What We Do

National University Heart Centre, Singapore (NUHCS)

National University Heart Centre, Singapore (NUHCS) brings together cardiac specialists and experts from a multitude of medical and surgical disciplines to provide a comprehensive and holistic approach to the treatment of heart problems. It is set up by the National University Health System (NUHS) to meet the growing need for expert care to look after the increasing number of people suffering from heart disease.

The establishment of the NUHCS – Singapore's second national heart centre, was announced in August 2007 by Health Minister Khaw Boon Wan.

"Singaporeans now have access to another national heart centre, one where high quality personalized cardiac care is available and which draws upon the expertise of specialist who are also at the forefront of academic medicine, teaching and researching at NUHS"

- Associate Professor Benjamin Ong, Chief Executive of the National University Health System (NUHS)

Prof Lee Chuen Neng (left) with A/Prof Tan Huay Cheem

NUHCS is headed by Director, Associate Professor Tan Huay Cheem and Deputy Director, Professor Lee Chuen Neng and is made up of the following constituents:

• Cardiac Department
• Department of Cardiac, Thoracic and Vascular Surgery (CTVS)
• Cardiovascular Research Institute (CVRI) to be ready in 2010
• Division of Endovascular and Vascular Surgery
• Cardiac Clinic and Clinic H" – consultations and various investigations of heart conditions are carried out.
• Angiography Centre – interventional cardiology procedures are carried out
• Non-invasive Cardiac Laboratory – non-invasive procedures like Electrocardiogram are carried out.
• Nuclear Cardiology Laboratory – non-invasive heart studies are performed using radioactive materials.
• Ward 23  – Coronary Care Unit (CCU) and Cardiac Monitoring Unit
• Ward 20  – Cardiothoracic Intensive Care Unit (CTICU)
• Ward 56  – Cardiothoracic Ward
• Ward 63  – Cardiology Ward
• NUHCS Operations and Administration Department

"The focus of NUHCS would be on four critical areas of cardiac care – heart failure, congenital heart disease, acute coronary syndrome and vascular disease. These four core clinical programmes are carefully selected because of their strategic importance, i.e. the needs of an ageing population and out current strengths in medical as well as surgical expertise and facilities. NUHCS is also poised to lead in the cutting edge treatment of theses conditions through the set-up of its Cardiovascular Research Institute which will focus on translational research efforts in these areas."

- Associate Professor Tan Huay Cheem, Director of National University Heart Centre, Singapore (NUHCS)

Our Four Core Clinical Programmes

Heart Failure programme: A model for disease management programme

This programme was first implemented in 2002. Patients at NUHCS are cared for by a multidisciplinary team of heart failure physicians, case managers, advanced practice nurses, dietitians, medical social workers, pharmacists, physiotherapists and occupational therapists. From only about 500 patients in 2002, the programme now caters to about 700 heart failure patients.

Spanning from inpatient to outpatient care, it serves as a model for other developing chronic disease management programmes and is in a process of continual expansion and improvement. As compared to international benchmarks such as the Centre for Medicare and Medicaid Services and United States Joint Commission International (JCI), treatment outcome indicators attained by NUH has been comparable:

• Median length of hospitalization stay in NUH is 3 days compared to 9 days
• Re-admission to NUH within 30 days of discharge is at 12.4% as compared with 22%
• In-hospital mortality in NUH is 0.93% compared with 6.7%
• 30-day mortality rate in NUH at 3.4% as compared with 11.1%

Congenital Heart Disease programme: Span-of-life care

Congenital heart disease (CHD) patients at NUHCS benefit from a continuum of care that spans a person's entire life. Under the care of a multidisciplinary team of specialists, parents with a history of congenital heart disease are offered pre-natal testing and genetic counseling, expectant mothers undergo ante-natal screening and imaging and newborns are screened for CHD.

NUHCS provides specialized care for patients with

• Heart arrhythmia
• Heart failure
• Pulmonary hypertension

The Centre also carries out surgeries for congenital heart conditions and percutaneous procedures (implanting devices and sealing congenital defects without open heart surgery). Setting NUHCS apart from other medical centres are these distinctive skills that will help meet the growing demand for CHD services in the Asia-Pacific region.

Acute Coronary Syndrome programme: timely help for heart attack patients

The NUHCS team has been working together with the nurses and specialists from the NUH Emergency Department and has reduced the time it takes to rush a patient suffering from a heart attack from the hospital doors to the procedural room for "ballooning". NUHCS's median 'door-to-balloon' time of 67 minutes is better than the international standards of less than 90 minutes, and 76% of NUHCS patients were treated within 90 minutes as compared to the 39% in the USA NRMI (National Registry of Myocardial Infarction) reports. The clinical pathway and therapy outcomes attained by the Centre have since been published in the Journal of Interventional Cardiology.

Further improvement of the care delivery process will be undertaken through working with the Singapore Civil Defence Force ambulance teams. They will administer pre-hospital ECG (electrocardiograms) for patients who are suspected with heart attacks while alerting the cardiac interventional team before arriving at the hospital. This is a practice that is rarely carried out worldwide.

Taking the lead in reporting treatment outcome indicators and also being an early adopter of innovative technology, the NUHCS will also develop a new statistical model through analyzing the large Singapore cardiovascular database to enhance the care, treatment and identification of patients.

Vascular medicine and therapy: saving limbs and prolonging life  

The lack of awareness for atherosclerosis (hardening of the arteries) often leads to patients seeking late treatment for multi-level ailments that involve the brain, heart, kidney and lower leg arteries. This results in a higher incidence of lower limb amputation, diseases of the heart and blood vessels as well as death. The Vascular medicine and therapy programme brings together specialists from cardiovascular medicine, vascular surgery, radiology, neurology and nephrology to provide personalized care for patients including:

• Non-invasive diagnostic testing
• Modification of risk factors
• Medical therapy
• Minimally invasive endovascular techniques
• Vascular surgery

One key component of the programme is limb preservation service. By introducing a personalized patient care plan comprising of cardiologists and vascular surgeons, NUHCS aims to reduce the rate for lower limb amputation. Following which, a vascular disease-tracking programme will be instituted to capture the data of all the patients in this service to encourage collaboration, innovation and improved patient experience.

Research

Reflecting parent organization National University Health System's focus on clinical care, education and research, the NUHCS will include a Cardiovascular Research Institute (CVRI). Heading the Cardiovascular Research Institute is Professor Arthur Mark Richards, who, amongst other positions that he holds, is a Professor of Cardiovascular Studies at the National Heart Foundation of New Zealand.

The upcoming CVRI in NUHS includes laboratory based research, clinical research, clinical trials, health services research, prevention and epidemiology research. NUHCS will be collaborating with international centres for multinational, miulticentre basic and clinical trials and

An artist's impression of the Cardiovascular Research Institute (CVRI) will reside within.

we will also be involved in outcomes-related research, setting standards for evidence-based best medical practice in Singapore.New research initiatives, which will benefit Singaporeans, include development of a risk prediction model for heart attack using novel biochemical markers, novel hormones and genetic analysis. Other areas of research include collaborative stem cell and tissue engineering research, device innovations etc.

Education

The NUHCS will develop novel training programmes, programmes to engage medicall undergraduates in education and research and programmes to link phD and advanced specialist training. The NUHCS also aims to remain the preferred training centre in Cardiology and Cardiothoracic Surgery for local and overseas trainees with its structured and comprehensive training curriculum, coupled with close mentoring and supervision.

Trainings of cardiology, cardiac surgery and vascular specialists are reviewed and all clinical training programme will incorporate formalized research training in bid to expand the pool of clinician-investigators and clinician-scientists by working closely with the Specialist Training Committee (STC)

Novel training programmes will be developed that could pave the way internationally for the training of cardiovascular specialists, such as exposure of cardiology trainees to cardiothoracic vascular surgery and vice versa. There will also be a special cardiovascular training programme to augment the knowledge of interested nurses who may wish to pursue a career in cardiovascular nursing.

Back to Top