“When patients are empowered to take ownership of their health, there is greater buy-in into their care plan, adherence to their action plans improve, resulting in better health outcomes,” said Ms Esther Lim, Director, SingHealth Centre for Person-Centred Care (CPCC), and Chief Allied Health Professional (Workforce Planning), SingHealth.

The approach works by seeing patients as ‘Experience Experts’ in their own health and care. By recognising that most patients have the capacity to direct and contribute to their own care, it shifts the attention of care providers to look at patients’ strengths, resources, preferences and personal values.

In the PCC model, patients are valuable partners in co-creating care solutions, which are aligned with their goals and lived experiences, thereby empowering them to take on a key role in managing their own health. PCC aims to achieve shared responsibility and shared accountability between patients and their healthcare teams while ensuring a holistic care environment.

Conversations with patients allow healthcare workers to better understand what matters to them, understand what their goals are, and work together with them to achieve those goals. At the same time, patients should see themselves as part of the solution and be active, equal partners in managing their health instead of being passive recipients of care.

But PCC does not mean that healthcare providers must fulfil everything the patient requests for. It is not personalised medicine, which refers to tailor-made prevention and treatment strategies for defined groups of individuals. It is listening to patients’ perspectives about what matters to them and involving them in all decisions related to their health.

SingHealth’s journey in person-centred care

The groundwork for SingHealth’s PCC initiatives was laid as early as 2016 when the ESTHER Network was introduced in SingHealth. Started in Jönköping, Sweden, in 1997, Esther is a symbolic elderly person who requires close coordination across different care settings to address health and social care needs. This paradigm challenges health and social care providers to rethink how care can be provided in Singapore’s healthcare system by focusing on the patient’s story while identifying what matters to the individual. ESTHER Network Singapore (ENS) endeavours to spread the adoption of PCC approaches in daily practices, as well as system-level improvement to transform the way healthcare is delivered across care settings.

CPCC, which was launched in January 2023, brings together SingHealth’s PCC initiatives. With its vision “Empowering Individuals. Everyone Matters”, CPCC brings together a network of people — including patients and caregivers — and serves to promote PCC awareness and practice through five focus areas: Education, Service Innovation and Translation, User Experience, Research, and Strategic Partnership.

Milestones in person-centred care

ENS recently won the Public Service Transformation Awards 2023 under the Citizen Engagement Excellence Award category, in recognition of its excellent organisational practice and for its personcentric model of involving patients in their care journey.

Over the past few years, ENS has embarked on several PCC projects, including the Enhanced Recovery After Surgery for Total Knee Replacement, or ERAS TKR, which enables patients to be discharged earlier after total knee replacement surgery. Home visits are initiated after surgery to help patients transition more seamlessly to the home environment. As a result, hospital stays are shortened and patients are well equipped to manage around their own home. The initiative now includes community partners for home visits. It has gained recognition in the National Healthcare Innovation and Productivity (NHIP) 2023 (Best Practice Award) for its innovative and transformative practice.

Another project, Walking with a Star, recognised patients’ wishes to ambulate during their hospitalisation. Patients were afraid of falling when walking during their stay in the hospital. However, they also raised concerns about the discomfort of using diapers as a result of being unable to walk to the washrooms, limited walking aids, and the lack of manpower to assist patients to walk in the wards. In addressing these concerns, appropriate walking aids have since been placed at patients’ bedsides, enabling caregivers, nurses and even volunteers to help them throughout the day.

As our healthcare system evolves, it is of paramount importance that what matters to a patient is considered in the work that we do, whether in clinical care or in planning and projects. Through partnerships with colleagues and patients, CPCC aims to promote and spread the PCC culture and live out the vision of “Empowering Individuals. Everyone Matters”.

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