About Tan Tock Seng Hospital

Published Date: 02 Nov 2017

About Tan Tock Seng Hospital

Tan Tock Seng hospital is a building for sick or injured, mainly for those who are confined to bed and are in needs of medical treatment. It has a history of more than 160 years of new and innovative medical care and development, and is currently the second larger multi-disciplinary hospitals after Singapore General Hospital in Singapore. Though Tan Tock Seng hospital came in next in the largest hospital in Singapore to Singapore General Hospital, its accident and emergency department is definitely the busiest because it was built geographically in the middle of the country. Tan Tock Seng hospital was set up in 1844 and the hospital came under the international public eye when it was chosen as the sole treatment centre for SARS outbreak in the country on 2003.

With a strong quality culture stood in patient safety, Tan Tock Seng Hospital continually challenges itself to deliver cheaper, faster, safer and better care for patients. Till now, the hospital continually updates and invests on the medical technology and system, including its staff upgrading. Thus, due to its comprehensive range of quality healthcare services and the commitment of delivering an excellent patient care, Tan Tock Seng hospital has been awarded the prestigious Joint Commission International accreditation and the ISO 90001 certification.

Services

The Hospital Complex

The Hospital Complex was completed in 1999, and is specially designed to provide complete in-patient and out-patient services in the same place. Most services are offered in the modern complex, consisting of the Tan Tock Seng Hospital Medical Centre, the Hospital Block and the Podium Block. It is calculated that the average of specialist clinics and the Emergency Department attends 1,500 patients and 400 patient daily, making it Singapore's busiest hospital emergency department.

Communicable Disease Centre (CDC)

The Communicable Disease Centre is the national referral centre for the diagnosis and management of communicable diseases that consist of HIV and SARS. The CDC is made up of 2 campuses, equipped with in-patient and out-patient facilities to handle disease outbreak as well as laboratory facilities to conduct research for better patient care and disease management.

TTSH Rehabilitation Centre

The Tan Tock Seng Hospital Rehabilitation Centre located at Ang Mo Kio-Thye Hua Kwan Hospital offers the largest in-patient rehabilitation services in Singapore. Managed by the Department of Rehabilitation Medicine, it also conducts therapy programmes and out-patient rehabilitation services.

Specialist Clinics

Tan Tock Seng Hospitals stay close to community by operates specialist clinics at Yew Tee MRT Station and Hougang Polyclinic.

Customer base

Every day, the hospital attends over 2,000 patients at its specialist clinics and attends 460 patients at its emergency department. Tan Tock Seng Hospital is part of the National Healthcare Group that deliver holistic and integrated care to patient.

Scale of operation

More than 6,000 healthcare staff works in Tan Tock Seng Hospital and furthermore, the hospital has 36 clinical and allied healthcare departments and 15 specialist centres.

Length of operation

Tan Tock Seng Hospital (TTSH) is in Singapore with the region font code of Asia/Pacific and it is positioned at an elevation of 1 metres above sea level.

Its coordinates are 1°19'19" N and 103°50'53" E in DMS (Degrees Minutes Seconds) or in decimal degrees, 1.32194 and 103.848. Its UTM position is UG74 and its Joint Operation Graphics reference is NA48-10.

Other interesting facts: History of Tan Tock Seng

Mr Tan Tock Seng was born in 1798 to an immigrant Hokkien father and Peranakan mother in Malacca. In 1819, 21 years old, he moved to Singapore to sell vegetable, fruit and fowl. He soon come to be a remarkable businessman and possessed huge parcels of land and property.

Mr Tan Tock Seng was a prominent Chinese leader and he was the first Asian to be chosen a Justice of Peace. He earned his title of "Captain of the Chinese" in assisting the early Chinese immigrants to settle disputes.

In 1844, at a time where violence, crime, poverty and disease were rife and the poor were dying from diseases, malnutrition, opium addiction and gangrenous sore, Mr Tan Tock Seng contributed $7,000 Spanish to the construction of the first Chinese Pauper's Hospital and he tasked it to look after the 'diseased of all nations'. From a founded on a legacy of philanthropy, compassion and care, this is how Tan Tock Seng Hospital came about.

When the years past, the hospital has carry on its duty as a people's hospital. It proceeded to make many milestone achievements in patient care. When SARs hit Singapore in 2003, the hospital came under the international public eye when it was chosen as the sole treatment centre in the national response efforts.

At present, Tan Tock Seng Hospital is considered the second larger multi-disciplinary hospitals after Singapore General Hospital in Singapore. Mr Tan Tock Seng's descendants carry on lending the hospital their support to this day.

Other interesting facts: Leveraging on Innovation and Technology

Convenience to visitors

The internet visitor registration portal was launched in February to allow visitors to register from the comfort of their own home or office via our website, bringing about greater convenience. This is in addition to our current kiosks, counters, and pre-registration forms.

Transforming Patient care with IT

We received the healthcare information and management systems society stage 6 EMR adoption model award – an internationally recognized benchmark that measures the use of IT and electronic medical records to transform healthcare to benefit patients. This is a testament of how much we have advanced in using technology to not only deliver higher levels of patient care and safety, but also to increase staff productivity and efficiency.

Enhancing Patient safety with RFID

We are the first hospital that utilizes RFID technology to track surgical instruments. This speeds up the process of tracking and retrieving contaminated or expired surgical instruments sets from an average of u7,6 minute to 1 minute and enhances the hospital’s ability to contain infection and ensure patient safety.

New cheaper and safer technique

Our department of general surgery has pioneered a new technique to remove turmours from the colon with less pain and shorter recovery time. It is a modified technique of the single port surgery, replacing the conventional surgical instrument with just a common glove, to similar effect. This costs only 10% of the conventional procedure.

Robotics for rehab

Our rehab centre expanded its operations with the opening of the centre for advanced rehabilitation Therapeutics (CART) in Auguest. Its rehabilitation programmes combine innovative robotics and virtual reality technologies with regular rehabilitation therapy. They are designed to increase patients’ participation and interest in therapy, thereby helping them to achieve functional independence and improve quality of life.

Keeping Track of waiting time

the patient information (PIB) is a new system at ttsh that helps predict the waiting time for patients waiting to see an ED doctor. It was developed in October 2011 to help ease patients’ and their caregivers’ frustration by keeping them informed of their expected waiting time. Besides this the system also helps tracks the movement of patients within the emergency department, keeping their loved ones waiting outside updated.

Organisation Structure

It is a formal organization structure so that to enable the hospital to meet its stated objectives. The type of structure that the Tan Tock Seng hospital uses is Bureaucracy structure. Bureaucratic structures maintain the strict hierarchies when it comes to people management and have a certain degree of standardization.

Organization is formed based on the concepts of decision of labor specialization and chain of command. Bureaucracy structure requires very formal rules and regulations for the employee along with the patient to follow the rules. Tasks are categories into different departments so people who have different specialize can enhance their skills and focus on a particular area of skills to maximize the use of the employee. Though there are narrow spans of control, it helps the hospital to make safety and stable pre-caution. Decision making follows a chain of command.

2. Major Processes

ai. Making an appointment

(See activity diagram 2bi.)

One of the major processes in hospital is making an appointment. Making an appointment is the main step for you to enter the hospital to consult a doctor or finding cure to your illness. Firstly, the patient takes a number. While waiting for the number to be called, the patient would have to queue for its turn. Once the number called, the receiptant gets and check the patient information.

This is one of the key functions performed because the hospital will have to keep the most updated patient information to make sure that the patient are at absolute care and also to make sure that the hospital have the appropriate medical equipment for treatment.

After that, the patient can choose to make new, changes or cancel the appointment. For making an appointment, the recieptant will help the patient to check for available slots, and if the slot is unavailable, patient will have to choose another date/time again until it is available. This is to ensure that the doctor is scheduled with appointment and to prevent any appointment crashes.

Once available, the recieptant will schedule an appointment and hand the appointment details to patient. For new patient, they have to update their personal details while for the old patient, they can choose to update, then after they can obtain their treatment. Finally, the patient made payment for the appointment. Patient can choose to pay by medisave or cash depending on the financial house-hold and the medical fee.

ii. Checking drugs/medicines for appropriate

(See activity diagram 2bii.)

The physicians first assess the patient records then after that the physician prescribes the therapy and make an order by filling in the drug order sheet. Then the nurse transcribed the prescription on the pharmacy module and transmitted the order online.

In the clinical pharmacology, they will review the order to make sure that the prescription is accurate and the appropriateness by the pharmacist. The review by pharmacist for the medication orders for appropriateness is an important step in making sure that patient safety is in the medication use process. Once the pharmacy received the drug order, the pharmacist assesses the order for appropriateness. If the drugs are not appropriate, the clinical pharmacology will reject the order. If it is appropriate, they will cross click the drug orders to make sure that it is correct before processing the drug order.

After that, they transport the drugs to the patient care areas. Next, the nurse will cross check again to make sure that correct drugs are received. Then, the drugs are stored in the appropriate place under appropriate conditions until the nurse uses seven rights of drug administration— right documentation, right drug, right patient, right dose, right time, right route and right technique before placing it at the patient’s bedside locker. Again, the nurse will make sure that they observe the side-effects of the drugs and document and report to any ADR if there is anything wrong with the drugs and sent the report to clinical pharmacology to regulatory authorities. Any error discovers by the pharmacist during the process is documented, mentioning the error details, action taken, and outcome. These errors are compiled closing at the month end are trended, and analyzed for quality improvement.

iii. Serving hospital food

(See activity diagram 2biii.)

Firstly, the cookery will have to retrieves the daily food order menu and then cook for the patient. Cookery must also ensure that the cook they cooked is healthy. Before cooking, the cookery will have to check for food quantity, if it is insufficient to prepare food for thousands of patient, the cookery will order the food. After the food is enough, the food will go through preparation such as chopping, washing then started to cook.

This is one of the key functions performed by each major process because they have to ensure that the food is chopped into smaller pieces for patient to digest easily. They also have to check the expiry date of the door and to make sure that fruits and vegetables are washed thoroughly before cooking.

After finish cooking, the food will be place in the food delivery cart according to the lists of paper. The nurse will transport the food delivery cart to its destination patient ward. The nurse will also have to check on the patient list to make sure that the food is dedicated to the particular patient in case the patient has certain allergy to the food or is opting for halal/vegetarian. After that, the nurse will bring the food to the patient. If the patient is handicapped, unable to eat themselves, nurse will have to feed the patient. This also help to improve the services provided in the hospital.

bi. Making an appointment (Activity digram 1)

ii. Checking drugs / Medicines for appropriate (Activity digram 2)

iii. Serving Hospital Food (Activity digram 3)

3. Information Systems

a. e-Commerce applications

E-Governemnt have been used by the hospital organization as it uses the internet technology in general and e-commerce in particular to deliver information and public services to citizens. (called government-to-citizen or G2C EC), and business partners and suppliers (called government-to-business or G2B EC). It is also an efficient way of conducting business transactions with citizens and businesses and within the governments themselves. E-government transfer benefits, such as Social Security and pension payments, directly to recipients’ bank accounts.

G2C takes place between government and citizens, making government operations more effective and efficient.

Benefits and limitations of E-Commerce

Few innovations in human history have provided as many benefits to organizations, individuals, and society as has e-commerce. E-commerce benefits organizations by making national and international markets more accessible and by lowering the costs of processing, distributing and retrieving information. The major benefit to society is the avility to easily and conveniently deliver information, services, and products to people in cities, rural areas, and developing countries.

Despite all these benefits, E-Commerce has some limitations, both technological and nontechnological, that have slowed its growth and acceptance. Technological limitations include the lack of universally accepted security standards, insufficient telecommunications bandwidth, and expensive accessibility. Nontechnological limitations include the perceptions that E-Commerce is insecure, has unresolved legal issues, and lacks a critical mass of sellers and buyers. As time passes, the limitations, especially the technological ones, will lessen or be overcome.

b. Wireless applications

Wireless applications have been used in the hospital to make productive use of time

The Wireless Application Protocol (WAP) is the standard that enables wireless devices to access web-based information and services.

Wireless Telemedicine

It is the use of modern telecommunications and information technologies to provide clinical care to individuals located at a distance and to transmit the information that clinicians need in order to provide that care. There are three different kinds of technology that are used for telemedicine applications. The first type involves storing digital images and then transferring them from one location to another. The second allows a patient in one location to consult with a medical specialist in another location in real time through videoconferencing. The third uses robots to perform remote surgery. In most of these applications, the patient is in a rural area, and the specialist is in an urban location.

Wireless technology allows mobile systems that allow physicians to enter a prescription onto a PDA. That information then goes by cellular modem or Wi-Fi to a company such as Med-i-nets. There employees make certain that the prescription conforms to the insurance company’s regulations. If everything checks out, the prescription is transferred electronically to the appropriate pharmacy. For refills, the system notifies physicians when it is time for the patient to recorder. The doctor can then renew the prescription with a few clicks on the modem.

Many companies now use mobile communications to attend emergency situations to remotely control medical equipment.

d. Customer relationship management systems

Customer relationship management (CRM) system is an organizational strategy that is customer-focused and customer-driven. That is organizations concentrate on satisfying customers by assessing their requirements for products and services, and then providing high-quality, responsive service. CRM objectives were to market each customer individually, treat different customers differently. It has been used in the hospital to build up long-term, sustainable patient relationships that create value for the hospital and the patient. This has help hospital to acquire new patients, retain existing profitable patients, and grow relationships with existing patients.

The hospital have been uses Customer Touch Points whereby the organizations recognize the numerous and diverse interactions that they have with their patient. These various types of interactions are referred to customer touch points, which they can communicate through direct mailing, electronic mailing, through telephone, website and etc to improve customer relationship by informing the customer the news and update of the hospital.

The company have been uses data consolidation as it is also critically important to an organisation’s CRM efforts where the customer data are consolidated and stored in interconnected systems built around a data warehouse now make all customer-related data available to every unit of the business. In this way, company can enhance its relationship with its customers and ultimately make more productive and profitable decisions.

e. Business Intelligence

Business intelligence is the capability of an organization to gather, maintain and consolidate data. This produces large volumes of information that can help and benefits the hospital to develop new opportunities. By identifying these opportunities, and carrying out an effective strategy, it can provide a competitive market benefits and long-term stability to the hospital.

The objective of modern business intelligence deployments is to support better business decision-making.

Applications has been used to benefit the hospital

1. Measurement – Using a program to creates a hierarchy of performance metrics chart and benchmarking that helps the business leaders keep track of their progress towards business goals

2. Analytics – Using a program to perform business knowledge discovery and to builds quantitative processes for a business to arrive at optimal decisions.

3. Reporting – Using a program to build infrastructure for strategic reporting to serve the strategic management of a business.

4. Collaboration platform – Using a program to get people from different areas to work together online through electronic data interchange and data sharing.

5. Knowledge management – Using a program to make the company data driven through strategies and practices to create, identify, represent, distribute, and enable adoption of insights and experiences that are true business knowledge. Knowledge management leads to learning management and regulatory compliance.

Business Needs

Because of the close relationship with senior management, another critical thing that must be assessed before the project begins is whether or not there is a business need and whether there is a clear business benefit by doing the implementation. The needs and benefits of the implementation are sometimes driven by competition and the need to gain an advantage in the market. Another reason for a business-driven approach to implementation of business intelligence is the acquisition of other organisations that enlarge the original organization it can sometimes be beneficial to implement business intelligence in order to create more oversight.