By Amy Weng

Every minute counts in our Cardiothoracic Intensive Care Unit (CTICU), where nurses provide round-the-clock care for patients recovering from heart surgeries. When precious time was being spent searching for medical supplies instead of focusing on patient care, Team The Revivors stepped forward with an innovative solution.

"As frontline staff, we felt a personal responsibility to improve the situation," said Senior Staff Nurse (SSN) Kimbell Tan, who leads the team, "If not us, then who?"

Spoken like a true advocate for patient safety, SSN Kimbell’s vigilance has helped avert potential harm to patients. Having actively participated in several quality improvement initiatives, SSN Kimbell proudly represents NHCS in this year's SingHealth Nurses’ Day campus visuals.

(L - R) The Revivors team and their facilitators comprising Nurse Clinician Norashikin Binte Sarip, Cardiothoracic Intensive Care Unit (CTICU); Senior Enrolled Nurse K Eswarii, CTICU; Nurse Clinician Maliga D/O Riaki Chinniah, CTICU; Deputy Director Nursing Foo Lee Lian, Nursing Administration; Assistant Nurse Clinician (ANC) Shuek Jia Ying Stefanie, Ward 56; Senior Nurse Manager Yeoh Lee Shien, CTICU; SSN Kimbell Tan, Nursing Administration.

Transforming Chaos into Order

In their assessment, the team found nurses spending valuable time locating essential supplies such as intravenous (IV) drip sets and specimen bottles. The manual stock tracking system also led to frequent supply shortages, requiring staff to borrow from other departments or place urgent ad-hoc orders.

Armed with determination to solve this issue once and for all, the team launched an ambitious four-week makeover. Their solution combined smart layout design, data-driven stock management and modern technology. They introduced a matrix grid system and implemented a Kanban system - a visual inventory management method that signals when supplies need replenishing - enhanced with radio frequency identification (RFID) technology.

"Adopting new processes isn't always easy,” admits Assistant Nurse Clinician (ANC) Stefanie, co-team leader of The Revivors. “We managed this through a collaborative approach by involving fellow colleagues in the design and refinement of standard operating procedures. Their inputs shaped the eventual changes, turning scepticism into active support."

SSN Kimbell sorting out stock in the CTICU storeroom.

A Transformed Storage

Today, the CTICU storeroom operates with newfound efficiency. Supplies are grouped logically by organ types, such as respiratory or cardiac systems, with frequently used items strategically placed near the entrance. Clear labels and an easy-to-follow directory guide staff to exactly what they need. The supply stock was also updated and decluttered to improve workflow.

The streamlined layout has significantly reduced inventory task time by 51%, saving 222 hours a year for nurses, clinicians, and Materials Management Department (MMD) staff. The RFID technology and Kanban system have automated inventory management, ensuring essential supplies like face masks and chest tubes are consistently available.

"This reliability has boosted staff confidence, particularly during emergencies," says Kimbell. "With stockouts prevented and shelves well-organised, our team can focus more on patient care rather than supply management. The improvements in both efficiency and job satisfaction have led to better quality of care."

A CTICU nurse uses a radio-frequency identification (RFID) card to order supplies. When stocks run low, nurses drop the card assigned to that item into the box, sending an electronic order to Materials Management Department (MMD). Upon delivery of supplies to the ward, MMD staff will open the box and return the RFID card to CTICU, completing the cycle.

Beyond the Storeroom

The team's efforts earned them a well-deserved Star Award at the Team Excellence Assessment (March 2025). Looking ahead, they welcome the opportunity to share these solutions with other wards managing high volumes of consumables. For other departments looking to implement similar improvements, SSN Kimbell advises, "Start with data collection and staff feedback to identify inefficiencies. Engage cross-functional teams early, and test improvements gradually. Most importantly, empower your staff to be part of the solution."