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31 Aug 2023

National Medical Excellence Awards 2023

The National Medical Excellence Awards event was held on 31 Aug 2023 at Four Seasons Hotel Singapore with Minister for Health, Mr Ong Ye Kung as the patron of the awards. The NMEA 2023 year marks the 16th year of the awards, with six individuals and one team recognised for their outstanding contributions and achievements.

The evening saw the presence of about 260 guests at the hotel venue to celebrate the success of the awardees for innovations in healthcare, patient safety, clinical quality, biomedical research as well as training and education of clinicians.

The National Medical Excellence Awards 2023 event was jointly organised by the Ministry of Health and SingHealth Duke-NUS Academic Medical Centre, with support from Lee Kong Chian School of Medicine, National Healthcare Group and National University Health System.

Award Winners:

National Outstanding Clinician Award
Professor William Hwang Ying Khee
Professor Tan Huay Cheem

National Outstanding Clinician Scientist Award
Associate Professor Mahesh A Choolani

National Outstanding Clinician Mentor Award
Adjunct Associate Professor Brenda Ang Sze Peng
Professor Julian Thumboo

Outstanding Clinician Educator Award
Associate Professor Tan Choon Kiat Nigel

National Outstanding Clinical Excellence Team Award
EAGLEcare
Dr Lien Tsung Chien Christopher
Ms Yee Kai Ying
Dr Shaun Gerald Nathan
Ms Ang Lay Teng

Click here for the Minister's speech.
Click here for the media release.
Click here to watch the NMEA 2023 citation video.

Please see the details of our awardees as follows.


NATIONAL OUTSTANDING CLINICIAN AWARD 2023
Professor William Hwang Ying Khee (黄殷祺)

Professor William Hwang

Chief Executive Officer
National Cancer Centre Singapore

Senior Consultant
Department of Haematology
Singapore General Hospital

Chair, Oncology Academic Clinical Programme
SingHealth Duke-NUS Academic Medical Centre

“For his dedication to serving his patients, sterling contributions in driving the advancement of haemato-oncology and stem cell transplantation, and steadfast leadership in steering National Cancer Centre Singapore to new heights in clinical service and research excellence.”

Professor William Hwang is a locally and internationally recognised expert in haematology, especially in the field of haematopoietic stem cell transplantation (HSCT). Prof Hwang has played key roles in establishing several clinical services including the Singapore Cord Blood Bank, Singapore’s first public cord blood bank, where he was the Founding Medical Director. He initiated and set up the SingHealth Duke-NUS Cell Therapy Centre, which he currently leads, to help train, coordinate, and execute various clinical cell therapy activities across SingHealth. To address the growing science of regenerative medicine, he also set up the Regenerative Medicine Institute of Singapore (REMEDIS) as a joint institute of SingHealth Duke-NUS Academic Medical Centre.

Prof Hwang serves in several national roles to help shape healthcare for the benefit of Singaporeans. He is Deputy Chairman of Ministry of Health’s (MOH) Clinical Services Strategy Committee for Cell Therapy, where he provides leadership for creating a pipeline for cancer therapeutics based on patients’ needs, and also part of the Board Oversight Committee of two entities in MOH Holdings – the Singapore Translational Cancer Consortium, and the Advanced Cell Therapy and Research Institute. He currently serves as Chairman of the Lien Centre for Palliative Care and Co-Chair of the National Advisory Committee on Cancer Care, to strategise and enhance collaborations to ensure patients receive holistic support every step of the cancer journey. Prof Hwang has also been involved in the development of various national-level guidelines, regulations, and recommendations as Chair of the Biobanking Advisory, MOH; Co-Chair of the Cell, Tissue and Gene Therapy Regulations workgroup, and Co-Chair of the HSCT Regulations workgroup.

Prof Hwang is internationally recognised as a key opinion leader in HSCT, and he was previously elected as President of the World Marrow Donor Association from 2013 to 2015 and was the first Asian to serve in this role. He was also an Executive Board member of the Asia Pacific Blood and Marrow Transplant Group, and currently serves as a Global Committee member of the European Blood and Marrow Transplant Group and Regional Vice-President (Asia) of the International Society of Cell and Gene Therapy.

Prof Hwang has published over 140 scientific papers, and conducted clinical trials and laboratory research in haematology. A key opinion leader in haematologic oncology and HSCT, Prof Hwang is regularly sought as an international speaker to share his expertise. He has two patents based on new molecules and cytokines which could be used to treat human diseases – one for growing blood stem cells and another for treating autoimmune diseases.

An advocate for training the next generation of healthcare professionals, Prof Hwang has mentored numerous young doctors, post-doctoral fellows and PhD students.  Prof Hwang has received several teaching awards, including Outstanding Faculty for Engagement, Distinguished Faculty, and Outstanding Faculty for his teaching in various modules at Duke-NUS Medical School.

Even with the diverse roles that he serves, service to patients as a clinician remains Prof Hwang’s passion. Over the course of his career, he has won several service awards, including the Singapore General Hospital (SGH) Service Quality “Service with a Heart” award, SGH Heart of Gold Award and SGH CEO Service Award for outstanding patient care. He has also been awarded the Singapore Health Quality Service Award (Star and Gold awards) and SingHealth Transplant Most Outstanding Doctor Award.

For his dedication to serving his patients, sterling contributions in driving the advancement of haemato-oncology and stem cell transplantation, and steadfast leadership in steering National Cancer Centre Singapore to new heights in clinical service and research excellence, Professor William Hwang is awarded the National Outstanding Clinician Award 2023.

NATIONAL OUTSTANDING CLINICIAN AWARD 2023
Professor Tan Huay Cheem (陈淮沁)

Professor Tan Huay Cheem

Senior Consultant Cardiologist and Senior Adviser
National University Heart Centre, Singapore

Professor of Medicine
Yong Loo Lin School of Medicine
National University of Singapore

Chairman
Singapore Heart Foundation

“For his excellence in clinical service and outstanding leadership and stewardship in revolutionising the cardiology service in Singapore and elevating it to world-class standards.”

Professor Tan Huay Cheem is an internationally renowned cardiologist who is well-regarded for his clinical acumen, procedural competence and teaching qualities. His medical career of 35 years in the public sector, which includes 18 years in positions of leadership, is marked by two legacies: service and mentorship.

Prof Tan’s lifelong commitment and devotion to patient care has brought about revolutionary changes to the cardiology service in Singapore. He was the Founding Director of the National University Heart Centre, Singapore (NUHCS), an established national centre known for its comprehensive clinical services, structured educational programmes, and research innovation. Under his leadership, NUHCS adopted an inter-departmental, barrier-free, and patient-centric approach to provide seamless multidisciplinary clinical care. His push to develop new areas of cardiology care, such as cardiac intensive care, sports cardiology, cardio-oncology, geriatric cardiology, and community cardiology, was visionary, and he has taken the cardiology service at NUHCS and in Singapore to its current comprehensive and world-class status today.

Prof Tan’s greatest achievement lies in the management of patients with heart attacks. He left his mark in the treatment of patients with ST-segment elevation myocardial infarction (STEMI) at NUHCS by setting up the primary (or emergency) percutaneous coronary intervention service in 1997, which became a 24/7 service in 2001. He initiated a clinical quality improvement project to reduce door-to-balloon time in 2007, which led to NUHCS being awarded the MOH’s National Clinical Excellence Team Award in 2011 and resulted in its adoption as a quality indicator for all other hospitals in Singapore.

In 2017, he conceived the idea of the Western STEMI network where all patients with heart attacks in the western cluster of Singapore will be directed straight to NUHCS via an ambulance to save time for maximal salvage of damaged heart muscle. In 2018, he also set up the Cardiogenic Shock Centre at NUHCS with its attendant multidisciplinary team capable of treating heart patients in the highest risk group for mortality and morbidity. NUHCS now holds the record of the country’s shortest door-to-balloon time, highest volume of patients treated annually, and lowest mortality rate.

Under Prof Tan’s leadership, cardiology services at NUHCS continued without disruption to provide COVID-19 patients with emergency angioplasty. This is noteworthy as the provision of hospital services for heart attack patients in many other countries were affected by the COVID-19 pandemic.

As an interventional cardiologist who has performed more than 11,000 procedures, Prof Tan is a key opinion leader in this field and often receives referrals for the most complex cases from his colleagues, both locally and internationally

Prof Tan has received many accolades in his illustrious career. These include the Chien Foundation Lifetime Achievement Award in 2023, Singapore Cardiac Society Lifetime Achievement Award in 2022, and Asian Interventional Cardiovascular Therapeutics (India) Golden Lights of Asia Award in 2012, which was awarded to him for elevating Asia to the world map of interventional cardiology. He was also the longest serving President of the Asia-Pacific Society of Interventional Cardiology.

Prof Tan is also an excellent mentor who has taught generations of medical students, cardiology trainees and interventional cardiology fellows. He is an active researcher who has published more than 200 papers in international peer-reviewed journals, authored 18 book chapters and is the Founding Editor of the AsiaIntervention journal, which is PubMed-listed.

For his excellence in clinical service and outstanding leadership and stewardship in revolutionising the cardiology service in Singapore and elevating it to world-class standards, Professor Tan Huay Cheem is awarded the National Outstanding Clinician Award 2023.

NATIONAL OUTSTANDING CLINICIAN SCIENTIST AWARD 2023
Associate Professor Mahesh Choolani

 Prof Mahesh Choolani 

Associate Professor and Head
Department of Obstetrics and Gynaecology
Yong Loo Lin School of Medicine
National University of Singapore

Head and Senior Consultant
Department of Obstetrics and Gynaecology
National University Hospital

“For his immense dedication, passion, unwavering commitment to developing the clinician scientist community in Singapore, and outstanding leadership in revolutionising the obstetrics and gynaecology field.”

Associate Professor Mahesh Choolani is a clinician scientist with a long track record in clinical and basic science research. His main research goal is in translational medicine through the development of advanced technology that addresses the unmet need for faster and more accurate diagnostic testing for precision healthcare of Asian women.

A/Prof Choolani has been actively pursuing technology for the isolation of cell-based foetal DNA non-invasively from maternal blood for prenatal diagnosis of chromosomal abnormality. He introduced and validated non-invasive prenatal testing/screening using cell-free fetal DNA in the plasma fraction of maternal blood. This liquid biopsy assay is an excellent screening tool for three common foetal trisomies (21, 18, 13) and is currently offered to pregnant women in Singapore and the region.

A/Prof Choolani’s work has been well-recognised by his colleagues in the field locally, regionally and internationally, and also by industry partners. Over the years, he has attained more than $20 million in grant funding as Principal Investigator, and more than $15 million in grant funding as Co-Principal Investigator. This funding has translated to more than 220 peer-reviewed publications including in top tier journals such as The Lancet, Nature, and Cell, with over 12,000 citations and a Hirsch index of 59. He has seven patents with six of them licensed by the industry. 

The importance of collaboration between science, medicine, and industry cannot be overstated. Cognisant of this, A/Prof Choolani founded INEX Innovate in 2006, as a women’s health diagnostic company offering molecular tests and developing new point-of-care diagnostics in the women’s health space. In recognition of INEX Innovate, the Association of Small and Medium Enterprises awarded him the Entrepreneur of the Year 2022 Award for Established Entrepreneur (Overall Winner). This highlights the relationship between Singapore’s medical academia and industry, and the role of the clinician scientist in converting a clinical need, through science, into a viable product for industry and society. 

A/Prof Choolani has been actively imparting his knowledge and skills. Over the years, he has introduced many programmes that have fostered closer interactions between clinicians, scientists, and other research professionals. Many of these programmes have led to collaborations, grant-funded projects and publications. He has worked tirelessly to establish a community of clinician scientists beginning with the establishment of the National University of Singapore (NUS) Clinician Scientist Unit in 2006 and continuing with his active involvement in the National University Health System (NUHS) Clinician Scientist Academy. A/Prof Choolani is now serving his second term as President of the College of Clinician Scientist, Academy of Medicine, Singapore.

The most significant recognition of A/Prof Choolani’s work is his leadership in various organisations that focus on foetal diagnosis and therapy regionally and internationally. He has held the appointment of Chairman or President in several professional societies, including the Asia-Pacific Conference for Fetal Therapy (2015 to 2016), the International Fetal Medicine and Surgery Society (2018) and the International Fetal Transplantation and Immunology Society (2018). He is currently the President of the International Society for Prenatal Diagnosis (ISPD), and the recently appointed President-at-Large for the International Fetal Medicine and Surgery Society (IFMSS). His goal in these societies is to cultivate a cadre of clinician scientists working in his own field and the broader field of medicine, and to build an eco-system to drive scientific medicine in Asia.

For his immense dedication, passion, unwavering commitment to developing the clinician scientist community in Singapore, and his outstanding leadership in revolutionising the obstetrics and gynaecology field, Associate Professor Mahesh Choolani is awarded the National Outstanding Clinician Scientist Award 2023.

NATIONAL OUTSTANDING CLINICIAN MENTOR AWARD 2023
Adjunct Associate Professor Brenda Ang Sze Peng (洪詩娉) 

AProf Brenda Ang 

Clinical Director
Department of Infection Prevention and Control
Tan Tock Seng Hospital

Emeritus Consultant
Department of Infectious Diseases
Tan Tock Seng Hospital

Clinical Senior Lecturer
Yong Loo Lin School of Medicine
National University of Singapore

Adjunct Associate Professor
Lee Kong Chian School of Medicine
Nanyang Technological University

“For her tireless dedication, passion and unwavering commitment towards championing the areas of Infectious Diseases (ID) and Infection Control and nurturing successive generations of ID clinicians.”

Over the past few decades, Adjunct Associate Professor Brenda Ang has been synonymous with Infectious Disease and Infection Control in Tan Tock Seng Hospital (TTSH). This award is a recognition of her efforts, having spent the past 30 years developing ID as a specialty in Singapore and advocating a culture of good infection control practices at institutional and individual levels. Through the relentless efforts of A/Prof Ang and her contemporaries, ID and infection prevention and control have become an integral and crucial part of our healthcare services.

From the threat of emerging IDs such as Nipah, Severe Acute Respiratory Syndrome, Chikungunya, H1N1, Middle East Respiratory Syndrome, Ebola, to the most recent COVID-19, A/Prof Ang has weathered different waves of ID outbreaks where her expertise and experience have contributed to their control and mitigation. Her leadership in the planning and implementation of policies relating to pandemic preparedness has also enabled TTSH, National Centre for Infectious Diseases and National Healthcare Group (NHG) to be prepared for unforeseen circumstances, contributing to a safer environment for staff, patients, and visitors alike.

Following her appointment as the Chairman of the TTSH Infection Control Committee in 1996, she has worked on reducing nosocomial infections and multi-drug resistant organisms. In addition to being Clinical Director of the Department of Infection Prevention and Control, she sits on multiple committees including the Steering Committee of Hospital Acquired Infection Elimination Collaborative, Antimicrobial Stewardship Committee, chairs the NHG Infection Control Committee and is a member of MOH’s National Infection Prevention and Control Committee (NIPC). She has been instrumental in strengthening surveillance of infections in the hospital, analysing and understanding reasons for transmission, and developing response measures such as infection control electronic surveillance systems, staff sickness surveillance systems, and real-time location systems.

She introduced active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) in all inpatients in TTSH from 2010. She initiated the use of rapid testing with polymerase chain reaction for patients listed for elective surgery or admitted via the Emergency Department, with TTSH being the first hospital to do so. These strategies resulted in improved workflows for staff managing MRSA patients and a reduction in MRSA infection rates. A/Prof Ang has been actively involved in coming up with recommendations to address key questions in preventing nosocomial infections and responding to antimicrobial resistance as well as emerging infectious diseases.

Her passion has led her to teach ID and create opportunities for learning through the exchange of ideas among members of the local ID community. A/Prof Ang has been a role model and a constant inspiration to younger generations of ID physicians. During her term as a member of the ID Specialist Training Committee from 1998 to 2006, and as Chairman from 2002 to 2006, she worked on developing the curriculum for ID training as well as the conduct of exit examinations, impacting the younger generation of ID physicians trained in Singapore.

Since 2004, A/Prof Ang has been teaching at National University of Singapore as a Senior Clinical Lecturer. She is also currently Adjunct Associate Professor at the Lee Kong Chian School of Medicine and helps mentor trainees as a Visiting Consultant to Department of Infectious Diseases at Singapore General Hospital.

A/Prof Ang has been recognised with numerous awards for her contributions over the years. She has continually been a role model with strong ethos, values, professional integrity, and conduct. Her distinguished contributions to the medical profession, Singapore’s public healthcare sector, and international community, in the areas of clinical service, education, and research, have also earned her the title of Emeritus Consultant, Department of Infectious Diseases at TTSH in 2021.

For her tireless dedication, passion, and unwavering commitment towards championing the areas of ID and Infection Control and nurturing successive generations of ID clinicians, Associate Professor Brenda Ang is awarded the National Outstanding Clinician Mentor Award 2023.

NATIONAL OUTSTANDING CLINICIAN MENTOR AWARD 2023
Professor Julian Thumboo

Professor Julian Thumboo 

Senior Consultant
Department of Rheumatology and Immunology
Singapore General Hospital

Research Director and Director
Health Services Research Unit
Singapore General Hospital

Advisor
SingHealth Centre for Population Health Research and Implementation

Professor
Office of Clinical and Faculty Affairs and Health Services and Systems Research Duke-NUS Medical School

Adjunct Professor
Yong Loo Lin School of Medicine
National University of Singapore

“For his outstanding contributions in guiding and mentoring clinicians and researchers, imparting knowledge, and instilling compassion, commitment, integrity, and a passion to learn.”

The filmmaker Steven Spielberg once said, “The delicate balance of mentoring someone is not creating them in your own image but giving them the opportunity to create themselves.”

That is exactly what Professor Julian Thumboo has been doing and beyond. Besides medical and PhD students, he has supervised and mentored doctors training in Rheumatology and Internal Medicine as well as budding clinician-scientists and clinician-researchers, amongst many others.

In particular, Prof Thumboo, who was Head of the Department of Rheumatology & Immunology at Singapore General Hospital (SGH) from 2007 to 2014, has mentored a generation of rheumatologists. Some mentees have become mentors themselves, just as Prof Thumboo was inspired by his own mentors to become one. One such mentee, Associate Professor Andrea Low, currently helms the Department of Rheumatology & Immunology at SGH. Others have taken on senior positions in public healthcare institutions or private practice or are making significant contributions in their respective fields of research.

To ensure there are proper structures and environment to facilitate mentoring, Prof Thumboo initiated several programmes at the national and institution levels, such as the SingHealth Nurturing Clinician Researcher Scheme, benefitting more than those he mentored personally over the years.

The successes of his mentees is a reflection of Prof Thumboo’s passion in helping and guiding individuals to fulfil their greatest potential. He believes that there is no success without a successor, and mentoring juniors helps mentors leave behind a legacy.

One of his mentees is SGH’s Associate Professor Low Lian Leng, who took over as Director of SingHealth’s Centre for Population Health Research and Implementation this year from Prof Thumboo, and is a recipient of the National Medical Research Council Health Promotion, Preventive Health, Population Health and Health Services Research Clinician Scientist Award. A/Prof Low describes Prof Thumboo as a dedicated, nurturing, and gentle mentor who devotes time to developing his mentees. By observing how Prof Thumboo conducted himself as a researcher and managed a large research centre and his collaborative leadership, A/Prof Low has learnt immensely and is now not only an independent researcher, but a clinician leader too. 

Prof Thumboo’s passion for mentoring has been recognised by the accolades he has received. Some of his recent awards include the National Day Award – Public Administration Medal (Bronze), SingHealth Excellence Award for Distinguished Mentor, and Duke-NUS Medical School Master Academic Clinician.

Prof Thumboo is also a keen researcher, having published more than 330 papers in peer-reviewed journals, and receiving several million dollars in individual grant funding. He also helped to secure $20 million in grant funding for SGH, and $21 million for the SingHealth Regional Health System in his role as Research Director of these organisaitons. His research interests are in population health, patient reported outcome measures, systemic lupus erythematosus and osteoarthritis.

For his outstanding contributions in guiding and mentoring clinicians and researchers, imparting knowledge and instilling compassion, commitment, integrity, and a passion to learn, Professor Julian Thumboo is awarded the National Outstanding Clinician Mentor Award 2023.

NATIONAL OUTSTANDING CLINICIAN EDUCATOR AWARD 2023
Associate Professor Nigel Tan Choon Kiat (陈俊杰)

AProf Nigel Tan 

Senior Consultant
Department of Neurology
National Neuroscience Institute

Group Director Education (Undergraduate)
SingHealth

Associate Dean
MD Programme
Duke-NUS Medical School

“For his tireless dedication and leadership in advancing the education and training of clinicians in Singapore and internationally.”

Associate Professor Nigel Tan is an epilepsy neurologist, whose diverse contributions to medical education have impacted individuals and organisations at the institutional, cluster, national and international levels.

A/Prof Tan is a natural teacher who is known for his infectious enthusiasm and for creating effective learning environments in clinical or classroom settings. His interest in medical education started as a neurology registrar and he continues to teach medical students from all three medical schools in Singapore and residents from SingHealth and National Healthcare Group in the wards and clinics. He has promoted active learning through effective teaching methods, fair assessment, and by providing actionable feedback.

A/Prof Tan was appointed Education Director of the National Neuroscience Institute (NNI) from 2011 to 2018. Recognising the need for formal training of education leaders, he led by example and graduated with a Master of Health Professions Education in 2013. A/Prof Tan has consistently applied his educational training to the creation of education programmes, strengthening of education systems to improve quality, and the development of fellow educators from all health professions. He also continues to mentor junior educators.

As Group Director of Education (Undergraduate) for SingHealth since 2018, A/Prof Tan led an interprofessional committee to conceptualise the Educator Development Framework. This interprofessional framework provides guidance for all healthcare educators across the SingHealth Duke-NUS Academic Medical Centre (AMC) to grow and develop as educators, specifying roles, competencies and development opportunities. With Professor Fernando Bello from Duke-NUS Medical School, he also co-developed a Certificate in Technology-Enhanced Learning in 2021 for SingHealth Duke-NUS AMC, when such learning became important during the COVID-19 pandemic as a means of quickly upskilling faculty in technology-enhanced learning.

At the national level, A/Prof Tan served on the Neurology Residency Advisory Committee (RAC) from 2013 to 2018. As RAC Examination Chair, he initiated and led an evidence-based overhaul of the national Neurology Exit Examination, successfully implementing the new examination format in 2015. With the introduction of the important concept of Entrustable Professional Activities (EPA) by the MOH in 2018, A/Prof Tan then led a national workgroup that successfully designed, piloted, and implemented neurology EPAs for neurology senior residencies in Singapore. These initiatives required significant education and change management expertise, a testament to A/Prof Tan’s knowledge and leadership skills.

Internationally, A/Prof Tan co-leads the Genetic Literacy Taskforce of the International League Against Epilepsy (ILAE), which is the global organisation for epilepsy neurologists. He conceptualised the ILAE Genetic Literacy Series, aimed at educating fellow neurologists about epilepsy genetics, using evidence-based techniques to enhance learning. By coordinating content and writing with international teams of authors, his efforts have led to nine publications in the series that have been well-received, with international readership and global impact.

As a believer of a scholarly approach to education, A/Prof Tan has 22 education publications, focusing on assessment, clinical reasoning and interprofessional education, and collaboration. These publications were co-authored with broad groups of authors across the three healthcare clusters, MOH, the three medical schools, and with international co-authors, attesting to his ability to collaborate with diverse groups in the pursuit of education scholarship. He has also received four awards for his education research, as well as awards in Singapore and internationally for his teaching.

A/Prof Tan is also a respected clinician and epilepsy neurologist, continuing to care for epilepsy and neurology patients. He has served on the council of the Singapore Medical Association and continues to serve on committees of the ILAE to advance patient care. He continues to actively publish as a clinician, having another 42 neurology or medicine biomedical research publications.

For his tireless dedication and leadership in advancing the education and training of clinicians in Singapore and internationally, Associate Professor Nigel Tan is awarded the National Outstanding Clinician Educator Award 2023.

NATIONAL CLINICAL EXCELLENCE TEAM AWARD 2023
THE EAGLEcare PROGRAMME

EAGLEcare 

Clinical Assistant Professor Christopher Lien Tsung Chien (连宗谦)
Senior Consultant
Department of Geriatric Medicine
Changi General Hospital

Director
Community Geriatrics
Changi General Hospital

Programme Director
The EAGLEcare Programme
Changi General Hospital

Ms Yee Kai Ying (余恺莹)
Executive
Intermediate and Long-Term Care Integration
Changi General Hospital

Dr Shaun Gerald Nathan
Senior Resident Physician
Medical Services
St. Andrew’s Community Hospital

Ms Jesslyn Ang Lay Teng (洪丽婷)
Senior Staff Nurse
Community Nursing
Changi General Hospital

“For their outstanding commitment in establishing a collaborative model of care with nursing home partners to enable meaningful and quality care to nursing home residents and their families towards their end of life.”

The Enhancing Advance Care Planning, Geriatric care and End of Life care in Nursing Homes in the East (EAGLEcare) programme by Changi General Hospital (CGH) was established in 2015 to provide coordinated health and social support for residents in nursing homes through a collaborative model of care delivery and training so that nursing home residents may receive the care that matters most to them and their families towards their end of life.

The EAGLEcare programme equips nursing home staff to provide quality geriatric and end-of-life care to their residents in partnership with acute and community hospitals and General Practitioners (GPs). More than 460 staff have been equipped with Advance Care Planning (ACP) facilitation as well as geriatric and end-of-life skills, guided by customised care paths to respond to common geriatric and end-of-life conditions. These activities are complemented by bedside teaching and case discussions at regular multidisciplinary meetings with the EAGLEcare team.

With strengthened knowledge and professional care capabilities, nursing home staff engage residents and their families or appointed representatives on ACP conversations throughout their care journey. Such conversations can be difficult and emotional but are important in explaining the underlying disease processes and clarifying goals, priorities, and preferences. Staff are also able to regularly and systematically identify and manage EOL residents through a digital screening assessment tool developed by the EAGLEcare team. Suitable residents who express a preference for comfort measures or limited interventions in their Preferred Plan of Care (PPC) are enrolled into the EAGLEcare programme.

Enrolled residents are cared for by their regular GPs and a core EAGLEcare team, comprising physicians and community nurses from CGH who are trained in geriatric and palliative care. They are complemented by clinical support from St. Andrew’s Community Hospital (SACH), which also provides the Violet Programme on-call palliative team service after office hours. This collaborative and synergised model of care delivery provides access to 24/7 clinical care and establishes regular psychosocial support in identifying and managing symptomatic care of residents at the end of life. This builds confidence and enables a mindset shift for the nursing home staff, residents and their families that quality palliative care can be received in the homes.

The programme’s effectiveness is anchored on the close partnerships between the CGH EAGLEcare team, SACH, GPs, and nursing home staff, as they co-manage residents according to their PPC wishes. To date, some 1,500 nursing home residents have been screened by the EAGLEcare-trained staff, and more than 500 residents have been identified and enrolled into the EAGLEcare programme to receive end-of-life care, support, and resources such as ACP and tele-geriatric consultations. From 2019 to 2021, the nursing homes saw a reduction in hospital admissions in their residents, including Emergency Department admissions, inpatient admissions, and Specialist Outpatient Clinic visits, as well as shorter lengths of stay in the hospital.

The decrease in avoidable hospital admissions also improved residents’ quality of life at the end of life by allowing them to be comfortably cared for at the homes. From 2020 to 2022, the EAGLEcare programme honoured 99% of enrolled residents’ wishes in terms of treatment preferences, and 91% in terms of preferred place of death, at nursing homes.

Two other nursing homes – Lions Home for the Elders (Bedok) and Apex Harmony Lodge – have come onboard the programme, and there are plans to reach out to 12 more nursing homes in the East. The EAGLEcare programme has also been identified for implementation across SingHealth institutions such as Singapore General Hospital and Sengkang General Hospital.

For their outstanding commitment in establishing a collaborative model of care with nursing home partners to enable meaningful and quality care to nursing home residents and their families towards their end of life, the EAGLEcare team is awarded the National Clinical Excellence Team Award 2023.