Secrets to Healthcare Innovations

The Alexandra Health System shares how it pursues fresh ideas and makes tough decisions to improve healthcare.
At the IdeaLab, AHS staff use sticky notes to brainstorm for ideas and 3-D print prototypes, such as a stethoscope that could be used in developing countries. Over at the Wellness Kampungs, residents can rearrange the furniture and organise activities.

At various locations in Yishun, Sembawang and Woodlands, seniors can gather over a bowl of high-protein, high-calcium soup every week. Be­sides enjoying the company of their friends, they also do simple exercises together. At the same time, community nurses monitor their well-being, especially their frailty and mobility, and conduct physical assessments quarterly.

As a way to keep tabs on elderly health while providing them with healthy meals, this Share-a-Pot programme was initiated in 2014 by the Alexandra Health System (AHS), the public healthcare system serving the northern part of Singapore. It had found traditional health screenings, which direct participants with poor results to an interven­tion programme, to be less effective.

The problem with such an approach, said Dr Wong Sweet Fun, Chief Transformation Officer at the AHS, was that everyone joined the intervention programme as a “fail­ure” – “and nobody wants to be a failure.” Not surprisingly, those conventional health screenings were poorly attended, since the elderly were apprehensive about failing them in the first place.

So, Dr Wong and her team de­cided to turn things around: they in­troduced the intervention – this time in the form of soup and community bonding – before the screening.

And it worked. The elderly now come in willingly and have fun, said Dr Wong. Some even engage in friend­ly competitions to be the healthiest, motivating one another to improve.

“They are happy to be screened and we have reframed the issue from a sickness-screening model to a com­munity-based wellness programme,” explained Dr Wong. The programme has been extended to 15 sites beyond northern Singapore, including Ang Mo Kio, Bukit Panjang and Tampines.

Backed by the top

The capacity to question and overturn set models, as shown by Dr Wong and her team, is characteristic of the AHS’ ap­proach to innovation. And all this is made possible because of strong support from the management.

For example, as a green initiative, the pharmacy at its Khoo Teck Puat Hospital (KTPH) has done away with giv­ing out free plastic bags. Patients can pay for a new bag, use a recycled one (donated by the public), or simply do with­out. While the move created some disgruntled customers, the staff confidently stuck to their guns, knowing that they were backed by the AHS management, shared Dr Wong.

Another initially unpopular decision by the manage­ment was to move staff parking lots farther away. “We re­framed the issue into a win-win,” said Dr Wong. Reallocat­ing lots closer to the hospital for patients makes it easier for those who are ill or less mobile. Staff, on the other hand, could benefit from the walk.

We have reframed the issue from a sickness-screening model to a com­munity-based wellness programme

Kampung sourcing

Top-down approaches aside, the AHS believes in letting customers step up to “fill in the blanks”. Take its three Wellness Kampungs at HDB void decks in Yishun. These designated community spaces are designed to be “incom­plete” – giving residents room and freedom to move fur­niture around to suit their needs, or to organise activities.

Residents themselves have come up with bright ideas like “DIY rehabilitation”, where able-bodied residents vol­unteer to play games with their less-abled peers, such as for­mer stroke patients. The games they play, e.g., ball throwing and ring tossing, are also a form of occupational therapy, strengthening fine motor skills and hand-eye coordination.

Getting residents to self-organise activities and contrib­ute ideas encourages ownership and sustainability. “People start to own it when they complete the design and they continue to look after it,” noted Dr Wong.

Freedom of space

Within the AHS compound, carving out an intentional space gives people the room to think differently. Hence IdeaLab was born. It is a prototyping area where staff can develop their ideas without scrutiny.

Ms Tan Liren, Industrial Design­er at the AHS who runs the IdeaL­ab, explained: “Staff can book rooms (called ‘dojos’) for three months or more to work on projects. They can use the ‘dojos’ to sketch, make notes, build flow charts, and leave their notes on the wall and revisit and review these. This is better than using meeting rooms where they will need to tear down their work each time to make way for different groups of people.”

The AHS also has a multifunction “maker’s room” that serves as a training room, toolshed and workshop. There, staff can do 3-D printing, build prototypes and road-test materials and designs. The space has been used to create and test ideas such as improved consultation rooms, self-regis­tration kiosks and tray-return at the KTPH’s “health-pro­moting” food court.

In the food court project, the KTPH team worked closely with a vendor to use behavioural insights and us­er-experience research to understand how they could better encourage healthy eating. So, healthier food options were placed at eye level and priced lower. A self-screening corner, where visitors can check their body mass index and blood pressure, was moved to the entrance of the food court as a prominent reminder to stay healthy.

All these innovations are essential given healthcare’s ever-changing nature, said Dr Wong. “From ‘fighting for survival’ against infectious disease, malnutrition and trau­ma, we now encounter different problems. Innovation, for us, is needed because it allows us to not just address today’s problems, but leapfrog ahead.”

    Aug 2, 2017
    Sheralyn Tay
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