besides the travel, she also had to leave her home by 6am for some appointments, such as to get blood tests done.
Now, help is never far away. She takes the short walk to see Dr Tay, who has been briefed by the hospital on her condition. Comfort levels are also very high. 'He is very detailed, very good. He knows my condition well,' she said in Mandarin.
Dr Tay is pleased with the arrangement, too. Madam Woon is one of 12 patients from CGH he sees, and treating them for both chronic and acute illnesses means he can ensure that medicine he prescribes will not interact with what they take daily, he said.
One positive side effect of the hospitals' programmes is that they have helped to ease the high demand for beds. Both TTSH and CGH, however, said caring for frail, elderly patients was always the objective, not freeing up beds.
Said Associate Professor Chin Jing Jih, TTSH's divisional chairman for integrative and community care: 'This project would still go on if there were a lot of vacant beds in hospital.'
[email protected]
Older patients are more susceptible to the bugs that hospitals house, and also tend to stay longer than others once admitted, and the hospitals - Tan Tock Seng (TTSH) and Changi General (CGH) - are working on ways to address the problem.
The hospitals have identified patients in their 70s and 80s and those with chronic illnesses as their target group. At TTSH, for example, doctors now go to nursing homes to attend to patients in need of urgent help, rather than the other way around, as was the case in the past.
A team of four doctors, five nurses and two social workers from the hospital does daily rounds of the homes to attend to patients. If one gets seriously ill, the team, which is on call round-the-clock, rushes over to treat him. To help with emergency treatment, supplies of medicine, equipment and other necessities like oxygen are kept at the homes.
CGH, meanwhile, is pairing up elderly patients with chronic problems like diabetes, heart disease or asthma with general practitioners in the east. The hospital had studied elderly patients who were warded and found that many had medical problems that had been on the boil for several days before flaring up.
If they had seen their general practitioners (GPs) when symptoms first appeared, many could have avoided hospitalisation, CGH's chief executive officer, Mr T. K. Udairam, said. With regular doctors near their homes looking after them, the patients are more likely to approach them whenever they feel ill, rather than put off treatment.
More than 300 patients are now on the scheme, and they are being cared for by 57 GPs of their choice. To help with costs, these patients are allowed to get medicine prescribed by their GPs from the hospital at a subsidised price. The schemes are meant to mitigate a problem brought on by an ageing population.
Mr Udairam said a third of the very sick patients who are admitted through CGH's Accident and Emergency Department (A&E) are more than 80 years old. Just three years ago, only one in five such patients were of that age.
Such patients, said TTSH geriatric specialist Ian Leong, are 'frail' and 'sitting targets' for the bugs that all hospitals house. If they are warded in hospital for one problem, many end up catching an infection there and are warded for three to four weeks.
As it is, patients in their 80s and 90s already stay twice as long in hospital - about two weeks - compared to younger people. The programmes started by the hospitals are starting to bear fruit. St Theresa's Home, one of seven that TTSH doctors and nurses work with, now sends only one or two patients a week to be warded at the hospital.
Before it started on the scheme last September, the number was five or six a day, said the home's administrator, Mr Victor Seng. Many family members of those warded at the homes also prefer to have their loved ones treated in-house. Mrs Maureen Leong, 74, whose paralysed husband Stewart is a resident of St Theresa's, says being treated at the home is 'better than if he was in hospital and surrounded by doctors'.
At the home, she said, there is always a priest present, and she can be with him till 'the end', something that would be difficult at a hospital. For Madam Woon Sam Mui, 64, being put on CGH's programme has been a godsend - she has not been warded since she began seeing Dr Jeff Tay, whose clinic is a five-minute walk from her home, in 2008.
Previously, the diabetic with heart problems had to shuttle between the hospital's specialist outpatient clinic and Tampines Polyclinic. Besides the travel, she also had to leave her home by 6am for some appointments, such as to get blood tests done.
Now, help is never far away. She takes the short walk to see Dr Tay, who has been briefed by the hospital on her condition. Comfort levels are also very high. 'He is very detailed, very good. He knows my condition well,' she said in Mandarin.
Dr Tay is pleased with the arrangement, too. Madam Woon is one of 12 patients from CGH he sees, and treating them for both chronic and acute illnesses means he can ensure that medicine he prescribes will not interact with what they take daily, he said.
One positive side effect of the hospitals' programmes is that they have helped to ease the high demand for beds. Both TTSH and CGH, however, said caring for frail, elderly patients was always the objective, not freeing up beds.
Said Associate Professor Chin Jing Jih, TTSH's divisional chairman for integrative and community care: 'This project would still go on if there were a lot of vacant beds in hospital.'
[email protected]
