Speech by Dr Lam Pin Min, Senior Minister of State for Health, at the Groundbreaking Ceremony for the new Singapore General Hospital Emergency Medicine Building, 3 April 2018

Prof Ivy Ng, Group CEO, SingHealth

Prof Kenneth Kwek, Deputy Group CEO/SingHealth and CEO/Singapore General Hospital

Prof Fong Kok Yong, Deputy Group CEO/SingHealth and Chairman Medical Board/SGH

Distinguished Guests

Ladies and Gentlemen

Introduction

1.            It gives me great pleasure to join you this morning at the ground-breaking ceremony for the new Emergency Medicine Building at the Singapore General Hospital (SGH).

2.            The SGH Department of Emergency Medicine (DEM) first began in 1948 as a "Casualty and Outpatient Service", and grew into the first 24-hour emergency unit in Singapore in 1964. The existing SGH DEM at SGH Block 1 was opened about 40 years ago in 1977.  At the time, it provided emergency care for a much younger population, attending to mainly trauma cases such as fractures and dislocations.  Over the years, population growth, together with the ageing phenomemom, has led to increased attendances, from patients both young and old, suffering from a much wider range of medical conditions.

3.            I would like to take this opportunity to applaud the dedicated staff – the doctors, nurses and allied health professionals, who despite pressures arising from capacity constraints, have been working tirelessly in the Emergency Department (ED) to ensure the prompt and safe delivery of emergency care to Singaporeans. As the first phase of SGH’s redevelopment and the Outram Campus Master Plan, this new building for the SGH Emergency Medicine services is indeed timely.

Responding to Emergency Care and Emerging Threats

4.            When completed in 2023, the new Emergency Medicine Building will add much-needed capacity to SGH’s DEM. Key clinical features such as resuscitation, critical care and observation cubicles, emergency observation ward as well as clinical consultation rooms will be added to better service emergency care needs. Increased diagnostic and treatment capacities such as Computed Tomography (CT) scans also allow for time-sensitive emergency conditions such as stroke, heart attack and trauma to be managed more efficiently and effectively. This will provide the ED team the room they need to deliver safe and timely care for our patients.

5.            The new Emergency Medicine Building will also include isolation rooms and an expanded Hospital Decontamination Station, enhancing SGH’s capability to handle disease outbreaks and mass casualty incidents where there may be patients exposed to hazardous materials. Connected to the main SGH hospital complex, the new building will enable better integration of care for patients.  Patients can benefit from the pooled expertise from the various specialties within SGH as well as national specialty centres located at Outram Campus.   

Transforming Models of Care

6.            Beyond adding capacity, I am glad to know that SGH would be implementing innovative and more patient-centric models of care to better care for patients with emergency medical conditions.

7.            For example, SGH currently has a 67-bedded Acute Medical Unit (AMU) which aims to provide prompt specialist medical and multidisciplinary management, for patients admitted from the Emergency Department with less differentiated medical needs such as sepsis.  Patients admitted to an AMU are given timely access to care, early assessment, appropriate investigations as well as formation of a management plan, and definitive discharge plan within 72 hours.  The SGH AMU has been shown to reduce length of stay as well as re-admission within 15 days for patients.  In the new DEM building, SGH will more than double their capacity of AMU beds and expand their admission criteria to include more conditions so that more patients can benefit from this new model of care.

8.            SGH, like all our public hospital Emergency Departments, also works in close collaboration with the Singapore Civil Defence Force (SCDF) to provide urgent care for patients with time-sensitive emergency conditions.   For example, for heart attack patients enroute to SGH, SCDF paramedics can perform an electro-cardiogram (ECG) and the reading is then rapidly transmitted to the SGH ED where the emergency medicine and cardiology teams can assess and activate the angiography suite to prepare for early intervention to unblock the patient’s clogged artery.  This close coordination cuts down the “the door-to-balloon time” and optimizes the immediate care and improves the outcomes of patients suffering from heart attack.

Preventive Healthcare

9.            However, from a holistic healthcare perspective, just treating patients who already have emergency medical conditions may be too late.  We can do better, by moving upstream to take care of patients and keeping them as healthy as possible.  For example, in 2017, the SingHealth team from SGH and Sengkang General Hospital (SKGH) piloted an Individual Physical Proficiency Test for Seniors (IPPT-S). This comprehensive community frailty screening programme measures physical fitness such as balance, flexibility, strength and endurance and includes a questionnaire that looks into the seniors’ nutritional status, ability to perform daily living activities and psycho-social risks. The idea is to identify seniors who are at risk of frailty before falls or other health crises that could possibly land them in hospital. Community partners who facilitate some aspects of the IPPT-S are equipped to follow up with participants including running structured exercise and nutrition programmes, co-developed with SKGH.

10.         Last year, SingHealth also launched its “Community of Care” programme to provide medical expertise to complement the social services run by the Kreta Ayer-Kim Seng Constituency. This collaboration links up health and social care for over 200 elderly residents in Chin Swee Road and Banda Street, and helps to support the residents to stay well at home, so that they do not need to go to the Emergency Department or get readmitted to hospitals.  I am confident that these, and other initiatives, will help our seniors stay healthy in their homes and community. 

Conclusion

11.         To conclude, let me congratulate SGH and the team once again on this very special occasion.  To my colleagues in the Emergency Medicine department, I am heartened by the passion and drive you have for improving the delivery of Emergency Medical Care and achieving better outcomes for your patients.  Together, let’s keep these inner fires burning as we seek to deliver better health, better care, and ultimately better lives for our patients. 

Thank you.