ILTC NIGHT: RAZZLE DAZZLE, YOU RE OUR STARS! bulletin. showcase INTERVIEW WITH PROF. PAMELA W. DUNCAN, HMDP-ILTC VISITING EXPERT

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1 bulletin ILTC NIGHT: RAZZLE DAZZLE, YOU RE OUR STARS! showcase INTERVIEW WITH PROF. PAMELA W. DUNCAN, HMDP-ILTC VISITING EXPERT newsbytes NEW ADDITIONS TO THE AIC FAMILY TAKE PART IN HAND HYGIENE DAY 2011 ACTIVITIES AND MORE! a bi-monthly publication

2 editor s note EDITOR'S N TE Welcome to the third issue of mosaic! In this issue, we invite you to relive the highlights of ILTC Night held on 28 January It was wonderful getting to know many of you better and to see so many familiar faces coming together to have a good time! From the exciting plans that we heard brewing, it looks like this is going to be yet another fruitful year for the sector! We also feature information on how the National Care Assessment Framework aims to improve care transitions and promote right-siting of patients. Read our interview with Professor Pamela W. Duncan, renowned physical therapist and epidemiologist, who visited Singapore last November under the Health Manpower Development Programme for the Intermediate and Long-Term Care (HMDP-ILTC) sector s Visiting Experts scheme. Pamela shares observations on Singapore s falls prevention programmes and ways in which organisations can improve their falls prevention plans. We also review David Hutchens' book, Shadows of the Neanderthal: Illuminating the Beliefs that Limit Our Organisations. Find out how your hidden beliefs may be informing or misinforming your decisions! Besides ILTC Night, the ILTC CEO Learning Forum was another first. Organised under the auspices of the ILTC Manpower Council, the topic of training, recruitment and retention of staff was keenly discussed. The ILTC Manpower Council addressed these issues and presented a series of initiatives as a way forward. For more details on these key strategies, turn to the Newsbytes section, where you will also find information on how to partner MOH Holdings and recruit choice persons during their career fairs. We also invite you to join us in commemorating global Hand Hygiene Day which falls annually on 5 May. Participate in activities leading up to the day and receive exciting gifts and prizes! Activities include a slogan contest and a (free!) hand hygiene training session beginning in early March. Finally, we are pleased to announce that commencing in April, we will also be publishing a small quantity of mosaic in hardcopy format to better serve those who have limited internet access. If you would like to receive copies for your organisation, please us at mosaic@aic.sg. Till the next issue, happy working! Lynda Soong CHIEF COMMUNITY CARE DEVELOPMENT DIVISION

3 bulletin ILTC NIGHT: RAZZLE DAZZLE, YOU RE OUR STARS! AIC in Action It was a night of revelry as 600 invited guests and sector partners came together for the inaugural ILTC Night (28 January) at the Grand Ballroom, Grand Copthorne Waterfront Hotel. Organised by Agency for Integrated Care (AIC) and representatives from Ren Ci Hospital and Medicare Centre, All Saints Home, Bethany Methodist Nursing Home, The Salvation Army Peacehaven Nursing Home, Man Fut Tong Nursing Home and Ling Kwang Home For Senior Citizens, the event was a culmination of months of frenzied activity to ensure that everything went just right! Present to show his support was guest of honour, Mr Khaw Boon Wan, Minister for Health. Meeting Partners and Guests Amidst merriment, good food and conversation, the audience were kept entertained by a medley of performances. These included songs and dances by AIC s senior management and staff as well as the highly-anticipated talent segment which saw six providers showcase their gifted staff. If you missed the event, fret not, we share some of the evening s highlights here.

4 bulletin Partners and Guests Talent Segment - HONOUR ROLL FIRST PRIZE THIRD PRIZE Dance: Club Can't Handle Me Bright Hill Evergreen Home Prize: $1000 Song: My Heart Will Go On by Celine Dion Joy Tabion Gerona Villa Francis Home for the Aged Prize: $500 SECOND PRIZE Dance: Mortal Kombat Lions Home for the Elders Prize: $800

5 bulletin Talent Segment - HONOUR ROLL CONSOLATION PRIZE Song: To Love You More by Celine Dion Maria Teresa L. Sambrano Ju Eng Home for Senior Citizens Prize: $200 CONSOLATION PRIZE Song: You re Still You by Josh Groban Rendol Santos De Rama Ren Ci Hospital and Medicare Centre Prize: $200 CONSOLATION PRIZE Dance: Jai Ho Man Fut Tong Nursing Home Prize: $200

6 THE NATIONAL CARE ASSESSMENT FRAMEWORK spotlight The growing burden of chronic diseases, coupled with Singapore s ageing population, will increase the demand for more Long-Term Care services. However, matching an elderly patient s needs to an appropriate Long-Term Care service commonly known as right-siting is not so easily done, especially when there are varying ways to assess a patient s needs. Clinical, social and financial status are just some of the many dimensions that can impact health, recovery and well-being. Presently, assessments are usually carried out by different clinical professionals across polyclinics, general practitioners, hospitals and Long-Term Care services. When different assessment tools are used in varied settings, it is difficult to comprehensively ascertain the patient s needs as s/he moves across settings. A National Care Assessment Framework (NCAF) to standardise care needs assessment across settings is hence pertinent to effectively and efficiently assess a patient's Long-Term Care needs at any point within the healthcare system. To put a NCAF into practice, a common and objective assessment tool, training and information technology (IT) system is needed. The interrai assessment suites were chosen for this task due to its unique strengths: it is comprehensive, uses common terminologies across different care settings and demonstrates reliability and validity in its assessment items. Over 20 developed countries, including Canada, United States of America and Hong Kong, use interrai. The Ministry of Health has approved two pilots to implement NCAF. The first will be launched from early 2011 in all hospitals and involves using interrai to right-site patients discharged from hospitals to Long-Term Care services.

7 spotlight Under this pilot, all patients applying for subsidised nursing home placement will be assessed by hospital-based interraitrained care coordinators and medical social workers. The information is then captured in an IT system to provide easy transfer and access by relevant care providers. Nursing homes receiving these patients will have interrai-trained care staff who are able to read assessments so that they have a common understanding of the patient's care needs. By mid-2011, assessments will be extended to patients applying for subsidised home care services. The second pilot involves studying the resources required and outcomes in care planning when using interrai, compared to the present system. Five Long-Term Care facilities comprising nursing homes (Bethany Methodist Nursing Home, Lions Home for the Elders, The Salvation Army Peaceheaven Nursing Home) and home care providers (Hua Mei Mobile Clinic and St Andrew s Community Hospital Home Care Services) will be part of this pilot. Care staff from these facilities will also be trained to carry out an interrai assessment for their patients. Outcomes pertaining to improvements in care planning and cost-benefits will be evaluated in The introduction of interrai will thus establish a common language in care assessment across the healthcare spectrum, facilitating right-siting and easing transitions for patients between different care settings. Data collected will also facilitate more accurate research studies, further improving Singapore s healthcare system. Potential Benefits of interrai Assessment include, amongst others: FOR THE HEALTHCARE SYSTEM Comprehensive and systematic categorisation of healthcare needs and levels of care; and More appropriate funding allocation, based on accurate care needs assessment, to optimally utilise resources. FOR SERVICE PROVIDERS More accurate communication and data-sharing between service providers through the use of a common assessment language ; and Improved quality in care delivery through the use of evidence-based triggers and care assessment protocols. FOR PATIENTS Provision of services most appropriate to the individual s care needs and socialenvironmental situation; and Better quality of care and therefore better functional outcomes, improving the quality of life for both patient and their caregiver/family.

8 PAMELA W. DUNCAN PHD, PT, FAPTA, FAHA HMDP-ILTC VISITING EXPERT showcase PROGRAMME: Falls Prevention for Older Persons Living in the Community DURATION: 9 to 19 Nov 10 TARGET AUDIENCE: Physiotherapists and Occupational Therapists CO-HOSTED BY: Agency for Integrated Care, The Salvation Army Peacehaven Nursing Home, St Andrew s Community Hospital and St Luke s Hospital ABOUT PAMELA Pamela W. Duncan is an internationally renowned physical therapist and epidemiologist. A professor at Duke University School of Medicine and School of Nursing, she is also Senior Fellow at the Centre for Clinical Health Policy Research and Centre for the Study of Ageing and Human Development, Duke University. Her research interests include the development of a recovery trajectory for stroke and the implementation of evidence-based practice models (such as falls prevention programmes) into community care. During her visit to Singapore as part of the Health Manpower Development Programme for the Intermediate and Long-Term Care (HMDP-ILTC) sector's Visiting Experts Scheme, she shared

9 showcase on topics such as Epidemiology of Falls; Geriatric Assessment for Therapists; Falls Risk Assessments; Falls Prevention Management; Engaging Client, Provider and the Community; and Research in Falls Prevention. WHAT ARE SOME OF YOUR THOUGHTS ABOUT SINGAPORE'S LEVEL OF FALLS PREVENTION KNOWLEDGE? Singapore has many good resources to tap on, including the comprehensive strategic framework that the Health Promotion Board has developed. It establishes points of influence for falls prevention and management at the individual, systemic and environmental segment. In addition, it also describes multiple strategies that are necessary to support falls prevention programmes: research, policy, communications, capacitybuilding, risk screening and management. The commitment in strengthening community falls prevention as demonstrated by Tan Tock Seng Hospital s Community Health Engagement Programme is also encouraging and shows how one institution s resources may be channelled to ensure that clients who are most at risk are targeted. My interactions with participants found them keen to update their knowledge and better their community falls prevention programmes. WHAT ARE SOME WAYS IN WHICH FURTHER IMPROVEMENTS MAY BE MADE? Singapore s strategic visions, plans, organisational support and infrastructure are one of the most innovative in the world, however, she is somewhat limited by workforce capacity. Revision of some of the present educational curriculum to develop an expanded workforce capacity in medicine, nursing and allied health professions would be beneficial. A strong programme in implementation research would also help translate evidence-based programmes for falls risk screening and management into real world practices. This will inform and ensure that the most appropriate structures and care processes are developed, enhancing care and the quality of life for the elderly. I trust that similar to the way that Singapore has generated strategic approaches to manage the public health crisis of falls, she too will find ways to increase workforce capacity to optimise these innovative strategies. WHEN IMPLEMENTING FALLS PREVENTION PROGRAMMES, WHAT ARE THE KEY AREAS TO FOCUS ON? Falls prevention programmes should be based in the community where falls happen. The multi-disciplinary team (including primary care physicians, allied health professionals, support staff, etc), family members, and most importantly, the client, must be taught ways to prevent falls in their residence and other familiar community spaces. At the organisational level, falls prevention programmes should focus on three areas: (i) the client s capabilities, circumstances and preferences; (ii) the community's support for the programme to ensure intervention sustainability; and (iii) the service providers skill set and resources in delivering the programme. Such programmes then need to be evaluated based on the RE-AIM framework, which looks at who the programme Reaches, the programme s Effectiveness (in falls prevention), the programme s Adoption methodologies by service providers and what resources are needed for Implementation and Maintenance. Falls prevention resources can be downloaded from sg/hmdpiltcfallsprevention.aspx For more information and eligibility criteria for the HMDP-ILTC Visiting Experts scheme, visit

10 improvements STEPPING OUT OF THE SHADOWS Shadows of the Neanderthal: Illuminating the Beliefs That Limit Our Organisations by bestselling author David Hutchens, is a metaphorical tale of how five cavemen Unga, Bunga, Oogie, Boogie and Trevor are afraid to step out of their cave because of uncertainties and preconceived notions about the world outside. Using this delightful story as his basis, Hutchens introduces readers to the concept of mental models categories in our brain that determine how and what we see. He lists seven principles that describe what mental models are and how they affect our understanding of the world around us. He also notes that these models can affect the way we make decisions and in the process, also constrain our ability to take effective action. SEVEN PRINCIPLES ABOUT MENTAL MODELS: 1 Everyone has them; 2 They determine how and what we see; 3 They guide how we think and act; 4 They lead us to treat our inferences as facts; 5 They are always incomplete; 6 They influence the results we get, thereby reinforcing themselves; and 7 They often outlive their usefulness. Hutchens proposes some ways we can challenge these models and break free of preconceived notions that hinder us from looking at things from different perspectives. These include: Understanding that our conclusions may be based on our inferences, and not selfevident facts; Understanding that our reasoning process could have gaps or errors that we do not see; Checking our understanding of a matter by paraphrasing (out loud) the meanings we hear in what others say; and Asking others if they have other ways of interpreting the data or if they see gaps in our thinking. This short and entertaining book is perfect material at management seminars because of its simple to understand yet meaningful story. The inclusion of an analysis of the tale, discussion questions and scenarios to reflect upon, also guide readers in understanding the concept of mental models better. It is a must-have resource for organisations looking for ways to liberate themselves from assumptions, make calculated risks and seize opportunities. If you are someone who wants to break out of your comfort zone and challenge assumptions that limit your progress, this is one book you cannot ignore.

11 WHAT'S NEW? NEW ADDITIONS TO THE AIC FAMILY COMMUNITY MENTAL HEALTH DIVISION (CMHD) The CMHD was formed to better coordinate and integrate mental health services beyond the acute care setting. Working with various ministries, agencies and community providers, the CMHD will develop, strengthen and improve integration of care services. In addition, it will also facilitate care navigation by helping patients and their families through outreach programmes, education (in collaboration with Health Promotion Board) and development of support mechanisms within the community. The division will focus on three strategic initiatives to achieve its aims: improving accessibility and capacity in the community; destigmatisation through communications and outreach; and empowerment through capability-building in the community. HEALTH INFORMATION & INNOVATION DIVISION (HIID) HIID's dual mission is to (i) help AIC understand and serve the Long-Term Care sector better through enhanced research, sharing of information, insights and newsbytes knowledge and to (ii) help the non-acute sector improve their services, whether by innovative use of technology or by process and infrastructural improvements. The division administers several funds to support the incubation and nurturing of innovative projects and monitors and evaluates projects on their potential, efficiency and impact. STRATEGIC MANPOWER PLANNING & DEVELOPMENT DEPARTMENT (SMPD) Recognising the need for good integrated Long-Term Care that is accessible by all Singaporeans, the SMPD s role is to attract, prepare and develop competent healthcare talent to meet the sustainability and long-term success of the Long-Term Care sector. SMPD works with external Long-Term Care healthcare providers and fellow divisions to: enhance human capital management; provide centralised resourcing and development opportunities for Allied Healthcare talent; prepare and develop key healthcare resources to meet demand; and develop AIC as a Centre of Excellence. PARTNER MOH HOLDINGS for your Recruitment Needs! Need assistance in recruitment? Partner MOH Holdings (MOHH) to get the desired employees for your organisation! MOHH, the holding company of Singapore s public healthcare institutions will be holding healthcare career fairs throughout the year. Send your manpower requirements to ILTC@mohh.com.sg! For more information, contact Josephine Leong at or josephine.leong@mohh.com.sg

12 CELEBRATE HAND HYGIENE DAY with AIC and win attractive prizes! newsbytes AIC is proud to support Hand Hygiene Day, an annual World Health Organisation (WHO) campaign commemorated globally on 5 May. This campaign supports healthcare workers in improving hand hygiene practices thereby increasing patient safety and preventing often life-threatening healthcare-associated infections. In conjunction with AIC s 2011 Hand Hygiene Day theme, You re in Good Hands, we invite you to: PARTICIPATE IN A SLOGAN CONTEST Complete this phrase, Hand Hygiene means (maximum of 20 words). Send in the best submission and win exciting prizes in the individual or group (two or more persons) category! Slogans can be sent to Candice Kan at mosaic@aic.sg or faxed to Please include your name, organisation and contact number so that we may acknowledge receipt of your slogan within three working days. Closing date: 31 March Results will be published in April s issue of mosaic. AIC thanks Schülke, our main sponsor for Hand Hygiene Day 2011 for their kind sponsorship of training sessions, alcohol handrub gel and prizes for the individual categories. More information about WHO s Hand Hygiene campaign can be found at PARTICIPATE IN A HAND HYGIENE TRAINING AND ASSESSMENT SESSION Learn proper hand hygiene techniques in this short and effective theoretical and practical session! Participants will receive specially-produced commemorative items! For more information on prizes, training details and other terms and conditions, visit WorldHandHygieneDay.aspx

13 newsbytes HAPPENINGS INAUGURAL ILTC CEO LEARNING FORUM SOME OF THE TASKFORCE INITIATIVES INCLUDE: Leadership Development Taskforce Chairman: Mr Chua Song Khim (Group CEO, China Healthcare Ltd) Adopting a framework for leadership competency development; Identifying a set of competencies for senior management staff in the ILTC sector; and Proposing a leadership development programme for the ILTC sector. 45 Chief Executive Officers (CEOs) and representatives from 38 ILTC institutions came together for the inaugural ILTC CEO Learning Forum on 14 January. Present for the session was Mr Roy Quek, Deputy Secretary (Health), Ministry of Health, who had a dialogue with participants on manpower matters in the sector. The forum also included sharing sessions by chairmen of the various taskforces in the ILTC Manpower Council. The Council, chaired by Dr Loh Yik Hin (CEO, St Andrew s Community Hospital), was set up on 1 April 2010 and brings together representatives from the ILTC sector to tackle manpower challenges. To champion the sector s development, taskforces have been set up to spearhead initiatives set out by the Council. Skills and Career Development Taskforce Chairman: Mr Chan Wah Tiong (CEO, All Saints Home) Harmonising job grades; Developing the ILTC Human Resources Guide; and Identifying ILTC-specific skills for Nursing and Allied Health Staff. Sector Promotion Taskforce Chairman: Mr Tan Soo Sam (CEO, Orange Valley Nursing Home) Identifying the unique selling points of working in the ILTC sector through ILTC employee engagement and satisfaction survey, and focus group discussions; Developing a sector promotion roadmap; and Creating awareness of the ILTC sector through various publicity channels. The next forum will be held next quarter!

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