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Streamlining inpatient admission at Singapore General Hospital

SingHealth is Singapore's largest public healthcare cluster. The group consists of a network of acute hospitals, national specialty centres, polyclinics and community hospitals, and offers more than 40 clinical specialties to patients.

Singapore General Hospital (SGH) is the first and largest hospital in Singapore and SingHealth. A not-for-profit institution, SGH is wholly owned by the government of Singapore and serves as the flagship hospital of the public healthcare system.

SGH has been considered one of the best hospitals in the world, consistently ranked in the top 20 of Newsweek's "World's Best Hospitals," reaching its highest (#3) in 2019. Subsequently, it is the highest ranked hospital in Asia, drawing in patients from around the vast region.

With a workforce of 10,000, SGH accounts for about a quarter of the total acute hospital beds in the public sector and about one-fifth of acute beds nationwide.

Ability to visualise realtime updates on bed status across the hospital
Reduces processing time for a bed request from 65 minutes to 25 minutes
Highlights special requirements for specified patients and facilitates their admissions to the right locations with minimal delay

Managing limited resources is one of the greatest operational challenges faced by hospitals around the world. SGH, which constantly seeks new ways to improve its processes and streamline resources, saw an opportunity in leveraging technology to enhance its bed management system, and therein improve its patient flow process from admission to discharge.

Previously, the bed status information in the hospital information system relied on manual updates by staff. Since staff may be busy, such information may not be updated in realtime. This meant that operations teams and bed management units did not have clear visibility of the real-time bed statuses, and had to spend time making phone calls to ascertain the status of beds and patients' whereabouts.

"The rich source of data in Altera Patient Flow can be extracted and analysed by authorised hospital users of the system. This enables bed management and utilisation patterns to be studied and a data-driven approach to be adopted for predictive analyses and planning for seasonal surges in patient load." 

Dr Gan Wee Hoe

Chief Medical Informatics Officer Singapore General Hospital

To overcome this, SGH formed a multi-department workgroup to review and streamline its bed management processes with aims to:

  • Enable better and more efficient management of bed resources by supporting new, reengineered work processes
  • Facilitate better decision-making to enable bed assignment with real-time availability of bed statuses
  • Drive prompt activation and efficient tracking of support services as well as fast bed turnaround by employing technology such as RFID
  • Harness the ability to dynamically manage bed situation in crisis and emergency situations
  • Streamline work processes to be more efficient and reduce unnecessary administrative and overhead work

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Using technology to efficiently manage beds, housekeeping tasks, etc., can help hospitals alleviate overcrowding, and improve efficiency and accuracy of its bed assignments.

Altera Patient Flow within the Sunrise EMR platform provides SGH with an integrated suite of solutions for bed management that can help optimise capacity planning and discharge forecasting. This enables SGH to improve patient throughput and communication while increasing overall efficiency and resource utilisation.

Key improvements include:

  • Patient movements are captured at source so that real-time bed availability is known
  • Real-time bed status readily available throughout the hospital
  • Integrated with RFID technology
    • Bed status is updated quickly with minimal data entry by nurses
    • Housekeeping staff are activated concurrently so there is higher bed turnover
    • SMS message will be sent to next-of-kin in future to inform them of ward/bed change for transfer cases
    • Activates printing of an interim bill upon patient discharge

"Altera Patient Flow has been deployed with great success at SGH. With the ability to visualise real time updates on bed status across the hospital, Altera Patient Flow's bed management solution significantly improved the efficiency of patients' bed assignments and contributed to a more streamlined inpatient admission/discharge workflow. Based on an estimated daily admission of 300 patients, Altera Patient Flow's automation features enable the processing time of a bed request to be reduced from an average of 65 minutes to 25 minutes. This frees up 200 man-hours per day that can be channelled to other patient-centric tasks.

With a seamless interface between Altera Patient Flow and Sunrise, Health Precaution Indicators (HPIs) are able to flow from patients' electronic medical records to Altera Patient Flow. HPIs identify patients who will need to be admitted in special wards or single rooms as a result of conditions such as infectious diseases or colonisation by multidrug resistant organisms. The transmission of these critical information directly from Sunrise to Altera Patient Flow immediately highlights the special requirements for specified patients and facilitates their admission to the right location with minimal delay. Altera Patient Flow's ability to interface with other systems such as a radiofrequency identification system that SGH deployed during the height of the COVID-19 pandemic, proved to be hugely beneficial in tracking the patient journey for contact tracing purposes." - Dr Gan Wee Hoe, Chief Medical Informatics Officer at SGH.

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