Building capacity and capability for quality improvement: insights from a nascent regional health system.

Objectives: Quality improvement (QI) is critical in facilitating advancements in patient outcomes, system efficiency and professional growth. This paper aimed to elucidate the underlying rationale and framework guiding JurongHealth Campus (JHC), a nascent Regional Health System, in developing its QI capacity and capability at all levels of the organisation.

Methods: An exhaustive analysis of high-performance management systems and effective improvement frameworks was conducted, and the principles were customised to suit the local context.

Impact of a rapid access chest pain clinic in Singapore to improve evaluation of new-onset chest pain.

Background: Chest pain (CP) accounts for 5% of emergency department (ED) visits, unplanned hospitalisations and costly admissions. Conversely, outpatient evaluation requires multiple hospital visits and longer time to complete testing. Rapid access chest pain clinics (RACPCS) are established in the UK for timely, cost-effective CP assessment.

Impact of the COVID-19 Pandemic on Door-to-Balloon Time for Primary Percutaneous Coronary Intervention - Results From the Singapore Western STEMI Network.

Background: Little is known about the effect of the coronavirus disease 2019 (COVID-19) pandemic and the outbreak response measures on door-to-balloon time (D2B). This study examined both D2B and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI).

Methods and results: This was a retrospective study of 303 STEMI patients who presented directly or were transferred to a tertiary hospital in Singapore for PPCI from October 2019 to March 2020.

Effectiveness of a post-emergency department discharge multidisciplinary bundle in reducing acute hospital admissions for the elderly.

Objective: We evaluated the effectiveness of the Subacute Ambulatory care for the Functionally challenged and Elderly (SAFE) programme, a post-emergency department (ED) discharge intervention for elderly and functionally challenged patients, in reducing acute hospital admissions.

Methods: This study was a 32-month retrospective quasi-experimental study comparing patients with at least one of six diagnostic classifications who underwent SAFE intervention with those who were eligible but declined and received usual ED care (control). The primary outcomes were rates of first acute hospital admission at 30 and 60 days post-ED discharge.

Formula one night race in Singapore: a 4-year analysis of a planned mass gathering.

Introduction: Every mass gathering presents its unique characteristics that influence medical resource utilization. Medical planning for mass gatherings involves both use of predictive models and analysis of data from similar past events. This study aimed to describe the medical presentations and the unique challenges influencing medical planning at the Formula One Singtel Singapore Grand Prix, the inaugural Formula One night race.

Stridor in an adult: not just a child's disease.

We report a 54-year-old lady who presented to the emergency department for stridor and shortness of breath of acute onset. Nasopharyngoscopy revealed subglottic swelling and plain radiographs revealed a classical 'steeple sign' typical of croup. Although rare, croup should be considered in an adult presenting with stridor to the emergency department and the emergency airway team should be notified in advance for possible surgical airway emergency tracheostomy.