Saturday, February 28, 2009

Having lunch with patients...

Today, I hosted a regular Patient Feedback Lunch. Some 10 patients and their family turned up and we had a very good conversation about what we can do to improve hospital processes and patient experience.

I first know about this idea to invite patient back for lunch when I was working at Toa payoh Hospital in 1993. The then CEO had the idea that it would be great if our staff could hear patients' feedback in person, while at the same time engage patients in our journey of quality improvement. To qualify to be invited, there was only one criteria - patients must have complained about their care and service in the hospital before. I remembered when he first mooted this idea, the leadership was quite concerned - to say the least. Many could not imagine how such a setup could produce any meaningful conversation as patients, we thought, would be too emotional about their experiences that led to their complaints. I was one of those.

When it was time for me to attend the first patient feedback lunch, I prepared mentally for a "show down". What became obvious to me very quickly was that patients appreciated the opportunity to be invited back to share their feedback for improvement, and the lunch with patients generated significant goodwill. Of course, there were the infrequent emotional "outburst" from patients. But, I have found that when patients know that we are sincere about making the improvements and gave them a listen ear, they quickly settle down and turn their comments into constructive feedback. Other patients in the midst also often provided alternative views on various care and service process issues and that helped balance the discussions. Having seen how powerful such a lunch session with patients could be, I have been a convert ever since.

So, when I moved to SGH some 5 years ago, I brought along this practice; and with the help of a very supportive and inspired SQ and Comms team we started it and have never looked back.

Personally, I am inspired after every patient feedback lunch that I host. Listening to patients, I know that the work that we do make a real difference to real people and that helped fan the flame that kept me going for 16 years in Singapore healthcare. What makes it even sweeter is to be able to make a difference along side a bunch of great people equally dedicated and committed to the cause!

Thursday, February 26, 2009

SGH - Employer of Choice @ HRM 2009!

SGH HR Director Ms Anna Fok Receiving the HRM 2009
Employer of Choice Award on Behalf of
Singapore General Hospital on 26 Feb 2009
It has been quite a night at the HRM Award event for SGH! Nominated for 5 categories of award, Singapore General Hospital won in 3 categories, namely:
Employer of Choice Award
Best Work-Life Harmony Award
Best Performance Management Award
SGH Director HR Ms Anna Fok, who was herself nominated for the Best HR Leader Award, represented SGH to receive the night's TOP trophy - The Employer of Choice Award! Even though Anna was not given the Best HR Leader Award tonight, she is definitely MY WINNER!

Congratulations Anna and the SGH HR Team for doing us proud. There is always something special about being part of the SGH team and these awards are recognition for the good work and dedication of our staff.
Well done, folks!

Wednesday, February 25, 2009

Rainbow - A Reminder of God's Promises

Rainbow peeking from the side of my house

A beautiful Arc...

Directly above my house

Wow!

My side of the Rainbow!

It rained cats and dogs this afternoon. The combination of lightning and thunder was so potent that it woke my kids from their deep afternoon slumberland.

But by 7:15pm, a beautiful rainbow appeared above my house. I have never seen such a perfect full arc of colours before in person! My wife, kids and I spent time outside just marveling at God's creation until the rainbow finally faded. At the same time, our hearts warmed because it is a reminder of all of God's promises to us. We can always expect good things to happen to us, but there are times that we needed that reminder - this is reason enough for God to create the rainbow.
Enjoy the sight... and claim God's promises for yourself as well!

Sunday, February 22, 2009

Touching a piece of old Singapore

Sometimes I think Singaporeans like me take being in Singapore for granted.

As usual, by late afternoon on a Sunday today, my family began the round of questions on where should we have our family dinner. Having just completed my run around my estate, my brain was cleared of the week-long gunk and a brainwave hit me. I said, why don't we try Lau Pa Sat?

There was a period of silence and I could tell everyone's brain was processing what I had just said. I broke the silence by telling everyone that I am told there are lots of food there. I named Prawn Noodles, and my mom's face brightened up and she said she has been craving it. I continued that there is a street full of satay stalls (like the old satay club) and Brittney's face lighted up. By the time, I finished by bath, i realised that my entire family was tucked in my MPV, engine fired up and ready to go.

The experience was pleasant right from the beginning. As my car inch towards Lau Pa Sat, a car parked just outside the food centre signaled to leave. So, I got the best parking spot!

The number of stalls in Lau Pa Sat amazed me. The food centre is lined up in "Streets" with many stalls along the streets. We were spoilt for choice. The only dark spot then was that there were many touts following us egging us on to their stall. We ignored them and soon they left us alone - good grief! I went for chah Kuay Teow - apparently a famous one from Lakeview. My mom went instead for fish soup, Brittney for porridge, melody noodles, Zachary noodles and fried chicken wings and we topped it off with 10 chicken satay, 10 mutton satay and 4 glasses of sugarcane drink. It was quite a meal but I feel a sense of relief that I had put in the run earlier.

After a happy meal, I brought my children around the Lau Pa Sat. Showed them the satay street, told them about the famous satay club in Singapore. I told them about the history of Lau Pa Sat, took some pictures and felt a sense of satisfaction that I had taken the time to experience a piece of old Singapore. Apparently, Lau Pa Sat was part of the Telok Ayer Market ordered to be set up by Sir Stamford Raffles at the port where the chinese immigrants arrived in Singapore. It was restored in its present day glory in the 1980s and gazetted for preservation in 1973.

The Lau Pa Sat stood in stark contrast to the skyscrapers along Robinson Road, the heart of Singapore business and financial district - a reflection of the past as we experience the present and future.

Looks like my family will be back to Lau Pa Sat for many more meals - good food, wide selection and minus the crowd. I wish the touting will stop though.

Wave to me when you see me at Lau Pa Sat!

Friday, February 20, 2009

"HERO"

My favourite singer is Mariah carey. Over the last 2 days, her hit song HERO resonated repeatedly in my soul. I did not know why. I did not sense the usual peace when I listened to that song... somehow, it was a different kind of HERO. I pondered about it, but could not understand why. The word HERO has taken on a different meaning, it sounded more like someone we would refer to in hokkien as "lao" HERO. I was not convinced. So I googled the words for the song HERO to verify... here it is:

There's a hero.
If you look inside your heart
You don't have to be afraid Of what you are
There's an answer
If you reach into your soul
And the sorrow that you know
Will melt away
And then a hero comes along
With the strength to carry on
And you cast your fears aside
And you know you can survive
So when you feel like hope is gone
Look inside you and be strong
And you'll finally see the truth
That a hero lies in you
It's a long road
When you face the world alone
No one reaches out a hand
For you to hold You can find love
If you search within yourself
And the emptiness you felt
Will disappear
And then a hero comes along
With the strength to carry on
And you cast your fears aside
And you know you can survive
So when you feel like hope is gone
Look inside you and be strong
And you'll finally see the truth
That a hero lies in you
Lord knows Dreams are hard to follow
But don't let anyone Tear them away
Hold on
There will be tomorrow
In time You'll find the way
And then a hero comes along
With the strength to carry on
And you cast your fears aside
And you know you can survive
So when you feel like hope is gone
Look inside you and be strong
And you'll finally see the truth
That a hero lies in you

Now, I know! The HERO that lies inside of me, gives me peace. The HERO on the outside would best be known as "HERO"... one in parenthesis. Know of a good "HERO" lately?

Thursday, February 19, 2009

Sick Around the World

This is an excellent video documentary about various healthcare systems around the world.

It was produced by PBS to see if the US can learn anything from the rest of the world about how to run a healthcare system.

The revelation is that while there are peaks in excellence in various healthcare systems around the world, there is none that is excellent at the systems level that is truly sustainable in the long term.

Watch the video and reflect against Singapore's healthcare system - the 6th best in the world, according to WHO.

Tuesday, February 17, 2009

Rating of doctors Restaurant Style

The New York times reported that a commercial insurer has asked a well known restaurant rater Zagat in the US to poll patients covered under the plan inorder to rate their doctors on various dimensions of care and service.

Not surprisingly, doctors have given the proposal low marks because they claim that patients are poor judge of good quality medical care. Hence, rating them, the way restaurants are rated would serve to mislead more than to inform.

Surely, if an appropriate spectrum of dimensions of care and service are included in the rating, trends will emerge that patients would be able to use to select "good doctors".

My sense is that a good doctor cannot be consistently rated low if he manages patient humanely (ie seeing the person in the patient), shows care and concern, is knowledgeable and diagnoses and produces good clinical outcome for patients. Sure, there will be some ups and downs but where there are broad consensus across dimensions, chances are these ratings will separate the excellent, good doctors from the mediocre. When done appropriately (i.e. methodology, sampling...), such ratings will be similar to the customer satisfaction surveys that we have come to expect.

Such ratings when used in conjunction with quality indicators and costs information would be even more helpful to the patient.

Can we see this happening in Singapore healthcare scene? My sense is that at the right time, such ratings may be inevitable.

The Danger of "A familiar Life"

I received this via an email on facebook today that became a timely reminder for me. I am sharing this because others may need this as well. The author of this note is credited at the bottom.

There is great comfort in the familiar, but there is also great danger, too. Most of us feel secure in the belief that we can trust the familiar in our lives, and we feel that there is comfort and peace in the predictable.

Actually, while this is true to some degree, it can also be a trap. You see, it is the unfamiliar, the risk, and the unpredictable that liberates us from boredom, unleashes our creative spirit, and enlivens our relationships. And it is the unplanned and unknown occurrences that make our life rich in possibilities.

Of course, some order, predictability and security are necessary for our survival and sanity. But a life without mystery, excitement and risk is merely an existence. I believe life was meant to be lived - joyfully, with a sense of wonder and surprise. So take some time to think about it. How much of your life is planned down to the last minute? How much of your free time is completely controlled by a tight schedule? Why not try relaxing and just letting things happen without trying to plan or control them? You know, the world is full of delight, if you will only allow it to unfold naturally around you.

It is surprise and spontaneity that keep us and our relationships from becoming dried out, locked up and eventually numbed and even deadened by repetitive daily routines.

Written by: Lou Tice The Pacific Institutewww.thepacificinstitute.com. For weekly updates, go to www.TPIGlobalNews.com

Sunday, February 15, 2009

Miracle Seed Sunday!

Today, 15 feb 2009 is Miracle Seed Sunday at my church. It is also the day of reminder of yet another miracle in my life - my 2nd daughter Melody was born on this day in 2003.

I sowed my SEED, set it apart and made it available for Jesus to multiply a harvest of more than a 100 fold! This is my best investment for I am reminded that seed left in the barn, kept in the bank, hoarded in the pocket cannot grow and multiply. But seed that is sown in the fertile ground of God's kingdom will produce a tree with many fruits, each fruit containing many seeds, and the many seeds will produce many trees bearing many fruits. Me and my household will be blessed and will be reminded of the many miracles as a result of the SEED that I have sown TODAY!

Today, will be the turning point of a new trajectory that God has set me and my family on. Soo Chun and I wish it upon our sisters' family, my brothers' family and our parents as well. May they all reap a 100 fold in 2009.

Saturday, February 14, 2009

A heart motivated by Love

The human heart is powerful, whereas the head thinks it is powerful. Our body basically takes instructions from the head but motivated by the heart.

A heart filled with love can do things that we ourselves cannot comprehend.

Even when our body is tired, the sight of our loved ones in need will prompt a strong signal from the heart to the head; which will then send an extra dose of energy for us to reach out to the ones we love.

The head acting alone is useless - it merely processes information sent from the body. Take for example running. After a while our body will send information to our head that it is tired. When the head receives this information and act without the heart, it will agree with the body and we stop running. However, when the heart steps in, the heart may tell the head, "come on, how can the body be tired after such a short distance, push on for the next 3km". The truth is the body will be able to take the next 3km stretch of run.

Our Heart are so powerful, guard it and use for good and for the one we love.

Friday, February 13, 2009

When Help becomes an obligation

"Help" - According to the Merriam-Webster Dictionary is to "give assistance or support to, to make more pleasant or bearable, to be of use to..."

Help usually extends from someone who has something of value to another who desire the value in question.

Help is beautiful when the one giving is willing and the one receiving is grateful.

Help sparkles when the one receiving says "Thank you".

When Help becomes an "expectation", an "obligation", a "demand", an "insistence", and worst still when it becomes a source of complaint from the receiver to the one providing the assistance, then help takes on a new meaning - a bad word.

Help will no longer be as helpful, as beautiful and loses its sparkle.

I ended my day today receiving an email that makes "Help" and "helping" unhelpful words. There was no gratitude. Even though it was not about me, I can't help but feel that help is being taken for granted.

Do we need any reminder to be grateful when we receive help? I hope NOT!

Wednesday, February 11, 2009

Pet Peeve ... Continued 16 - 25

I cannot resist continuing with my list...

16.

17. The use of an intellectual arguement when the practical arguement fails

18. Talk for the sake of talking

19. A pussy cat faking like a "tiger in the kitchen"

20. Putting on the "other hat" when only this hat matters

21. The whiner...

22. Politicking - otherwise do it with style

23. The silent destroyer

24. People who turn around other's idea as their own and take credit

25. mumble, mumble, mumble

Raffles Town Club - The Saga Continues

Peter Lim's suit against current owners of the Raffles Town Club revealed interesting facts - that the new owners systematically depleted the assets of the club by paying handsome dividends to themselves amounting to some $54 Mil and bought questionable art craft pieces. This was revealed in the ST article today.

The article went on the say that when the founding members (Raffles5000) of the club sued and won the case against RTC and were awarded $3,000 damages each, the current owners claimed that they could not afford to pay the damages in cash. The article reported that it was because, by then, the owners have depleted the assets of RTC. If this is indeed true, I wonder whether members have been misled into accepting the damage in the form of food vouchers, etc.

The Raffles Town Club the "exclusive" club debut at a cost of $28,000 and was in the trouble right from the beginning. Members complained of overcrowding from day 1. I recalled the day when members were invited for the club's launch when it first opened it doors and the place was like a fish market! Then, when I invited my family to the club for a swim at my "exclusive" club, they were told to park along the road outside the club and to share a towel because the club ran out of towel. At that time, I learnt the latest meaning of "exclusive".

More suits to continue - this time by the new owners against the founding owners including Dennis Foo. I hope more incriminating details will be revealed, much like the suit of TT Durai against SPH. Till that day comes, I often looked at the parking label on my car and sigh... my worst investment that is now valued less than $4000 on the open market!

Monday, February 9, 2009

Counting Blessings...

1. A wife that I delight in and whose presence I enjoy

2. Three healthy, happy kids whom I adore with all my heart

3. A great career

4. Great bosses - past, present and future

5. Wonderful colleagues

6. Parents who still dote on me :-)

7. Laughter still fills my day

8. A beautiful house and a comfortable home

9. Meaningful work

10. Colleagues who care beyond work

11. A nice old 20-year old car whose sight I behold

12. A healthy body

13. Having enough to enjoy what I like

14. A bunch of good friends

15. Wonderful church where I can count on to get my spiritual feeding and support

16. Kids who adores me

17. A pond with beautiful kois that I could only dream of in my own backyard

18. Education at Harvard (albeit short one at AMP) fulfilling my childhood dream

19. Able to enjoy 2 models of Apple iPhone although for only 2 weeks each

20. To have a savior who died for my sins so that I may live life more abundantly, that his body was pierced so that mine can be whole, that he took all my sins (past, present and future) so that I may be his righteous, that he became poor so I may be rich, that he distanced himself from God at the cross so that I might call God my Abba father and enjoy an eternal relationship of love, grace and mercy.

There are so many blessings to count that I have decided not to continue my previous list of pet peeves. I would rather spend time counting my blessings :-)

Sunday, February 8, 2009

The "Never Reply" Syndrome

I was just chatting with my wife and she said that she is rather annoyed with the "never reply" syndrome from my daughter's primary school.

She said that she had left multiple messages for my daughter's math teacher, form teacher, CCA teacher and the school's CCA coordinator since mid of last week about a new conflict in schedule in the math and CCA class, and never received a reply. What is most disconcerting is that the conflict in schedule will start tomorrow and the one caught in this maze will unfortunately be my daughter.

Waiting in the absence of information is very uncomfortable indeed. During such time, we conjure up new imagery and imagine new information which may be completely wrong to "fill the void" in information. Negative emotions are generated and often result in conflict, ill opinion and complaints.

This syndrome is particularly bad in the healthcare setting. Do we ask patients to wait for the call regarding a lab test result and then forget to call? Do we tell patients that we have already received their feedback/ complaint letter even as we are working on it? Do we make patients wait for indefinitely long period at the clinic even when the delay is inevitable eg. doctor called away for emmergency? Do we keep a patient waiting without information about his delayed surgery even as we are working hard to reinstate it? The answer is YES, sometimes, because processes do break down, but when it happens we should learn quickly and make it right (so that the possibility of it happening again is eliminated or reduced) because they create highly anxious situations for our patients and their family.

All organisations with service operations would do well to reduce/ eliminate the "Never Reply" syndrome.

25 Pet Peeves...

1. Drivers who care only about their convenience and put others at risk

2. Injustice, particularly when demonstrated towards those who are vulnerable eg young, elderly and weak

3. People who carry a "black face", as if the whole world has offended them

4. Those who has lots to say, but won't move one inch to makes things happen

5. People who ask for suggestions but turn down every suggestion put forth by others; then when asked for their suggestion, they say they have none

6. People who throw tantrum to get their way

7. People who are full of themselves - when we all know that it is the ONE behind behind them who matters

8. People whose first response to every idea is "No" and then goes on to say how much they welcome creativity and innovation

9. People who "curse and swear at the way the world is going around", but dont make the world go round

10. Self interests disguised as noble purpose

11. Say "A", mean "B" and do "C"

12. Those who say "Charge!" and then suddenly has a shoe lace to tie

13. Throwing the baby out with the bath water

14. Signal to park but the car behind inches his way so close that it becomes impossible to do so

15. Signal to change lane and the car speeds up to make it dangerous to do so

To be continued...

Saturday, February 7, 2009

Wash Our Hands For Safe Patient Care

Culture after Cleaning Healthcare worker's Hand

Culture of Healthcare worker's hand after palpating a patient with MRSA

These are images from the Jan 15 2009 New England Journal of Medicine. They are startling reminders of the need to consistently and constantly maintain hand hygiene in the healthcare setting.
To bring home the message on hand hygiene - watch this excellent skit by the SGH team at the recent Quality convention. The yellow balloons are bugs, the yellow stickies are bugs passed on from contacts and become a source of contamination from one patient to another. This light-hearted skit brings home a serious message for all healthcare providers "Wash our hands for excellent patient care".

Thursday, February 5, 2009

Throwing tantrums, think again!

I am beginning to observe a troubling trend.

More people are decidedly throwing tantrums to get their way. In the spirit of harmony, they often get their way. The problem is that the more such behaviors are tolerated, the more they are perpetuated.

I have decided that I will not tolerate such behavior anymore.

The remedy could be for such people to swallow their own medicine, be put in their place, or be shamed for bad behavior.

Monday, February 2, 2009

Mobile Phone Bill too complicated!!

Has anybody tried to read their mobile phone billing statement recently? Or have you given up, like me?

The complexities in billing when you have a multi-sim, broadband on mobile, Blackberry, auto-roaming add up. There are "surcharges", "discounts", "rebates" that do not seem to add up, plus broadband use on blackberry that is docked against your mobile broadband subscription when you actually surf the internet on a blackberry. Ask your Telco and they will tell you to check your APN - go to "Options", "Advance Options" and then TCP, if it is "empty" there are no charges for using the internet on blackberry, otherwise it is chargeable and not part of the BB subscription. Gosh, how will anyone know such garbledegook! Access the internet via YahooMail or Gmail other than the Blackberry browser and the data charges will be docked against your mobile broadband - gee that makes sense!

Try calling your Telco and they too will need to take time and study your questions on billing and revert to you hours or a day later.

IDA has made a good decision on number portability. People as frustrated as me will switch even when it means paying the hefty penalty just to make a point!

Teach Less, Learn More

I am on my way to fetch my daughter in Primary 5 for her Chinese tuition. On saturdays, she goes for her science tuition and soon, my wife intends for her to restart her math tuition.

My second daughter who is currently in K2 at a nearby Kindergarten has also started Chinese tuition and math tuition.

The intensity of learning even in junior school is very high and I must say the same can be said about the standard. Some of the school problems that they are expected to solve are quite difficult and require a fairly high level of reasoning and modeling skills. Based on our judgement, to entirely depend on the teaching done in school without supplementation by additional home coaching or tuition is insufficient for the student to be able to fully grasp the subject matter and to do well. Doing well, is important because of the meritocratic society that Singapore has become and where education feature high in one's destiny.

So, no choice - In school, they "Teach Less" and in order to "Learn More", many parents have resorted to sending their kids for many tuition classes. Actually, this gives a new meaning to "Teach Less, Learn More" - the motto of our education ministry. We should add, "Pay More".

Not complaining but just making an observation as I live my life with my children growing up.