​NUHCS Services At Ng Teng Fong General Hospital: A New Chapter Unfolds

Dr Loh Poay Huan helms NUHCS @ Ng Teng Fong General Hospital

PULSE Issue 39 | June 2022

Dr Loh Poay Huan, Senior Consultant, Department of Cardiology, National University Heart Centre, Singapore (NUHCS), recently took up the role of the new Head of Cardiology at Ng Teng Fong General Hospital (NTFGH), and will be spearheading the management of cardiovascular health services at the hospital. At NUHCS, he is the Clinical Lead for the Western STEMI Network and Acute Myocardial Infarction Service which oversees and manages acute cardiac services in the western region of Singapore. 

Before Dr Loh took the helm in January 2022, the NUHCS team at NTFGH has already been recognised for achieving a number of firsts. They established the first Rapid Access Chest Pain Clinic (RACPC) in Asia which won the Excellence Award under the “Patient Experience Improvement” category at the 2020 Asian Hospital Management Award. RACPC has reduced patients’ waiting time to see a heart specialist from roughly two months to just 24 hours, lowering the number of visits to the hospital by 50%, reducing the need for unnecessary hospitalisations and consequentially, the cost of invasive testing by 20% as well. In January 2022, the experienced multi-disciplinary divisions across NUHCS campuses came together to plan for a cluster-wide service to treat Pulmonary Embolism (PE) with the introduction of two new minimally invasive techniques. 

The NTFGH team is the first in Asia to use suction tools, and the first in South-east Asia to use ultrasound, to treat PE. Riding on the wave of achievements by the NTFGH team so far, Dr. Loh hopes to improve efficiency in clinical care delivery. For instance, he intends to establish a “one-stop” clinic, increase accessibility to diagnostic imaging such as the Computed Tomography (CT) angiogram service and point of care echocardiography. Dr. Loh believes that these will expedite diagnosis, improve clinical service delivery and standard, and ensure sustainability in the face of meeting healthcare demands with limited resources. However, such efforts would require a new approach to current issues, adopting new concepts and adapting new systems. 

“Here at NTFGH, the small team is dynamic and enthusiastic towards innovative ideas,” observed Dr Loh. “With such a driven and progressive team, we will be able to get inputs from everyone and come up with new or improved workflow, embrace and support each other’s ideas, to better the care we render to our patients.” Dr Loh hopes the NTFGH team can be proud of their achievements thus far and strive to achieve greater heights in their respective subspecialties, to eventually attain the Centre of Excellence in a relevant area of cardiovascular care. He is motivated to achieve his goals efficiently through sharpening the current systems in place, embracing innovative approaches and enhancing the patient experience.

Under the National University Health System (NUHS), the National University Heart Centre, Singapore (NUHCS) oversees the management and delivery of cardiovascular health services across three different hospitals within the cluster – Ng Teng Fong General Hospital (NTFGH), National University Hospital (NUH), as well as Alexandra Hospital (AH). This means that specialised medical professionals under NUHCS attend to patients across all three campuses. Within NTFGH, a multi-disciplinary team of cardiologists, cardiothoracic surgeons, specialist nurses and allied healthcare staff work together in managing a wide range of cardiovascular conditions with support from NUH for tertiary level care. While many patients are seen through referrals from polyclinics and private practitioners, patients looking for outpatient specialist care can also choose to visit the Specialist Cardiovascular Clinics at NTFGH. 

Some of the conditions treated at NTFGH include the diagnosis and management of:

• Chest pain / Breathlessness / Palpitations 

• Coronary heart diseases – the narrowing or blockage of arteries that could lead to heart attacks 

• Heart rhythm disorders 

• Heart valve diseases 

• Heart failure and cardiomyopathy – diseases that affect the heart’s ability to pump blood 

• Women’s heart health 

• High blood pressure and high cholesterol 

• Comprehensive cardiovascular health screening and risk assessment 

• Cardiac rehabilitation

Remote Cardiac Monitoring Device Check

NTFGH provides heart patients carrying implanted pacemakers or other cardiac devices with remote monitoring services, whereby patients can send their device’s signals directly to the heart clinic from the comfort of their homes. This allows the medical team to easily evaluate if the device is functioning well, as well as to quickly access and monitor the patient’s heart health without a physical visit to the clinic, boosting the convenience of health checks for these patients and their caregivers. If the patient’s device detects any abnormalities, this information will be sent automatically to the clinic as alert transmissions. Such early detection of abnormalities allows for early treatment, reducing the risks of emergency hospitalisations, stroke or heart failure.

Rapid Access Chest Pain Clinic (RACPC) 

RACPC at NTFGH allows patients who are experiencing chest pains to be seen by heart specialists within 24 hours of referral and receive same day, one-stop evaluation and diagnosis of their condition. Specialist cardiac nurses will perform blood tests, and record medical history and treadmill stress tests before the patient consults with a cardiologist for a confirmed diagnosis. Through RACPC, about 90% of patients with chest pains can be safely and promptly managed through the clinic’s comprehensive diagnosis without the need to wait for weeks to receive an analysis. Patients would also not be required to be admitted to a hospital for other invasive tests. Those with coronary artery diseases or other more serious conditions can be identified through the tests at RACPC and recommended for further treatment where necessary. NTFGH RACPC is the first established clinic of its kind in Asia and has won an Excellence Award under the “Patient Experience Improvement” category at the 2020 Asian Hospital Management Award.

Cardiac Rehabilitation Clinic 

The Cardiac Rehabilitation Clinic is a comprehensive, personalised service for patients to achieve their physical and lifestyle goals based on their unique medical condition. Following the recommendation of a cardiologist, each patient will go through an evaluation before being provided an appropriate rehabilitation programme supported by a multi-disciplinary team that includes a physiotherapist, dietitian, occupational therapist, pharmacist and a psychologist. Cardiac rehabilitation programme for patients typically begin from the moment they are admitted into the hospital and follows through after their discharge as an outpatient. Depending on the severity of their heart condition, physicians will recommend a therapy plan to help patients regain mobility and increase their functional abilities. Aside from an exercise programme, patients will also receive education, counseling, and recommendations for making lifestyle adjustments to maintain a healthy heart.