First page 1 Next page Last page

Caring Issue 6, 2023

Learn about our initiatives and innovations by our Changi General Hospital care team to advance health and healthcare for the community, and gain useful health and wellness tips from CGH’s bi-monthly flagship publication.

I S S U E 6 2 0 2 3

cgh.com.sg

Changi General Hospital

P u t t i n g P a t i e n t s F i r s t

EMPOWERING SENIORS

TO STAY HEALTHY

CGH sets new GUINNESS

WORLD RECORDSTM title

Tackling hypertension

and diabetes at the

CGH DOME Centre

ALL GLANDS ON DECK

A TOAST TO

88 YEARS OF

TRUSTED CARE

Looking back at highlights

of CGH’s 88th Anniversary

1 Navigating the

body’s chemistry:

all ‘glands’ on deck!

Managing hypertension

and diabetes

5 CGH DOME Centre

Patients with endocrine

conditions can receive

care at CGH’s one-stop

multi-disciplinary centre

IN-DEPTH

IN PERSON

10 Leading with optimism

CEO Professor Ng Wai Hoe

shares his heartfelt

reflections as he wraps up

his time at CGH

8 Driving precision in

hypertension diagnosis

CGH redefines the diagnosis of

curable forms of hypertension

13 A toast to 88 years of

trusted care

Key highlights from CGH

88th Anniversary

IN THE SPOTLIGHT

INSPIRED

Navigating the body’s chemistry:

IN-DEPTH

I S S U E 6 2 0 2 3

all ‘glands’ on deck!

Supervising Editor

Vincent Lim

Editorial Team

Teo Yin Yin

Adryl Leong

Design & Production

Mediacorp Pte Ltd

Have a story idea?

Tell us!

To get in touch, provide

feedback or update your

subscription details, email

us at Caring@cgh.com.sg

TO CARING

READ THE

LATEST ISSUE

ONLINE

MCI (P) 077/12/2022.

General Hospital (registration

number: 198904226R).

may be reproduced in whole

or in part with written

permission. For permission

requests, please write to CGH

Corporate Communications at

cgh_comms@cgh.com.sg. The

views and opinions expressed or

implied are those of the authors

or contributors and do not

necessarily reflect those of CGH

or the publisher. The information

in Caring is for educational

purposes and not intended as

personalised medical advice for

any individual’s health condition.

P u t t i n g P a t i e n t s F i r s t

I S S U E 6 2 0 2 3

Dive into the body’s endocrine system,

where glands and hormones play a

vital role in regulating everything from

blood pressure to glucose levels,

and take a look at how Changi

General Hospital’s (CGH) multi-

disciplinary care helps patients

with endocrine conditions.

ndocrinology is the medical specialty that

deals with hormones, which are chemicals

produced by certain organs (endocrine

glands) in the body and released into the

bloodstream, where they exert effects on various

tissues around the body. The body produces

more than 50 different hormones, which are

instrumental in regulating numerous bodily

functions such as mood, temperature, growth

and development, metabolic processes including

control of blood pressure and glucose, as well

as sex and reproduction.

The production of these hormones also

changes in response to feedback from the tissues

they act on to maintain a healthy body and mind.

Conditions that cause hormone levels to become

too high or too low can lead to diseases.

Like the crew of a ship, endocrine glands such

as the thyroid, parathyroid, pancreas, adrenals

and testes/ovaries each have their different but

equally important functions, with the pituitary

gland as the captain directing their activities to

steer the body in a healthy direction.

The endocrinologists at CGH’s Department of

Endocrinology provide specialised and holistic care

for patients with conditions that involve their

endocrine glands. These conditions include

diabetes mellitus, hypertension (high blood

pressure), obesity and cholesterol disorders,

as well as disorders of the bone, thyroid,

pituitary, adrenal and reproductive glands.

We take a deeper look at two common

endocrine conditions and CGH’s one-stop

Diabetes, Obesity, Metabolism and Endocrine

(DOME) Centre, which caters to patients who

require multi-specialty consultation and care.

HYPERTENSION

Blood pressure refers to the force with which

your heart pumps blood throughout the body.

An individual’s blood pressure can vary

from time to time, depending on various

factors such as the time of day, the amount

of salt intake from food and drinks, physical

activity and emotions. As such, it is

recommended that blood pressure be taken

on more than one occasion and when an

individual is in a resting state.

The endocrine system consists of glands that produce hormones

which regulate various bodily functions.

FOR ADULTS:

Normal blood pressure is less than 130/80mmHg.

High blood pressure is 140/90mmHg or higher.

16 Staying healthy over 65

Tips for staying healthy in

your golden years — and a

CGH world record

IN THE MIND

19 A community embrace

Driving mental well-being for

seniors in the community

IN THE COMMUNITY

20 Reducing

sodium intake in our diets

Healthier living with

low-sodium choices

IN ADDITION

“By taking proactive steps to care for

our endocrine health, we can reduce

the risk of various health issues. At CGH,

we partner our patients on their health

journey, empowering them through

comprehensive, multi-disciplinary care

and innovative treatments.”

Clinical Associate Professor Joan Khoo,

Head & Senior Consultant, Department of Endocrinology, CGH.

ENDOCRINE SYSTEM

A silent killer

Hypertension, also known as high blood pressure,

occurs when the pressure in the blood vessels

is too high. Many people with hypertension

do not experience any symptoms and it may

remain undetected for years. Some people

with hypertension may experience increased

headaches, shortness of breath or nosebleeds.

However, these symptoms are not specific to

hypertension as they may also be present in

other diseases. The only certain way to detect

hypertension is through measuring the blood

pressure. If left untreated, or not properly

managed, hypertension can cause further health

complications including heart attack, heart

failure, stroke and kidney failure.

Diagnosing endocrine hypertension

Most patients with hypertension have essential

(unexplained) hypertension and have to be treated

with lifelong medications. However, 5-10% of all

patients with hypertension may have underlying

conditions, which may lead to the improvement,

or cure, of hypertension following treatment.

In particular, the adrenal glands — which are

part of the body’s endocrine system — may

produce too much of a hormone, like aldosterone,

which can lead to hypertension occurrence.

Patients with too much aldosterone often

develop hypertension and low potassium levels

(hypokalemia). This is an important condition to

treat, as patients with high aldosterone levels

often have difficult-to-control hypertension, and

are at greater risk of heart and kidney disease.

In addition, this is a curable cause of hypertension,

and early treatment makes it more

likely for patients to be cured.

Managing the pressure

“Hypertensive patients

should have their

aldosterone and renin

levels checked at least once,

especially if they have low

potassium levels,” says

Clin Asst Prof Troy Puar, Senior Consultant,

Department of Endocrinology, CGH.

I S S U E 6 2 0 2 3

“While hereditary risk factors are non-

modifiable, there are other actions that can

lower the risk of hypertension.”

For example, reduce or stop smoking, limit

alcohol intake, eat a healthier and balanced

diet and exercise regularly to achieve a

healthier Body Mass Index (BMI) — exercise

can also help to lower the blood pressure

and manage stress. “If you have other health

conditions, take the medications consistently

and go for reviews as needed. If you are

constantly stressed, make time to rest and

try to have adequate sleep. Additional

treatments may be needed to manage the

hypertension,” says Clin Asst Prof Puar.

Managing hypertension at CGH

The CGH Adrenal Hypertension Centre was

established in 2023 to offer comprehensive

evaluations for patients with hypertension

that is caused by excessive adrenal hormones.

These evaluations include blood and urine

tests for excess hormones.

The Shimadzu-CGH Clinomics Centre

(SC3) was launched in 2021, and currently

runs hormone tests using mass spectrometry,

eliminating the need to run the tests overseas.

At these centres, CGH’s multi-disciplinary

team, involving endocrinologists, radiologists,

laboratory medicine specialists, histopathologists

and surgeons, work together to diagnose

and treat patients with various adrenal

conditions, such as primary aldosteronism,

pheochromocytoma and Cushing’s.

DIABETES

Diabetes Mellitus, commonly known as

diabetes, is a chronic disease where the sugar

levels in the blood are abnormally high.

Most of the food we eat is converted into

glucose upon digestion, which enters the

bloodstream. Insulin then moves the glucose

from the bloodstream into the body cells for

use as energy or storage. Insulin is a hormone

produced by the pancreas that regulates the

glucose level in the blood.

If the pancreas does not produce enough

insulin, or if the body is unable to effectively use

the insulin, glucose is unable to enter the cells

and accumulates in the bloodstream, resulting

in diabetes.

Honeyed hints

While mild diabetes is often without symptoms,

one may experience increased thirst, frequent

urination, intermittent blurred vision, slow-

healing sores or frequent infections or even

weight loss when the sugar levels in the

bloodstream are significantly increased. If

not properly managed, diabetes can lead to

complications such as blindness, chronic kidney

disease, amputations, heart attack or stroke.

These symptoms might indicate that further

tests are required to determine the diagnosis.

Blood glucose tests include a fasting blood

glucose level test, a random blood glucose level

test and an oral glucose tolerance test.

The pancreas produces insulin, which regulates glucose levels in the body.

Prone to infections

(commonly involving

skin, urine or lungs)

Numbness

or tingling in

hands/feet

Loses weight

without trying

Sores or

wounds

that take a

long time

to heal

Dry skin

Often hungry

Blurred vision

Need to

urinate often

Often thirsty

ADRENAL HYPERTENSION

PATIENT SUPPORT GROUP

CGH recently started a patient advocacy

group for patients with hypertension — the

first meeting will be held in May 2024 in

conjunction with World Hypertension Month.

IN-DEPTH

Steps can

be taken to

lower the risk

of hypertension.

Type 1 diabetes

Type 1 diabetes is an autoimmune condition

where the body’s immune system attacks

and destroys the beta cells (the cells that

make insulin) of the pancreas. The damaged

pancreas is then unable to produce insulin,

and the body cells are unable to absorb

glucose from the bloodstream. Persons with

this condition will require lifelong insulin

injections. Type 1 diabetes affects 5% of all

people with diabetes.

Type 2 diabetes

In Type 2 diabetes, the body’s cells require

more insulin than usual to absorb glucose

from the bloodstream, due to resistance that

has developed towards insulin. Being unable

to produce enough insulin to cope with these

increased needs, glucose levels rise.

Common causes of Type 2 diabetes:

• Overweight or obesity

• Sedentary lifestyle

• Family history of Type 2 diabetes

• High blood pressure (above 140/90mmHg)

• Abnormal cholesterol levels

• Gestational diabetes, or previously

delivering a baby weighing more than 4kg

COMMON

SYMPTOMS

OF DIABETES

ALMOST ONE-QUARTER OF SINGAPORE RESIDENTS

AGED BETWEEN 30 AND 69 SUFFER FROM HYPERTENSION.

Read more about SC3 on page 8.

IN-DEPTH

I S S U E 6 2 0 2 3

Together with the multi-disciplinary team,

the endocrinologists enhance the care

outcomes of patients.

CGH DOME Centre

he CGH Diabetes, Obesity, Metabolic and

Endocrine (DOME) Centre manages and

treats patients with diabetes, hypertension,

obesity and other endocrine disorders with its

multi-specialty practice. For instance, patients

with diabetes are likely to also have weight

management issues, hypertension and related

conditions. Instead of visiting several clinics

for treatment, patients can see two or more of

CGH’s multi-disciplinary care team at the DOME

Centre to better manage their chronic diseases.

Hormonal harmony with

endocrinologists

“The entire care team at the CGH DOME Centre

plays an important role in caring for our patients.

The endocrinologists help patients with

diabetes manage and maintain their blood

glucose levels within a target range, monitor

the development of complications and provide

self-management education and support to

empower patients and their families to allow

them to care for themselves,” says Dr Zeng.

Lowering the risk

“Prevention is better than cure.

The key to lowering the risk of getting

Type 2 diabetes is making lifestyle changes

for the better,” says Dr Zeng Wanling,

Consultant, Department of Endocrinology, CGH.

Some tips include:

• Maintain a healthy diet with an emphasis on

vegetables, fruits, nuts, fish and whole grains and

avoid sugar-sweetened beverages and snacks

• Have 150 to 300 minutes of moderate-intensity

physical activity per week

• Maintain a healthy BMI

• Stop smoking

• Limit alcohol intake

Managing diabetes

As a smart hospital, CGH integrates technology

into the care for patients. Integrated technologies

such as the continuous glucose monitoring (CGM)

device and insulin pumps help to improve glucose

control, patients’ quality of life, and facilitate the

self-management of diabetes.

The CGM device monitors blood glucose levels by

using a sensor inserted under the skin to measure

the interstitial glucose level. It allows the patients

to monitor their glucose levels throughout the day

without the need for finger pricks. “Patients can

share their glucose data with our CGH care team

through a secure cloud-based platform to enable us

to make adjustments to their treatment regimen,”

explains Dr Zeng.

The insulin pump is a battery-operated device

inserted into the subcutaneous layer of the

abdomen to deliver continuous insulin (basal insulin)

and rapid acting insulin (bolus insulin) into the

bloodstream. The hybrid closed loop (HCL) pump

is an advanced insulin pump with the ability

to deliver variable amounts of basal insulin

and bolus insulin

automatically, based

on the glucose

readings obtained by

the CGM device.

This enables patients

to receive the

customised amount

of insulin required.

SAVOURING EVERY MOMENT

Even though Mr Gilbert Khor has Type 1

diabetes, he continues to live life to the

fullest with his family.

Over 10 years ago, Mr Khor started

experiencing a drastic drop in weight

and frequently blacked out when

climbing the stairs. After being referred

to CGH, it was found that Mr Khor had

diabetic ketoacidosis (DKA), a serious

complication of diabetes common among

people with Type 1 diabetes — which

Mr Khor was then diagnosed with.

Over the years, Mr Khor transited to

an insulin pen, and in 2022, he started

on the CGM device and insulin pump.

“I decided to sign up for the CGM device

and it has provided great convenience

when holidaying or when I go for meals,

as I can adjust the insulin doses to be

administered on the go,” says Mr Khor.

“Dr Zeng and CGH Senior Nurse

Manager Authilakshmy D/O N M have

been great companions on my diabetic

journey. Dr Zeng continually seeks

ways to help with the management

and betterment of my health by

understanding more about what I do

and eat, providing advice based on

them and getting me additional support

from the other specialists. The nursing

team has also been a great support,

ensuring that I am well taken care of

and in the best of health.”

While diabetes prevention is

important, Mr Khor, now 39, wants to

also encourage those with diabetes

not to fear the disease but to manage

diabetes with proper care, so that it does

not impact the quality of life significantly.

Find out more about

diabetes through

these videos.

Integrated technologies

help to improve patients’

quality of life and facilitate

the self-management

of diabetes.

Mr Khor believes that proper care of diabetes enables him

to still do the things he enjoys.

I S S U E 6 2 0 2 3

CGH endocrinologists

also oversee and coordinate

the overall care of the

patients, working with

different members of the

multi-disciplinary care team

to enhance the care and

outcomes of the patients.

For example, if more intensive

monitoring of the blood

sugar and adjustment of

insulin regimen is required,

the endocrinologist will refer

the patient to the diabetes

nurse educator (DNE). If the

endocrinologist identifies diet

as a major factor that affects

a patient’s management of

diabetes, they will refer the

patient to the dietitian.

“We also support our

patients through the various

stages in their life journey as

we have a long-term patient

and doctor relationship,” says

Dr Zeng.

Nursing care

CGH nurses at the DOME

Centre not only provide

routine care, but also support

patients with hypertension

through monitoring tests such

For patients with hypertension

who also struggle with weight

management, CGH dietitians

explain the theory behind how

diet can help with weight loss

and blood pressure control, and

provide practical advice on how

to achieve a lower sodium or

lower calorie intake in their diet.

For patients newly

diagnosed with diabetes,

the dietitians provide

comprehensive explanations

on the link between diet and

disease. “For example, patients

need to know about the

sources of carbohydrates and

their impact on the blood sugar

level, so that they can take the

right steps in changing their

diets,” says Ms Chua.

as salt loading (determining

how the body handles salt

by producing a hormone that

regulates blood pressure) and

Synacthen tests (assessment

of the adrenal glands’

functions). For patients with

diabetes, the nurses conduct

diabetes complication tests

such as retinal photography

and foot screenings.

“Patient education is a key

role of the DNEs at the DOME

Centre,” says CGH Senior

Nurse Manager Authilakshmy

D/O N M. “It tends to be for

newly-diagnosed patients,

or those initiated on a new

diabetes therapy.” DNEs play

a pivotal role in reducing

hospital readmission rates and

preventing delayed discharges.

Utilising technology, the

nurses also monitor patients’

blood glucose levels and make

insulin adjustments through

telemonitoring.

The DNEs also work

closely with the dietitians,

conducting joint counselling

sessions for patients on

insulin therapy. During these

sessions, patients are taught

CGH dietitians also aid

other groups of patients

at the Centre, including

patients undergoing bariatric

surgery, renal patients —

such as those on peritoneal

dialysis — and patients with

lipid disorders.

Best foot forward

At the CGH DOME Centre,

CGH podiatrists primarily

provide care for patients with

diabetes, and educate them

in taking responsibility for

their foot health. Foot wounds

are common complications

that arise from nerve

damage, foot deformities,

poor circulation, external

trauma such as poorly-fitted

footwear, or amputations.

Podiatrists remove dead

or unhealthy tissue from a

patient’s wound, and apply

appropriate strategies to

redistribute pressure on the

foot, preventing infections and

facilitating wound healing.

carbohydrate counting and

how to calculate their insulin

doses for their meals.

For patients in the

community, the CGH nurses

conduct patient empowerment

workshops to educate them

on how to monitor their

glucose levels and skills for

diabetes management.

Nourishing wellness

“During the consultations,

dietitians conduct nutrition

assessment based on

information about patients’

weight, biochemical, clinical,

dietary, physical activity, and

social factors,” says Ms Fionn

Chua, Senior Dietitian, CGH.

“To support patients in

making positive changes,

we provide them with the

required knowledge, and

guide them to make informed

choices about their dietary

habits to better manage their

medical conditions.”

Many patients have

multiple comorbidities and

require individualised dietary

counselling to help them

achieve their health goals.

Many diabetic patients

have skin and nail

abnormalities such as ingrown

nails, fungal nails, calluses

and corns. When patients and

caregivers are unable to do

so appropriately, podiatrists

help with specialised trimming

and removal. “In a diabetic

patient with inadequate

blood supply to the lower

limb, ingrown nails can

result in a non-healing

wound, possibly gangrene

and toe amputation,” says

Ms Kuah Bao Peng, Principal

Podiatrist, CGH.

Offloading (reducing and

redistributing pressure to

areas of the foot) is another

critical aspect in preventing

wound recurrence. “We

prescribe customised insoles

for patients or refer them to

our orthotist for footwear

modifications based on our

knowledge of our patients

and the insole’s material

properties,” says Ms Kuah.

IN-DEPTH

Scan the QR code to learn more about the services

available at the CGH DOME Centre.

Nurses conduct diabetic

retinal photography

screenings to detect

diabetes complications.

Dietitians at the CGH DOME Centre provide patients

with dietary counselling based on their conditions.

CGH podiatrists ensure optimal foot health for diabetic patients,

an important aspect of maintaining their overall health.

CGH’s nurses and dietitians conduct

multi-disciplinary team clinic

consultations for patients

with diabetes at the

Joint Dietitian and

DNE (JDD) sessions.

Changi General Hospital (CGH) redefines the diagnosis of

salt-sensitive and curable forms of hypertension with technology.

in hypertension diagnosis

Driving PRECISION

he Shimadzu-CGH

Clinomics Centre (SC3)

clinical service leverages

liquid chromatography and

artificial intelligence (AI)-

assisted mass spectrometry,

allowing for the precise

measurement of two hormones

— aldosterone and renin. This

advancement is crucial in

differentiating and diagnosing

salt-sensitive hypertension

and primary aldosteronism, a

lesser-known yet curable form

of hypertension.

Reaping the fruits of

research for patient-centric

healthcare outcomes

In Singapore, about 5% of all

patients with hypertension

have the curable form of

primary aldosteronism

hypertension, yet many are not

screened and treated. For these

patients, the underlying cause

of their high blood pressure is

an abnormal growth in one or

both of their adrenal glands,

which are responsible for

producing hormones that help

to regulate blood pressure.

Through a keyhole surgery

to remove the growth in

the adrenal gland, a patient

with primary aldosteronism

may significantly improve

or be totally cured of

their hypertension.

Prior to the establishment

of the SC3, the testing of

hypertensive patients’ blood

specimens had to be sent to

overseas laboratories, where

results often took several

weeks. Now, specimens can

be processed locally, allowing

for shorter turnaround times

of three to five days. This

enables more patients to be

successfully tested, diagnosed

by doctors, and treated with

at CGH in September 2023 to

remove his affected adrenal

gland. Just two weeks after his

surgery, Mr Khoo’s condition

improved significantly. Today,

he requires less medications

and his blood pressure —

which is now at a normal level

— has stabilised for the first

time in several years.

“I believe in the importance

of testing, especially for long-

term hypertension patients

like myself,” says Mr Khoo.

“With the quick and detailed

investigations done at SC3, the

doctors were able to arrive at

spectrometry technology used

at the SC3 is equipped with a

unique algorithm incorporating

AI assistance. With machine-

learning capabilities, the

AI employed at SC3 can

process test data at a high skill

level. This allows us to pick up

the correct chromatography

peaks and measure plasma

aldosterone and renin activity

even when present at very

low concentrations.”

The two tests have been

rigorously validated based on

CLSI (Clinical & Laboratory

Standards Institute) guidelines.

“Being part of this research

in the early stages to the

translation to a full-fledged

clinical service in February

2023 — and eventually

seeing such improved patient

outcomes from the tests that

we have developed collectively

with clinicians and laboratory

medicine colleagues — is

indeed a rewarding and fulfilling

experience,” shares Ms Tan

Yi Ting, Research Associate,

CGH, who was involved in

developing the tests at SC3.

Serving as a regional

reference centre, the SC3 is

also developing unique mass

spectrometry solutions,

including catering to various

clinical diagnostics and

applications for other chronic

conditions, to more countries in

the Asia Pacific region.

the accurate diagnosis of my

type of hypertension — primary

aldosteronism — enabling me

to seek treatment at CGH and

improve my condition.”

Technology for tomorrow

The use of liquid chromatography,

mass spectrometry and AI

marks a significant shift from

traditional diagnostic methods,

and presents clinicians with a

more nuanced understanding of

the two types of hypertension.

Dr Daryl Hee, Assistant

Director, CGH, who oversees

the SC3, explains: “The mass

precise care. To date, CGH

has conducted over 1,000

clinical tests in patients

with hypertension.

The shift to local testing

at the SC3 has also made a

noticeable difference in patient

care. Quicker test results

lead to a more enhanced

patient journey from testing

to treatment, thus reducing

stress and uncertainty for

patients who have lived

with hypertension — often

uncontrolled — for many years.

One such patient is

Mr Khoo Keow Pin, 66, who

struggled with the condition

for more than 15 years, having

been unaware that he had

primary aldosteronism and

the fact that it is curable.

Following testing at the SC3

and his diagnosis in June

2023, Mr Khoo underwent

an adrenalectomy surgery

The AI-assisted

algorithm at the

SC3 can process

data at heightened

accuracy.

“ As a smart hospital innovating

healthcare for tomorrow, CGH looks

to provide crucial and advanced

diagnostics for patients. SC3 will

continue to expand its reach to

more patients through upcoming

partnerships with both local public

and private hospitals in Singapore.”

Dr Daryl Hee, Assistant Director, CGH

I S S U E 6 2 0 2 3

INSPIRED

Mr Khoo undergoing the salt-loading drip test as

part of testing for primary aldosteronism.

Left: Ms Tan Yi Ting, Research Associate, CGH, carries out research and assists to process blood samples sent for testing at the SC3.

IN PERSON

From clinician scientist

to healthcare leader

Inspired by his interest in dismantling

and assembling electronics, and a

fascination with neuroscience as a

student, Prof Ng Wai Hoe made his

choice to pursue neurosurgery, a

marriage of neuroscience and surgery.

A passionate storyteller with a flair for writing,

Prof Ng has also been prolific in scientific

publishing, having produced numerous high

impact factor scientific papers over the years.

2012 was a watershed year for Prof Ng as

he made the vital switch from an academic and

clinical career to also become an administrator

and a leader at the National Neuroscience

Institute. He took up his next leadership role in

the midst of the COVID-19 pandemic when he

was appointed CEO (Designate) of CGH in

May 2020, and subsequently CEO in July 2020.

The immediate challenge for him was facing

off against the COVID-19 battle. He recognised

how crucial it was to rally the CGH care team

to care for patients not only in the hospital,

but also in the community. Besides adapting

to the needs on hospital grounds, the CGH

care team was deeply involved in organising

operations in external COVID-19 facilities,

including managing care for migrant workers

at their dormitories, as well as administering

vaccinations and performing swab operations

in the community.

“We did not know how long-drawn the

pandemic would be, but everyone at CGH was

motivated to chip in and go the extra mile to

care for our patients,” says Prof Ng. “We had

to do all these while balancing the needs of

our regular patients who had other diseases,

and maintain regular operations and services.

It was not easy, but we did our best to ensure

that the morale and welfare of our colleagues

were looked after.”

From bland to glam

Another key challenge of rebuilding and

enhancing the reputation of the hospital

awaited Prof Ng. “There was a constant

negative refrain on what the letters ‘CGH‘

stood for, and some of our own colleagues

started believing in it, bringing about a lack of

confidence in our own abilities,” says Prof Ng.

Examining the hospital’s capabilities and

competencies, Prof Ng recognised that CGH

has many talented people, and the hospital’s

clinical outcomes are on par with or even

better than that of other healthcare institutions.

Taking the bull by the horns, Prof Ng

supported branding efforts and initiated

visioning exercises to dispel misperceptions

about the hospital, and over time, this has

borne fruit. “There is a change in perception of

CGH, with many patients saying that we now

stand for ‘Can Go Home’, and our colleagues

are acknowledging their abilities and the

hospital’s capabilities in providing trusted care

for patients.”

From hospital to home

Part of this seismic shift in perception was

made easier by CGH’s legacy of constantly

pushing to stay ahead of the demands of the

dynamic healthcare landscape. A forerunner

of population health, CGH had long been

developing its community programmes and

collaborations with community partners —

even before the broader concept of population

health becomes widely understood.

In the last three years, some of CGH’s

community programmes such as CareLine,

GPFirst and EAGLEcare have won national

accolades and expanded to become national-

level programmes. “To meet the needs of the

older demographic, CGH also established a

dedicated multi-disciplinary wound healing

centre and the CGH-NNI Integrated Spine

Centre,” says Prof Ng. CGH’s dedication to

community health has also seen it dive into

and thrive in non-traditional disciplines such as

aviation medicine and correctional medicine.

From old to gold

Another area that CGH has been powering

up on is the integration of automation and

robotics into its care process, which reduces

manual or repetitive work and streamlines

processes, transforming the way we work.

These innovative solutions augment the care

team throughout the hospital. For instance, a

group of robots streamlines processes at the

Emergency Department to enhance patient

experiences, and social robots carry out

physical and cognitive activities with patients

with functional decline, dementia or delirium.

Such strategic directions and robotic initiatives

— as well as its focus on Artificial Intelligence,

innovation and research — have earned CGH

the recognition of being one of the smartest

hospitals globally, as ranked by Newsweek.

Since the days of the old Changi Hospital

and Toa Payoh Hospital, CGH has had a history

of innovation. “The spirit of enterprise and

innovation is embedded in our DNA,” says

Prof Ng. “We innovate healthcare for tomorrow

I S S U E 6 2 0 2 3

LEADING WITH OPTIMISM

As Professor Ng Wai Hoe, Chief Executive Officer (CEO), Changi

General Hospital (CGH), wraps up his time at the Caring General

Hospital, he shares his memorable journey and heartfelt reflections.

Above: Prof Ng (left) sharing with Mr Ong Ye Kung, Minister for Health,

on how CGH’s Emergency Department was managing the patient load

during the pandemic.

Left: Prof Ng at the unveiling of the

new CGH Vision in 2022.

Below: Prof Ng, who

gamely dressed up as

Captain America, with

Mr Cheng Wai Keung,

SingHealth Chairman

(far left) and long-

serving staff at the

CGH 88th Anniversary

Dinner & Dance.

I S S U E 6 2 0 2 3

by driving research, innovation,

enterprise and education, to transform

and enhance care delivery and patient

outcomes. Our healthcare systems

must continue to evolve as we face the

challenges of a super-aged society.”

Care models can be redesigned to better

the health of patients and communities,

complemented by the use of technology

to humanise healthcare.

As a smart and caring hospital, there

is a need to balance the ‘cold and efficient

technology’ with the ‘warmth of the

human touch’. “It is not about pitting them

against each other, but finding ways for both

to improve patient care, safety and outcomes,

as well as make our work more efficient,” says

Prof Ng. “I believe the way to do it is to scan

the horizon for the next five to 10 years and

ask ourselves what innovations or technologies

are needed to achieve that.”

Developing talent and creating joy

To continue to strengthen CGH’s best practices

and patient outcomes, Prof Ng believes that

talent development plays an important role.

“We need to have a pipeline of talent for

the hospital, and invest time and resources

to support them,” says Prof Ng. “It is also

important to have in place an ecosystem

where our staff have opportunities to grow

and showcase their abilities. Partnerships also

provide our care team with the platforms to be

involved in research and innovation.”

As the nation eased back to the post-

pandemic new normal in 2023, CGH celebrated

its 88-year legacy of trusted care with the

launch of the CGH Life Video, the unveiling of

Singapore’s largest community mural, the world

record-setting of the Largest Senior Citizen’s

Health Awareness Lesson, and painting of the

CGH Heritage and Legacy wall art.

Prof Ng takes on the appointment as the

Group Chief Executive Officer of SingHealth on

1 February 2024, with Assoc Prof Ng Kee Chong

taking over the reins as CEO of CGH.

IN PERSON

Left: Prof Ng and

the care team with

some of CGH’s

many robots.

A TOAST TO 88 YEARS

OF TRUSTED CARE

That’s not to say that Prof Ng’s tenure at

CGH has been all work and no play. On April

Fool’s Day, Prof Ng sent an email to CGH

staff saying that the year’s Family Day would

be taking place at the old Changi Hospital,

rumoured to be one of the most haunted

places in Singapore. “It was amusing to see

the responses that came back,” says Prof Ng

with a laugh. “That brought people together

and generated more excitement for CGH’s

88th anniversary celebrations.”

On what makes CGH unique, Prof Ng finds

that the hospital has a nice family vibe to it.

“I appreciate the openness in CGH. Our care

team is truly sincere, nice, and welcoming.”

Prof Ng’s work as CEO of CGH earned him

the Most People-Focused CEO Award at the

HR Excellence Awards 2023.

“In my time at CGH, I believe we have

become an organisation that is forward-

thinking, optimistic, with a growth mindset

and winning attitude. My hope and aspiration

for CGH is for us to continue to be even more

so in the years to come.”

Unveiling Singapore’s largest

community mural

CGH staff and its community partners put together

Singapore’s largest community mural made of

photobricks under the Singapore Book of Records, with

a total of 264,292 photobricks measuring 6m by 2.8m.

World record for

Largest Senior’s Health

Awareness Lesson

CGH set the GUINNESS WORLD

RECORDSTM title for the ‘Largest

Senior’s Health Awareness Lesson’,

at the CGH 88th Anniversary

HEALTHFest. 469 seniors aged 65

and above set a new world record

and learnt the secrets to staying

healthy in their golden years.

Revealing CGH Heritage and

Legacy wall art

A hand-painted wall art feature at the CGH

Main Building Atrium weaves together

the past, present and ongoing CGH story,

serving as a visual representation of the

hospital’s continuing legacy of trusted care.

IN THE

SPOTLIGHT

As we wrap up Changi General Hospital’s (CGH) 88th anniversary

celebrations, we look back at the key highlights of 2023.

CGH Life video

Encapsulating the dynamism,

spontaneity and dedication that

defines life at the Caring General

Hospital, the CGH Life video showed

the care team at work and play.

Launching CGH’s 88th Anniversary

CGH kicked off the celebrations with the unveiling of its

88th anniversary logo and the launch of a call for former

staff, patients and members of the public to share their

treasured memories and memorabilia of CGH, the

former Toa Payoh Hospital and old Changi Hospital.

IN THE

SPOTLIGHT

I S S U E 6 2 0 2 3

Advancing care outcomes

Bettering patient outcomes with new clinical services

CGH, through the Shimadzu-CGH Clinomics Centre (SC3),

successfully performed clinical tests in Singapore for patients to

identify those with primary aldosteronism — a common but lesser-

known, curable form of hypertension — as well as salt-sensitive

hypertension. With the SC3, specimens can now be processed

locally, allowing for shorter turnaround times, enabling more patients

to be successfully tested, diagnosed and treated with precise care.

Advancing correctional

medicine in Singapore

CGH received a gift of

S$300,000 from the Singapore

Teochew Foundation to its CGH

Health Fund in support of the

research and education efforts

towards Correctional Medicine

in Singapore. A developing

medical discipline around the

world, Correctional Medicine

encompasses the holistic delivery

of healthcare to the prison

inmate community, and plays a

key role in social rehabilitation.

Newsweek Rankings

CGH continued to make the Newsweek rankings for the

World’s Best Hospitals 2023, World’s Best Smart Hospitals 2024,

World’s Best Specialized Hospitals 2024, and World’s Best

Specialized Hospitals Asia Pacific 2023. Based on global

surveys and recommendations from healthcare

professionals, the consistent recognition over the years

reflects CGH as Your Trusted Care Partner, Innovating

Healthcare for Tomorrow.

Nursing Excellence

CGH nurses earned a

multitude of national

achievements, including

the Ministry of Health’s

Nurses’ Merit Award 2023,

SingHealth Nurses’ Day

Awards 2023, and Wee

Foundation Nurses’ Day

Awards 2023. CGH’s

nurses also clinched

honours at the Public

Sector Transformation

Awards 2023 and the Tan

Chin Tuan Nursing Award

for Enrolled Nurses 2023.

Enhancing end-of-life care for seniors

Established by CGH in 2015, the EAGLEcare (Enhancing

Advance Care Planning, Geriatric Care and End of Life

Care in Nursing Homes in the East) programme provides

coordinated health and social support for residents of

nursing homes, and has reduced hospital readmissions.

The programme clinched the National Clinical Excellence

Team Award 2023 at the National Medical Excellence Awards.

SingHealth Excellence Awards

CGH care team members were conferred the 2023 SingHealth

Excellence Awards and GCEO Excellence Awards 2023 for their

exemplary and invaluable contributions to healthcare leadership

and administration, patient care, education and research.

Singapore Health Quality Service Awards 2023

Some 600 care team members and service partners from CGH

were celebrated at the Singapore Health Quality Service Awards

(SHQSA) 2023, the most number of winners at this year’s awards.

They were honoured for their compassion and dedication to

improving the lives of their patients and their outstanding

contributions to healthcare.

Communications Excellence

CGH’s flagship publication, Caring, was the only Singapore

publication to win the International Association of Business

Communicators (IABC) Gold Quill Award 2023. It also

clinched the IABC APAC Silver Quill Award of Excellence

2023, and the 2023 APEX Award for Publication Excellence.

Singapore’s Best Employers

CGH was ranked 32nd among 250 top

employers in Singapore across 27 industries,

out of 2,000 companies evaluated, based

on an independent

survey conducted

by The Straits

Times and Statista.

Commemorating 10 years of

Neighbours for Active Living

The Neighbours for Active Living

Programme, pioneered by CGH

and the South East Community

Development Council, reached

out to more than 13,000 seniors,

in collaboration with over 70

community partners and Friend-A-

Senior @ South East volunteers, over

the last decade to keep them well at

home after their discharge, reducing

readmissions to the hospital.

Setting up CGH@Home

CGH launched the CGH@Home

model of care, which enables more

patients to receive hospital-type

care at home. The CGH care team

is able to obtain patients’ vital signs

data through wearable medical

devices, and connect with the

patients through video consultations

and app-based programmes.

Augmenting care with automation

Developed by a team of Emergency

Department (ED) nurses, pharmacists,

engineers, operations staff and service

ambassadors, autonomous mobile robots

at CGH’s ED increase efficiency and

productivity, and enhance the experience

of patients and visitors.

Driving pharmacy

innovations

The CGH Pharmacy

team drove the

development of the

Pharmacy Smart

Interface System

(PharmaSIS), the first

smart vending machine

in Singapore to offer

access to Pharmacy Only

Medicines by providing

on-site tele-consultations

with a pharmacist.

Find out

more about

these

innovations.

Find out more about

these robots.

I S S U E 6 2 0 2 3

Celebrating our champions of care

of our body functions, which

increases our vulnerability to

stressors and in turn can lead

to a poorer quality of life.”

Frailty can result from

the weakening of multiple

body system functions, low

physical activity, malnutrition

and social isolation. Seniors

who are frail are more prone

to increased risks of falls,

dementia and delirium, face a

higher risk of functional decline

after illness or injury, and are

more vulnerable to adverse

health-related outcomes. Age-

related loss of skeletal muscle

mass and the loss of muscle

strength, also known as

sarcopenia, is also a risk factor

that can lead to frailty. “Frailty

can be prevented, reversed

or delayed in the early stages

and managed in the later

stages,” says Dr Ang.

As we move towards a

healthier nation, here are some

healthy choices seniors can

make towards staying well and

lengthening their health span.

n delivering trusted care for the

community, the CGH 88th Anniversary

HEALTHFest was held on 6 January

2024 to empower seniors to take

active steps towards better health.

469 seniors joined in the

‘Largest Senior Citizen’s Health

Awareness Lesson’ by CGH, setting

the GUINNESS WORLD RECORDSTM

title for the Caring General Hospital.

Helmed by Dr Alexis Ang, Senior

Consultant, Department of Geriatric

Medicine, CGH, the lesson saw

seniors aged 65 and above getting

on their feet and learning about the

importance of healthy lifestyle and

dietary choices as well as maintaining

social connections.

IN THE

COMMUNITY

I S S U E 6 2 0 2 3

Changi General Hospital (CGH) held its very own HEALTHFest,

where the hospital set a new world record, and seniors gained

vital insights on staying healthy in their golden years.

STAYING HEALTHY OVER 65

Scan the

QR code to

watch the

health lesson.

By 2030, a quarter of

Singapore residents will be

aged 65 years and above.

Common fears of ageing

include losing independence,

deteriorating health and

loneliness. “These happen to

be the effects of frailty,” says

Dr Ang. “Frailty involves a

gradual decline and reduction

Key determinants

for ageing well

MAKE HEALTHY

LIFESTYLE CHOICES

Stop smoking. Quitting

smoking lowers the risk of

various cancers and chronic

obstructive pulmonary disease.

Moderate your alcohol intake.

Excessive alcohol consumption

increases the risk of high blood

pressure and liver diseases.

Practise safe daily behaviours.

Wear protective helmets

during higher-risk activities

such as cycling, apply good sun

protection when outdoors to

reduce the risk of skin cancer,

wear sunglasses to protect your

eyes from cataracts, and wear

ear plugs to protect your ears

from excessive noise that can

induce hearing loss.

Have seven to eight hours of

sleep per night. Lack of sleep

can cause poor coordination

and judgement, which can result

in injuries and falls.

NUTRITION

Ageing brings about a change

in nutritional requirements —

there is a decreased need for

calories, but an increased need

for certain macro-nutrients such

as proteins, carbohydrates or

fats, and micro-nutrients like

vitamins and minerals. While

age-related factors — such as

poorer digestion, lower levels of

sensory perception (taste, smell

and sight), dental issues and

swallowing problems — can

affect the amount and type of

food a senior consumes, it is

important to have a healthy diet.

A healthy diet

Provides you with the

nutrients required for energy

and mobility

Reduces the risk of chronic

disease such as diabetes,

heart disease and stroke

Reduces the risk of

malnutrition and sarcopenia

(loss of skeletal muscle mass

and strength)

Helps you achieve or maintain

a healthy body mass index (BMI)

Helps with your mental health

Above: (From second from left) Prof Ng Wai Hoe, Chief Executive

Officer, CGH; Mdm Rahayu Mahzam, Senior Parliamentary Secretary,

Ministry of Health and Ministry of Law; Mr Cheng Wai Keung,

Chairman, SingHealth; and A/Prof Ng Kee Chong, Chief Executive

Officer (Designate), CGH, participate in a shoulder flexion exercise

together with the seniors.

“ I am proud to be part of this record-

breaking event for CGH, and Dr Ang’s Health

Awareness Lesson on healthy ageing

resonates greatly with me. I keep myself

motivated by doing things I enjoy so that

physical and mental exercise is an enjoyable

pastime. In fact, I rarely think about my age;

to me, it’s about how many more good years

there are to come!”

Ms Kammy Choo, 68, one of the participants of the CGH HEALTHFest