Integrated Cardiovascular Services between National University Heart Centre, Singapore and Ng Teng Fong General Hospital.

In January 2017, the Ministry of Health announced the regrouping of Singapore’s six Regional Health Systems (RHS) into three integrated clusters. This brought on a closer partnership between NUHCS’s and NTFGH’s cardiology teams, which are part of the National University Health System (NUHS) cluster.

With the reorganisation of Singapore’s public healthcare system into three integrated clusters, NTFGH became a member of NUHS.

Together, the institutions offer a full spectrum of services including health promotion, disease prevention, curative care and rehabilitative care. Across NUHS, every clinical discipline is reconfigured to ensure patient-centred care that leverages on the clinical expertise of the group.

More Seamless Services

In the field of cardiovascular medicine, the regrouping has led to an integration of NUHCS’s and NTFGH’s cardiology divisions. Prior to this, NTFGH cardiologists were participating in the primary Percutaneous Coronary Intervention (PCI) roster as part of the Western ST-elevation myocardial infarction (STEMI) network and some cardiologists from NUHCS had been conducting monthly sub-specialty clinics at NTFGH. The integration increased the level of cross-site activities with interventional colleagues from NUHCS now providing 40% of coverage at NTFGH’s cardiac catheterisation laboratories. Sub-specialty services such as the pacemaker and arrhythmia clinic also began to offer weekly sessions.

With the support of the Cardiac, Thoracic and Vascular Surgery (CTVS) team from NUHCS, NTFGH is now capable of handling emergency cardiac surgery. NUHCS’s Extra-Corporeal Membrane Oxygenation (ECMO) team can also be rapidly mobilised to provide on-site circulatory support for critically-ill patients at NTFGH before transferring them to the Cardiothoracic Intensive Care Unit (CTICU) in NUHCS. Similar cross-site collaborations are occurring for virtually every cardiac sub-specialty such as cardiac rehabilitation, heart failure and non-invasive cardiac imaging.

The expansion of cardiology services at NTFGH was made possible with the addition of four Associate Consultants in 2017.

Enhanced Cross-Learnings

The integration also provided a broader platform for professional development through cross-learnings. For example, NTFGH nurses from outpatient clinics and cardiac catheterisation laboratories are now rotating to Kent Ridge Campus for clinical attachments whilst associate consultants gain experience in complex PCI and device implantation by undergoing training at NUHCS. Such cross-learnings aid in the transfer of skills, teambuilding and harmonisation of clinical practices across both campuses.

By Asst. Prof. Pipin Kojodjojo