Empowered by their supervisors, nurses from Tan Tock Seng Hospital’s Ward 12D initiated the set-up of a standardised, multi-purpose trolley in late 2008 to significantly cut down on the 30 to 45 minutes spent every day searching for case notes, stationery and medical equipment.

This improvement enabled them to spend more time on direct patient care. This project was later implemented across all wards.

Said Staff Nurse Tan Pei Ru, one of the nurses involved in the project: “It’s great that nurses can be part of such innovative projects. We worked together with other colleagues such as the physiotherapists and patient service associates to come up with this idea. I felt a huge sense of achievement and satisfaction when doctors praised what we had done.”

This is only one example of how the “MyCare Basic” programme in Tan Tock Seng Hospital (TTSH) has built an environment that enables rank-and-file staff to proactively identify process inefficiencies and continually make improvements.

Indeed, the programme earned TTSH the Asian Hospital Management Award 2010 in the Human Resource Development category, in recognition of its efforts to empower staff to deliver better patient care.

“MyCare” is the name for the movement in all National Healthcare Group institutions to adapt and implement Lean principles in the health-care setting.

Professor Philip Choo, chairman of the medical board in TTSH, adds: “Embracing this movement in TTSH has given us a platform to holistically address the complex challenges we face.

“In the process, we realised that great improvements could be achieved through simple, but well-thought-out ideas, based on the basic principles of identifying and understanding what patients value, and redesigning care to deliver that value.”

Started in 2008, the MyCare Basic programme essentially builds a culture of empowerment and improvement. This is facilitated through equipping each staff member with simple Lean concepts and tools that he or she can proactively use in the workplace.

To accelerate the rollout of this programme, line trainers were identified in each of the hospital’s divisions.

They included, among the hospital’s many diverse professions, nurses, patient service associates and medical technicians who were trained in Lean management principles, as well as facilitation and presentation skills.

The line trainers in turn trained their fellow colleagues, and facilitated improvement projects in their divisions, matched by input from fellow ground staff to give everyone a sense of ownership and pride in their work.

To support the work of the line trainers and teams, divisional champions were also appointed to provide the mandate, resources and directions required, and to facilitate the spread of best practices that emerged.

Improvement projects

To date, 90 per cent of staff have been trained through the MyCare Basic programme. This has translated into the completion of more than 800 improvement projects.

In the Post-Anaesthesia Care Unit, for instance, nurses designed flash cards with pictures and words in the four main languages to communicate with deaf or mute patients.

This also helped as a language translation medium for nurses and patients. Communication between ward staff and patients was thus improved.

The MyCare Basic programme has been rolled out to many areas — from wards and clinics to administrative offices.

For example, the administration of patient records was greatly improved through a simple organisational methodology called “6S” — Safety, Sort, Straighten, Shine, Standardise and Sustain.

In essence, patient records are re-arranged and filed for easy retrieval, and colour codes are used to identify the location of the records quickly.

As a result, the time spent searching for records each month has been reduced by 32.7 hours to just 2.3 hours, and the process of filing patient records has been cut from 10 to five steps.

All these improvements translate to better clinical support.

The culture of empowerment and improvement is taking root in TTSH.

Says patient service associate Yoong Jia Horng, a line trainer for the Specialist Outpatient Clinics, of the programme: “Initially, I was apprehensive about carrying out improvement projects, but when I saw the trust put in me, I became more confident.

“The projects I have rolled out might be on a small scale, but I’m inspired by their success and I am always on the lookout for more areas of improvement.”