1. Ms Jinxiu Charmaine Tang, Tan Tock Seng Hospital
   Abstract Title: Exploring newly qualified nurses’ perceptions and experiences of working with preceptors: A qualitative descriptive study

2. Mr Eugene Teoh Yen Tjuin, Tan Tock Seng Hospital
   Abstract Title: Effectiveness of a Transition to Practice Programme for Newly Qualified Registered Nurses

3. Adj A/Prof Yip Chee Chew, Khoo Teck Puat Hospital
   Abstract Title: Training Enhancement and Accreditation for Community and Home Eye Screening (TEACHES) for Opticians.

1. Mr Chan Kai Siang, Nanyang Technological University
   Abstract Title: Assessing adequacy of informed consent in an Asian population with student administered interview

2. Ms Eng Goi Khia, Nanyang Technological University
   Abstract Title: Altered resting-state network activity and cerebro-cerebellar functional connectivity in Obsessive-Compulsive Disorder (OCD)

3. Ms Claudia Koh, National University of Singapore
   Abstract Title: Serum Carcinoembryonic Antigen as a Clinical Marker in Hypohidrosis

4. Ms Thanita Pilunthanakul, Duke-NUS Graduate Medical School
   Abstract Title: Preliminary results for an open-label pilot study on the efficacy of phosphatidylserine-omega-3 (Vayarin) in pediatric patients diagnosed with Autism Spectrum Disorder (ASD) and comorbid Attention Deficit Hyperactivity Disorder (ADHD)

5. Ms Shilpa Tyagi, National University of Singapore
   Abstract Title: Caregiver determinants of hospitalizations over one-year post stroke: adopting a stroke patient caregiver dyadic approach.

1. Ms Chan Mei Leng, Tan Tock Seng Hospital
   Abstract Title: OFF-ROAD VS. ON-ROAD ASSESSMENT OF OLDER TAXI DRIVERS AGED ≥ 70 YEARS

2. Ms Betty Teo Ching Ching, Tan Tock Seng Hospital
   Abstract Title: Comparison of custom-made thermoplastic splint and commercial wrist brace for acute and stable distal radius fractures: A randomised controlled trial

3. Mr Qi Yuan, Institute of Mental Health
   Abstract Title: Prevalence of Depression among Informal Dementia Caregivers in Singapore and Its Correlation with Coping Strategy and Knowledge of Dementia

1. Dr Lim Wei-Yen, Tan Tock Seng Hospital
   Abstract Title: Screening for diabetes with HbA1c: Test performance of HbA1c compared to fasting plasma glucose among Chinese, Malay and Indian community residents in Singapore

2. Dr Lim Jun Pei, Tan Tock Seng Hospital
   Abstract Title: Association between autophagy and genomic stability as determinants in successful aging of nonagenarians

3. Dr Louis Lim Wei Yi,  Tan Tock Seng Hospital
   Abstract Title: Optical coherence tomography angiography evaluation and correlation of the superficial and deep retinal vessel densities

4. Dr Ngo Wei Kiong, Tan Tock Seng Hospital
   Abstract Title: Surrogate retinal perfusion measurements and its relationship with the severity of diabetic retinopathy and diabetic macular edema

5. Dr Pauline Seah See Joon, Tan Tock Seng Hospital
   Abstract Title: Prolonged sleep duration predicts rapid cognitive decline in mild cognitive impairment (MCI) and early Alzheimer’s disease (AD)

1. Ms Lian Xia,  Tan Tock Seng Hospital
   Abstract Title: The impact of regular short-message-service (SMS) on diabetes related emotional distress: a short-term randomized controlled Trial

2. Ms Kee Huang Anita Ng, Institute of Mental Health
   Abstract Title: Impact of an aggression management programme on mental health nurses’ perception and attitude, and the transferability of its theory into clinical practice.

3. Ms Rachel Soh E-Jing, Khoo Teck Puat Hospital
   Abstract Title: Perception of the clinical learning environment among Pre-Registration Consolidation Placement (PRCP) nursing students: A descriptive, cross-sectional quantitative study

1. Dr Mobashar Hussain Urf Turabe Fazil, Nanyang Technological University
   Abstract Title: Multifunctional Linear Polyethylenimine for advanced wound care therapeutics

2. Dr Liu Yuchun, National Dental Centre Singapore
   Abstract Title: From Device Design to Preclinical Evaluation: A Novel Modular Mandible Endoprosthesis For The Repair Of Segmental Mandible Defects in Macaca fascicularis

3. Dr Kumaran Rasappan, Tan Tock Seng Hospital
   Abstract Title: Truly Tension Free Nerve Repairs Using A Nerve Conduit: A Biomechanical Study In An Animal Model

1. Dr Lee Eng Sing, NHG Polyclinics
   Abstract Title: Concordance between Clinical Diagnoses for Selected Chronic Conditions in Clinical Notes and Patient–Reported Conditions

2. Dr Wee Wei Keong, NHG Polyclinics
   Abstract Title: Dietary behaviour among polyclinic patients with pre-diabetes

1. Ms Zhu Xiaoli, NHG Polyclinics
   Abstract Title: Effectiveness of Nurse-Led Wound Clinic on Clinical Outcomes for Patient with Chronic Leg Ulcer in Primary Healthcare: A Quasi-Experimental Study

1. Dr Gerrard Gan, Tan Tock Seng Hospital
   Abstract Title: Spinal Navigation for Cervical Pedicle Screws: Early Clinical Results & Surgical Pearls

2. Dr Ngo Wei Kiong, Tan Tock Seng Hospital
   Abstract Title: Comparing different photodynamic therapy treatment regimens in polypoidal choroidal vasculopathy

3. Dr Young Barnaby Edward, Tan Tock Seng Hospital
   Abstract Title: Six-monthly Versus Annual Influenza Vaccination in Older Adults in the Tropics: an Observer-blind, Active-comparator Controlled, Randomised Superiority Trial

1. Mr Jonathon Khoo Kay Chin, Khoo Teck Puat Hospital
   Abstract Title: A Mixed Method Analysis of a Health Screening and Coaching Intervention for a Hard to Reach At-Risk Occupational Group

2. Dr Sharon Pek Li Ting, Khoo Teck Puat Hospital
   Abstract Title: An evaluation on clinical effectiveness and cost-savings of excluding aspartate aminotransferase measurement in Lipid Monitoring Panel among patients with Type 2 Diabetes

3. Ms Michelle Jessica Pereira, National Healthcare Group Corporate Office
   Abstract Title: The cost of home-based palliative care for advanced dementia patients: What is the cost-savings threshold?

• Rising incidence of opiod recared / complication
• How to select the right patient, right medications
• Surveillance and monitoring and multidisciplinary assessments

• Pain often impacts our emotional and mental well-being beyond the physical.
• Pain is subjective yet very real to the person suffering from it. The ability to validate patient’s reports of pain and suffering is pertinent for any successful treatment.
• Psychological treatments does not just involve “talking therapy”.

• Interventions for pain arising from peripheral nerves
• Interventions for pain arising from major joints
• Interventions for pain arising from neuraxial structures

• A brief overview of the system responsible for nociceptive signal transmission
• Understand the benefits and hypoalgesic physiological effects of exercise
• To provide guidelines to tailoring exercise programs for individuals with chronic pain

•  Am I still able to participate in my first Ironman?
• That awkward encounter of hypo & howrecording help
• My encounter of pump & monitoring systemduring race

• Benefits of Exercise diabetes
• Guidelines on exercise amount and type of exercises
• Exercise precautions and injury preventions

• Knowing the type of exercise and impact on glucose control
• Knowing the time of exercise and impact on glucose control
• Knowing the strategies to avoid hypoglycaemia during and after exercise

• Common myths about Diabetes answered
• Should I go ‘low-carb’?
• Learn useful tools for eating well with Diabetes

• Psychological Aspects of Diabetes
• Non-compliance and Burnout
• Coping with Burnout

• Patients with Diabetes can travel and maintain optimal control
• Patients with Diabetes can fast with lifestyle adjustment

The most prevalent theme that has emerged in diverse learning environments across industries, is the need to create psychological safety for each participant in a learning space; even including the teacher or instructor.

Powerful learning requires that participants are able to bring the fullness of their presence in a room and take in all that can be offered. Yet, highly stressful schedules, disrupted environments, and complex work dynamics have all contributed to both instructors and students to bring only functional parts of themselves into the classroom. We know that work today demands us to learn beyond cognitive understanding. It also demands emotional resonance, alignment with integrity and the ability to draw relevance with work place realities.

How do we create learning environments that facilitate holistic learning? How do we make sure that students experience safety in fully learning as they bring in their questions? What are the barriers to learning that take away safety and learning impact? In this experiential workshop, we will be working with the dynamics that are involved with this learning theme.

The most prevalent theme that has emerged in diverse learning environments across industries, is the need to create psychological safety for each participant in a learning space; even including the teacher or instructor.

Powerful learning requires that participants are able to bring the fullness of their presence in a room and take in all that can be offered. Yet, highly stressful schedules, disrupted environments, and complex work dynamics have all contributed to both instructors and students to bring only functional parts of themselves into the classroom. We know that work today demands us to learn beyond cognitive understanding. It also demands emotional resonance, alignment with integrity and the ability to draw relevance with work place realities.

How do we create learning environments that facilitate holistic learning? How do we make sure that students experience safety in fully learning as they bring in their questions? What are the barriers to learning that take away safety and learning impact? In this experiential workshop, we will be working with the dynamics that are involved with this learning theme.

• Welcome address by ALIVE Co-Directors
• Announcement of Serious Games Grant 2018 Awardees

• Objectives of game prototype developed
• Development process
• Product showcase through snapshots and video clips

• Managing Expectations
• Overcoming Challenges
• Breaking New Ground

• How far can we go? In terms of quality of serious game.
• Lessons learnt: working with Students, Faculty and Industry Mentors
• What are the next steps?

• Impact
• Diabetes Application
• Patients with DM

• Overview of Gamification as Applied for Attention Bias Modification Interventions
• Gamification Techniques adopted in Commercial Bias Modification Apps
• Co-designing a Personalized App for Bias Modification Amongst Individuals With Addictive Disorders

• Serious Games
• Virtual & Augmented Reality
• Healthcare training
• Rehabilitation

• Gamification as a Silver Bullet & The Myth of Pokemon.
• What real Gaming Companies do for success.
• What we need to do, to make Healthcare Serious Games succeed.

Facilitator :

• Dr Ng Kian Bee, Deputy Director, School of Interactive & Digital Media, Nanyang Polytechnics
• A/Prof Nabil Zary, Acting Director, Medical Education Research & Scholarship Unit, Lee Kong Chiang School of Medicine
• Mr Matt Laird, Product & Game Designer, Creative, Perx Health

Moderator :

• Dr Loh Yong Joo, Consultant, Department of Rehabilitation Medicine, Tan Tock Seng Hospital

Panelists :

• Mr Christopher Kuah, NTF PI for Jintronix Rehab Game
• A/Prof Eric Yap, Associate Professor of Human & Micronial Genetics, Lee Kong Chian School of Medicine
• Mr Lee Seng Beo, Director, Taggle Health Pte Ltd
• Mr Eric Loh, CEO, Trendlines Medical Singapore Pte. Ltd

We humans are quite resilient and have adapted to diverse environments all over the globe. But as our primate ancestors evolved, not many achieved old age. We evolved sufficient reserves and auto-repair mechanisms in our cells and organs to meet the needs of most life-spans, but now many of us live long enough to outlast them! This is the inevitable result of the “damage” from living metabolic processes, but affects us differently according to socioeconomic factors, lifestyle and chance.

The addition of specific risk factors or chance genetic events produces the phenotypes we recognise as distinct diseases, but these develop not independently of these ageing processes, not even alongside them, but embedded within them. The combined effects on the capacities of cells, organs and integrated physiological systems results in functional losses, and depending on the physical and social environments we live in, our functional ability then affect our well-being, life roles and healthcare use.

When a person with heart failure presents to hospital with dypsnoea, it is not only their heart disease which is driving this. There will be age-related other changes in the heart and cardio-vascular system, lung function, muscle mitochondrial function etc. All these play together to impact physical ability and recovery rates. The chance of developing delirium will depend on the co-existing ageing changes in the brain and its blood supply, as well as medications etc.

He will describe several Frailty tools which assess this overall vulnerability, explain their differences and how they can be useful in various circumstances.

• Shares the story of Mdm CC, who came in to hospital for elective surgery, only to develop multiple medical problems
• Highlights how the patient’s condition became increasingly frail with each recurrent admission
• Describes the partnership between acute and community hospitals in caring for such patients and coordinating their care and discharge.

• Shares the story of Mr L, who received inpatient rehabilitation only on his third admission to hospital yet was able to make progress beyond what was initially expected
• Illustrates why a good rehabilitation plan for the frail patient should be based on functional reserves, rather than severity of medical conditions alone
• Highlights the importance of follow-up rehabilitation for the frail patient in the community post discharge

• The story of supporting the care of a frail person with heart failure, social isolation & complex care issues
• Highlight main care issues & challenges
• Reflect the elements of good collaboration with community partners

• Descriptive presentation of inpatient rehabilitation programme in an acute setting
• Experience of interdisciplinary rehab programme in a community hospital setting
• Challenges faced by the healthcare professionals between these 2 settings

• The development of Geriatric Surgical Service
• Communication and team work
• Studies and outcomes

• Introduction of NICHE program in Tan Tock Seng Hospital
• Hospital Elder Life Program (HELP) in surgical unit in Tan Tock Seng Hospital
• Behaviour Management Consultation in Tan Tock Seng Hospital

• Multidisciplinary rounds (MDR) in Geriatric Medicine provides an important platform for the whole interprofessional team to come together to discuss patient cases and subsequent plans for each patient.
• This presentation will share the results and learning points of a qualitative study looking at communication and collaborative decision making at MDR and how the members of the interprofessional team contribute to this.
• It will also cover learning points from working with an interprofessional research team

More Information Coming Soon!

• Patient Value Measurement in Yishun Health
• Systematic Value Improvement in Yishun Health
• Applying Value Based Care Methodologies to a Regional Health System

More Information Coming Soon!

• There is a strong preference for home as the place of death. Various studies including systematic reviews have examined factors that influence home deaths across a range of settings, populations, taking into account the associated effects of the illness, personal issues, and the caregiving and healthcare environment.
• Our findings suggested that the decision on where to die, is often a family decision. Therefore, the preference elicitation process needs to be family oriented, conducted by a healthcare professional with whom the patient shares a supportive relationship with.
• System-level factors including national policies such as Advance Care Planning, and the expansion of home palliative care services have been found to support the achievement of home death preferences. Policies to improve home-based care must ensure that families are well-supported in the process of trying to meet the place of death preference.

• Diabetes burden increases rapidly due to aging population.
• Prevention programs reduce cost by preventing early onset of chronic diseases. However, cost may increase if prevention programs prevent fatal complications.
• Simulation model is used to project diabetes burden up to 2050 and illustrates the impact of prevention program in terms of direct medical cost, productivity loss and DALY.

• Cost-effectiveness of clinical quality registries
• Benchmarking and risk-adjustment
• Health process improvement

• We often need to plan and justify the amount of resource needed in some objective manner
• This talk uses Queueing theory and proposes simple utilisation ratio as a tool
• I will illustrate with some healthcare examples

• The cumulative pAF positive rate could be as high as 15%
• To study if Inpatient pAF monitoring is cost effective compared with no monitoring or outpatient monitoring
• To determine how many days monitoring is most cost effective

• This presentation introduces the nature and logic of qualitative research methods, highlighting the constructivist-interpretivist approaches to human inquiry.
• It will also present the conceptual underpinnings of participatory action research, as well as its methods for promoting social change.
• Finally, local examples of participatory action research will be shared for advancing applied understanding and translational practices of qualitative research methods.

• There are numerous way of presenting the health status of a population
• Indicators should align with the purpose of measurement
• Stakeholders must agree on the criteria and definition of “health”

• A tool to measure a person’s health.
• Takes into account the various domains that significantly contribute to health; i.e. physical, mental and social functioning, health-related risk factors and historical healthcare utilization.
• Allows for monitoring and longitudinal assessment of the health of the population over time.

• Understanding the relationship between learning environment, stress and coping amongst residents is important for optimal learning
• Data from our own residency program will be shared
• Attendance to these elements can enhance learning amongst our residents

• Despite the higher levels of burnout among psychiatric residents as compared to other medical residents, there has been a poverty of literature relating to burnout among psychiatric residents.
• We reviewed the existing reports to evaluate the prevalence and clinical correlations of burnout specifically among psychiatric residents.
• We found that the prevalence of burnout in psychiatric residents was at the upper limit of the range of burnout among all residents and that there is some data to suggest that structural interventions may reduce the prevalence of burnout among medical residents in the long run.

• What crisis workers do when activated to respond to a critical incident
• Preparations to be crisis worker
• Post critical incident care

Questions asked will surround the following:

• The challenges of PSS: what are the challenges faced among the PSS? How does one identify it and overcome it? How to help others by helping myself? What guided me to be a PSS and how to maintain my well-being?
• How to engage so that the PSS vocation can be sustained? What helps?
• The experiences of working with others: PSS and their advocates/superiors or partners?
  1. PSS and their superiors can share about the experiences of working together; how they support each other etc. How do their working relationship impact on the workplace and what can build towards workplace resilience?
• How do one deal with fatigue? What are the challenges of sustaining our work? How do one recharge and how to maintain resilience?
• From the RO’s perspectives, how do they see the outcomes of PSSs’ involvement and their experiences? What are the changes they see in the workplace – before and after PSS movement?

• Time Trends in Prevalence of Mental Illness
• Early Intervention, and Recovery Focused Approach
• Access to Evidence Based Care

• There is no health without mental health.
• The overall vision for the Community Mental Health Plan in Singapore is to build a network of care and support systems to enable integrated community living, maximise individual potential and promote ageing in place.
• Through population health approach, we have developed a system that allows easy accessibility to mental health services in the community, through enhancing capability and capacity of the community services. With integrated services, we can provide holistic integrated health, mental and social care support to our clients and caregivers.

• Overall care of Long Stay Psychiatric Patients in IMH
• Slow Stream Rehabilitation
• End of Life Care

• Over half of older Singaporeans, 60+, are lonely
• Loneliness is associated with poor health outcomes including mortality
• Resilience (psychological) is lower compared to western populations.

• A brief overview of some of the active ageing projects conducted at the training and research academy
• There will be a focus on the results from the mindful awareness practice randomized controlled trial
• We discuss the effects of mindful awareness practice on cognition, psychological well-being and other biological factors associated with cognitive decline in the elderly

• The elderly have complex medical, social and psychiatric needs that require integrated and comprehensive care.
• As the focus is on population health, mental health services for the elderly will need develop innovative models of care including health promotion and prevention
• The challenge is build effective partnerships and networks of care

• A practical approach to knee pain
• Review of basic knee anatomy and biomechanics
• Provide primary care providers with tips on evaluating common causes of knee pain

• Surgical options in knee arthritis
• Knee replacement – indications
• Latest technology in arthroplasty

• Nurses play a key role in ithe management of patient with arthritis.
• Patient education is associated with improved function, coping, self-efficacy and mental health.
• Enabling self management and coping is the key to optimize clinical outcome

• Evidence of Exercise therapy in Knee Osteoarthritis
• Different types of exercises for rehabilitation of Knee Osteoarthritis
• How Tan Tock Seng Hospital is utilising Technology in the rehabilitation of Knee Osteoarthritis patients

• Anatomy of Shoulder Tendons
• Common Pathologies
• Ultrasound guided injections

• Indications of surgery for shoulder tendon injury
• Types of surgery

• Overview of SCR cases seen
• Current evidence of SCR rehabilitation
• Rehabilitation guidelines

• Emerging evidence on efficacy of acupuncture
• Possible mechanisms
• Through the lens of Chinese medicine

• Enhancing infrastructure for better response to emerging infections
• Singapore set-up an unique structure globally placing clinical services, public health, academy and community engagement under one organisational structure
• Emerging infection is no longer an if but when

• Designing a specialist hospital for Infectious Diseases
• The High Level Isolation Unit
• Designing for Peacetime Vs Outbreak

• Outbreaks occur everywhere all the time
• If we don’t look for them, we will not find them
• If we miss them, our patients and us will pay a price

“The Practice and Process of Change’’

Hear from change leaders and practitioners who believe that organisations and people thrive when they can master the art and science of change.

• Mr Felix Tan, MD of The Finlab (joint venture of SGInnovate and UOB) will share his story on how change and innovation is facilitated at large system level through networks and connections. Learn how shared visions for innovation are built across the network, to catalyze digital transformation of organisations across Singapore.
• Get deeper into the change process and hear from Mr Peter Ong, MP of Rested Edge Advisory, how the 9E Model of Change – based on thought leadership and research work towards an integrative theory of change – Theory E & Theory O, offers a model to mastering change.

“Transforming You & Your Team’s Ability to… Design & Master Change – Using the 9E Model of Change”

Participate in a Change Clinic and learn first-hand how to design a change plan.

• Try your hands at applying the 9E Model of Change to a project you are doing.
• Mr Ong, MP, Rested Edge Advisory, will be offering guidance for these projects.
• Project discussions will be guided by NHG Organisation Development Practitioners to facilitate model application.
• Learning event as ideas are generated and co-created.

All participants will be invited to join in the various NHG Institutional projects, to gain insights in applying the 9E Model of Change to develop a change plan.

Case Studies of Multiple Agency Collaborations

Hear from leaders who are driving multiple agency collaborations – what are they experimenting with? Learn from their challenges and successes.

A. ) Story of the “Yellow Ribbon Project” and “Dads for Life” Movements

The “Yellow Ribbon Project” and the “Focus on the Family” movements shifted the paradigm of community involvement in national movement.  Learn what it takes to put a vision in place and set change in motion.  What does it take to shift behaviors and mindsets across multiple agencies to build a common vision and commitment to collectively own the problem?

B. Activity – ‘Perspectives’

Do we understand our patient’s perspectives? Explore how the world looks like in the “eyes of the patient and caregiver”.

C. Story of Central Health and Yishun Health

The Regional HS has redefined the way we provide patient care and collaborate with our partners and stakeholders. This involves collaboration beyond the hospital walls with our RHS alliance partners – who include primary care providers, community hospitals, nursing homes, home care providers, hospices and other social service providers – to provide care for the community. Learn first-hand about challenges and solutions to managing large scale change.

D. Panel Conversation – Multiple Agency Collaborations:  Role of Leaders and Leadership

• Early initiation of palliative care alongside chronic disease management
• Integration of palliative care, rehabilitation and respiratory management in the setting of a community hospital
• Preliminary results demonstrate improvement in function, exercise tolerance, readmission and length-of-stay at tertiary hospitals

• Approach and trajectory of End-Stage Organ Failure Patients
• Results of Programme IMPACT
• Challenges in End-of-Life care in End-Stage Organ Failure Patients

• Palliative Care for advanced dementia is important and vital
• Advanced Dementia Palliative Care requires an integrated approach
• More should be done to ensure dignified care for patients suffering with advanced dementia at the end of life.

• Existing models of care do not adequately meet the needs of patients
• Adequate patient engagement is a necessary component of patient centric care
• This will necessitate changes in workflow, training of healthcare providers and new business models

• Traditionally, our healthcare system is designed to deliver acute care, and is less well configured to effectively support people with chronic diseases even when the need in this area has increased tremendously with the dramatic increase in prevalence of various chronic diseases.
• There is evidence to suggest that personalised care planning programmes improve outcomes in chronic diseases, especially when they are integrated in their routine care.
• Modelled after the “Year of Care” programme in England, this initiative aims to improve engagement of people living with diabetes by transforming routine clinic visits into a patient-centred, collaborative care planning process. This presentation will share our experience of implementing a transformative care model through an iterative process of rapid implementation and evaluation.

• Concept of PDA and its development
• Illustration of an example of PDA
• Application of PDA in Clinical Practice

• Healthcare challenges require a rethink of model of delivery of care.
• Be bold in not accepting status quo.
• Adopt an Inter-Professional approach.

• Why take this change? What were the changes?
• Challenges to surmount to bring about the change
• NCPP – Before, after and the future; less supervision needed? What has changed for you?

• The National Collaborative Prescribing Programme (NCPP) is one of turnkey programmes to empower the APNs and pharmacists to practice at the top of their licence.
• The curriculum, teaching and learning activities and assessment system lay the foundation that the CP practitioners need and at the same time, gives assurance of safe practice.

This segment of the symposium explores the design, development, implementation and long term outcomes of Local Area Coordination in England and Wales.

Building on 30 years of international learning, Local Area Coordination is an integrated, evidence based approach to supporting people of all ages who may be facing complex life situations (including living with disabilities, mental health needs, ageing) and their families/carers to:

• Build and pursue their personal vision for a good life.
• Stay strong/resilient, safe and connected as contributing citizens within their local communities.
• Build practical, sustainable, local, non-service solutions to problems wherever possible.
• Build more welcoming, inclusive and supportive communities.

Therefore, rather than waiting for crises and responding with services and money, it is about:

• Strengthening individuals and families – choice, control, opportunities and resilience.
• Reducing isolation and loneliness, improving health and well-being
• Preventing or reducing demand for, or dependency on, costly services wherever possible.
• Building community capacity and resilience.

Supporting service reform and integration, having high quality services as a valued back up to local solutions.

More Information Coming Soon!

There is a bidirectional relationship between mental illness and physical health. We find that patients with chronic diseases have a higher risk of mental illnesses; likewise patients with mental illnesses are more prone to have chronic medical illnesses.

This discussion looks into the significant role that Primary Care Providers play in the detection and management of these conditions in the community.

Moderator:
Dr Wong Kirk Chuan
Chief Operating Officer, Population Health, National Healthcare Group Pte Ltd; Campus Chief Operating Officer, Woodlands Health Campus

Panelists:
Mr Ralph Broad
Director, Inclusive Neighbourhoods Ltd; Founder, Local Area Coordination Network, UK

Mr Yong Keng Kwang
Chairperson, NHG Community Nursing and Chief Nurse, Tan Tock Seng Hospital

Dr Alvin Lum
Head of Medical Services, Institute of Mental Health (IMH) and Deputy Director and Resident Physician, Mental Health-General Practitioner (MH-GP) Partnership Programme (IMH)

With the number of older Ontarians set to double over the next twenty years, in 2012 the Ontario government set about developing a Seniors Strategy – its first attempt to establish a comprehensive plan that established sustainable best practices and policies at a provincial level that could support the overall coordination of the delivery of health, social and community care services with an intense focus on supporting older Ontarians to stay healthy and stay at home longer.

With older Ontarians already accounting for half of Ontario’s health and social care spending, it becomes clear why ensuring that older Ontarians have access to the right care, in the right place at the right time was placed at the centrepiece of the Government of Ontario’s subsequent Action Plans for Seniors.  Dr. Sinha will share what he learned and what he thinks it might take to enable the delivery of a system across Ontario that will deliver the care we need now and in the future in a sustainable way that also invests in upstream initiatives that promote wellness and prevention, better recognition and support for caregivers and the provision of more sustainable and cost-effective models of care that are in line with the overall desire of citizens to receive care as close to home as possible are all essential to achieving better outcomes for an ageing population.

A public health approach requires general measures to shift population behaviour and exposures plus targeted intervention, which may be delivered via health and/or social care providers. He will describe health promotion messages delivered at national level, particularly on physical activity recommendations which modifies advice according to characteristics of population groups.

In England, national guidance from The National Institute for Health and Care Excellence (NICE) and policy frameworks have been developed to promote healthy aging, delay onset of frailty, and reduce falls. Some is aimed at the whole population of older people and some at individuals at higher risk or resident in care homes.

Detection of frailty using the deficit accumulation model using primary care diagnostic codes is now mandatory across England and linked to a requirement for falls prevention, medication reviews and advance care planning for those considered to be living with severe frailty.

The evidence for such approaches is limited and there are concerns about acceptability, feasibility and cost-effectiveness. There is gender and socioeconomic differences in risks of frailty and addressing these may require a much broader approach than healthcare.

He will review the current state of these initiatives and thoughts for the future.

The programme is a collaborative effort to facilitate advance care planning,  develop care pathways for early symptom recognition and management and to reduce crisis episodes that result in hospital admissions.  We share our learning journey with our partners and some of our preliminary results.

It is imperative to know that nursing homes and acute hospitals share a common aim: To provide good quality care for patients. While having this common vision, we must not forget that forging a trusting relationship between hospitals and nursing home are more important to ensuring that key performance indexes are met.

Gericare@North is about building trusting relationships with nursing homes. We endeavor to walk the journey of care with the homes in order to help them achieve their goals of patient centric care.

This talk focuses on the elements of building a successful relationship with nursing home partners.

Project CARE from Department of Continuing and Community Care TTSH started working with nursing homes in central region since 2009, with initial focus on upskilling advance care planning and palliative care in nursing homes. Results and challenges of this program will be shared. Nursing homes and their residents require more than end of life support and hence quality improvement programs and various other new initiatives will be shared too.

• Surveillance is often multi-faceted, and when put together provides a clearer picture of the current state of health of Singaporeans.
• Surveillance methods may need to evolve over time, for example, shifting towards use of the National Population Health Survey.
• Once existing gaps are identified, data contributes to the development and evaluation of national policies and programmes aimed at improving the health of all Singaporeans.

More Information Coming Soon!

• Behavioral science and individual psychology have tremendous potential to help us implement “nudges” that result in cost-effective behavioural changes
• To be truly sustainable in a long-term perspective, these need to be embedded into the health system and include all stakeholders
• Tradeoffs and challenges remain to be addressed.

• The Community Networks for Seniors (CNS) puts together three main building blocks:
  (a) Preventive healthcare in the form of “Active Ageing” to keep well seniors active;
  (b) Supportive care in the form of “Befriending” to pair lonely seniors with a friend in the community and
  (c) Proactive interventions in the form of “Care and Support” to help those in need of care promptly.
• The model illustrates an inter-ministerial, public-private and people collaboration to bring together social sector and volunteers.
• It operates by TOUCHING (reach out systematically to all seniors 65 years and above Silver Generation Ambassadors) and HOLDING (keep in regular contact) the senior while having the NGOs and private players in health and social sectors to HELPING the seniors in need.

• Connection between neighbourhood built environment and older person’s health
• Implications for designing ageing-friendly neighbourhoods
• Some examples from around the world

• Seniors are vulnerable to the threat of vaccine-preventable diseases such influenza and pneumococcal disease.
• Vaccinations are currently an under-utilised resource among seniors, with very low uptake rates.
• This presentation highlights key challenges with increasing vaccination uptake and solutions to address existing issues

• 0830 ~ 0840 : Welcome Address
  Associate Professor Chong Phui-Nah
  Family Physician, Senior Consultant;
  Chief Executive Officer, National Healthcare Group Polyclinics and Primary Care
• 0840 ~ 0855 : Guest-Of-Honour Opening Address

• 0855 – 0935: PLENARY 1: SUCCESSES, SORROWS AND STRATEGIES FOR PRIMARY CARE NETWORK
• 0935 – 0940: Q&A

0940 – 1020:  PLENARY 2: THE POPULATION HEALTH APPROACH TO MANAGING DIABETES

1020 – 1025: Q&A

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• Theory-driven comprehensive behavioural intervention was able to increase STI-preventive behaviours over a 12-month period
• Clinic-based programme remains a feasible and practical way in reaching out to high-risk youths

• Overview of healthcare risks for LGBTQ+ community
• Barriers to help-seeking behaviour for LGBTQ+ clients
• Role of healthcare professionals

• Female sex workers who are a diverse group are vulnerable to STI/HIV in Singapore
• The Medical Surveillance Scheme has been effective in controlling STI/HIV among brothel-based female sex workers in Singapore
• Challenges on STI/HIV prevention continue to exist and emerge among other groups of female sex workers in Singapore

• Research findings indicate a relationship between alcohol and drug use with higher incidence of sexual activity, riskier sexual behaviour and increased vulnerability to HIV/STI exposure.
• It is useful to explore substance abuse as an attempt at self-regulation and self-soothing, and/or a symptom of unmet psychological and developmental needs.
• In the therapeutic process, counsellors work to encourage safer sexual behaviour in patients, and harness motivation for change, by working with underlying core feelings and beliefs that drive addiction.

• Community engagement and partnerships
• Social epidemiology of HIV/STI
• Conceptualizing frameworks for behavioural interventions

• History and evolution of HPV
• HPV vaccination
• HPV testing for cervical cancer screening

• The incidence of infectious syphilis is increasing in Singapore
• Syphilis is a great mimicker in dermatological clinical morphology
• Prompt recognition & treatment prevents onward transmission

• Start of Opening Ceremony
  Opening Ceremony Video
• Welcome Address
  by Prof Philip Choo, GCEO, NHG
• Opening Address
  by Mr Gan Kim Yong, Guest-of-Honour, Minister of Health
• Minister ‘Token of Appreciation – DiS Book’ Presentation
  by A/Prof Tan Suat Hoon, Director, NSC
• Signing of Memorandum of Agreement for ALIVE-POLY-ITE Student Internship Programme
• Signing of Memorandum of Understanding for Joint Programme for Clinician Scientist Development
• Citation of Keynote Speaker
  by Dr Martin Chio, SHBC 2018 Org Chair
• SHBC Keynote Address
  by Prof Martin Marshall
  
• Keynote Speaker  ‘Token of Appreciation’ Presentation
  by Prof Philip Choo, GCEO,  NHG
• SHBC Scientific Competition Award Prize Presentation
  by Mr Gan Kim Yong, Guest-of-Honour, Minister of Health
• Medical Humanities ‘Gold’ Prize Presentation
  by Mr Gan Kim Yong, Guest-of-Honour, Minister of Health
  

Opening Ceremony Schedule  *subject to changes*

Modern medicine has had a remarkable impact on people’s health over the decades but there are growing concerns that doctors adopt too narrow a focus on illness, that they too often ignore the social determinants of health and well-being, and that investing in medical technologies may not be the most effective use of limited financial resources. In this presentation, Martin Marshall, a family doctor in London, UK, and Professor of Healthcare Improvement at UCL, will describe how doctors around the world are starting to engage in practices which are not considered to be part of the traditional medical model – social prescribing, person-centred care, shared decision making, community involvement and health systems improvement. He will describe how these practices are resulting in a re-thinking of the medical model of disease in a way that is likely to benefit the diverse populations that we serve, and the implications for health professionals in the future.

Working at scale in general practice
In many countries general practitioners work from small premises based in local communities, with limited support from administrative staff and other health professionals. This contrasts with hospitals where specialist doctors tend to work closely with other colleagues, supported by multidisciplinary teams and by a substantive organisational infrastructure. General practice is slowly changing, with more doctors working together, alongside other health professionals and in large purpose-built premises. This trend is associated with many advantages, but also carries some risks, in particular in relation to the provision of person-centred care. In the UK, for a range of policy and practical reasons, there has been a dramatic increase in ‘at-scale’ working in recent years, utilising a range of different models. In this presentation Martin Marshall, a family doctor in London, UK, and Professor of Healthcare Improvement at UCL, will describe the evolution of general practice in the UK, how the benefits of at-scale working are being realised and the risks minimised, and will outline what other countries could learn from the UK’s experiences.

Is improvement a science?
A commitment to continuously improving what doctors, nurses and other health professionals do is considered to be a core element of what it means to be a professional. But experience from around the world suggests that improving professional practice and patient outcomes is far from a straight-forward task. In recent years we have seen a growing interest in systematic approaches to improving quality and safety, based on high quality data, rigorous methods of analysis and interpretation, and a strong focus on implementation and on the spread and sustainability of good practice. These approaches to improvement are increasing termed ‘improvement science’. In this presentation Martin Marshall, a family doctor in London, UK, and Professor of Healthcare Improvement at UCL, will describe the development of the science of improvement, how it complements the traditional biomedical and clinical sciences and how different models of improvement science can be used to address different improvement challenges.

In an era of rising health-care costs and meeting patient expectations, we outline the role and benefits of running a ONE-STOP thyroid clinic for performing the 4 -step evaluation of goitres in a single day.

This not only provides a hassle-free patient experience by avoiding multiple different specialist visits but also leads to faster work-up, reduces costs and improves productivity.

• Bariatric & Metabolic surgery is the most effective treatment for morbid obesity as well as resolving its related co-morbidities such as Type 2 Diabetes, Hypertension, Hyperlipidemia.

• There is increasing long term evidence of such benefits after surgery with improvements not just in metabolic syndrome, but also psychological and psychosocial aspects.
• Setting up the ICOD clinic in Khoo Teck Puat hospital, we integrate care of obesity and diabetes, providing a one stop hassle free solution for patients with obesity and it’s related co-morbidities.

• Establish: surgical floor wards for surgical inpatients to improve outcomes
• Engage: patients and healthcare professionals to facilitate their early discharge
• Empower: patients to eat together at a common dining place in the surgical wards

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• Fecal incontinence
• Constipation
• Rectal prolapse

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• Citation for Plenary 1

• Healthcare Financing evolves to meet the needs of the time.
• Beyond affordability, we need to finance healthcare so as to bring out value.

• Citation for Plenary 2

Older Adults represent 16.9% of its current population but 40% of hospital admissions and 60% of hospital days across Canada every year.  While they represent its greatest users of health care, it is clear that while the users have changed, Canada’s health system hasn’t.  In dealing with a hospital system that was designed 50 years ago when the average Canadian was 27 years of age, it is clear it needed to be adapted to meet the needs of the older patients with increasingly complex needs that now rely on it the most.

In his talk, Dr. Sinha will discuss how he came to understand how an ageing population presented both a challenge and an opportunity to rethink how we organize and deliver elder care. Toronto’s Mount Sinai Hospital responded with the development of its Acute Care for Elders (ACE) strategy, led by Dr. Samir Sinha which has demonstrated significant improvements in overall quality of care outcomes by better managing and integrating the care of frail older adults across the continuum. It has reduced lengths of stay by 28 percent, lowered readmission rates by 14 percent and other adverse outcomes and inappropriate resource utilization through the successful implementation of evidence-informed care processes, including integrating & coordinating care for the elderly to community care settings that has saved millions and allowed Mount Sinai to close dozens of beds.  Understanding the ACE Strategy Principles and lessons learned on how to apply them in a real world setting will reveal what it took to better deliver better patient and system outcomes.

Moderator:
Prof Pang Weng Sun

Panelists:
1. Ms Lim Yee Juan
2. Mr Chan Beng Seng
3. A/Prof Ian Leong Yi Onn
4. Dr Samir K. Sinha

• Citation for Plenary 3

Many older people present for acute care with falls, reduced mobility or confusion. There is usually an associated acute event such as a new infection, medication change or distressing event on a background of reduced physiological reserves and/or social support. Identifying and treating a new illness is important but not sufficient. The vulnerable (frail) patient is more prone to deconditioning, complications and poor functional recovery.

Most geriatric syndromes share risk factors so a comprehensive approach in the community or in the hospital should address not only the presenting event but also consider other potential problems. A comprehensive geriatric assessment is required to understand the range of issues and create an individual treatment plan. The plan should look further from the hospital stay to include post acute care and rehabilitation in the community.

As frailty becomes more prevalent in our ageing populations, it must also become “everybody’s business.” We need therefore to create interdisciplinary models of care with specialist geriatricians, nurse practitioners and therapists working with internists, surgeons, anaesthetists and oncologists, etc. The most established model is orthogeriatrics, especially for patients with hip fracture, but evidence for this approach is growing in acute medicine, surgery and cancer care.

He will describe several initiatives in the England NHS and also review the research literature to guide how new service models might look.

• Citation for Plenary 4

This plenary session explores the design, development, implementation and long term outcomes of Local Area Coordination in England and Wales. Taking a look also into creating the conditions for positive outcomes and sustainable change.

Building on 30 years of international learning, Local Area Coordination is an integrated, evidence based approach to supporting people of all ages who may be facing complex life situations (including living with disabilities, mental health needs, ageing) and their families/carers to:

• Build and pursue their personal vision for a good life.
• Stay strong/resilient, safe and connected as contributing citizens within their local communities.
• Build practical, sustainable, local, non-service solutions to problems wherever possible.
• Build more welcoming, inclusive and supportive communities.

Therefore, rather than waiting for crises and responding with services and money, it is about:

• Strengthening individuals and families – choice, control, opportunities and resilience.
• Reducing isolation and loneliness, improving health and well-being
• Preventing or reducing demand for, or dependency on, costly services wherever possible.
• Building community capacity and resilience.
• Supporting service reform and integration, having high quality services as a valued back up to local solutions.

Initially developed in Western Australia in 1988, it is now growing across England and Wales (in large cities, regional cities and towns, rural areas, island communities – alongside people from a wide range of backgrounds) as part of health and social care reform, personalisation and community capacity building. It is also expanding across the whole of Australia, as part of the National Disability Insurance Scheme (NDIS) reforms of disability and mental health services and funding.

Local Area Coordinators are based in local communities and develop a more personal relationship with the wide range of people of all ages facing complex life situations and their families. As they combine a range of traditionally separate roles and work with a full-age range of people in their local communities, they are in an ideal position to build strength, capacity and sustainable local solutions to issues, rather than just intervene in crisis situations.

Local Area Coordination has a strong evidence base after many UK and international evaluations showing that, where there is strong design (fully implementing core design, values, principles and learning) and strong, connected community and service leadership, there are a range of consistent, positive outcomes for individuals, families, communities and the wider system.

To find out more about Local Area Coordination (http://inclusiveneighbourhoods.co.uk)

Moderator:
Dr Wong Sweet Fun

Panelists:
1. Dr Tan Thai Lian
2. Prof Finbarr Martin
3. Mr Ralph Broad

• Citation for Plenary 5

The trajectory of healthcare policy is charting a much-needed return to community, but what exactly does that mean for healthcare, and what are the implications of that move for the community? This session will challenge traditional notions of health and healthcare while compelling us to review our perspectives on community, the self and others. It will also examine the real pros and cons of shifting our caregiving frameworks “from hospital to community”, from “quality to value”, and “from healthcare to health”.

• Citation for Plenary 6

Microsimulation is a type of computer modelling that aims to simulate the behaviour of a large number of synthetic individuals which are representative of a population of interest. Each individual is characterized by a number of unique attributes, such as demographics/socioeconomic status or   disease and healthcare utilization profiles. In a microsimulation individuals exhibit behaviours, allowing them to change some of their attributes, such as health status, in response to external stimuli and random shocks. By appropriately choosing individual behaviours and external stimuli it is then possible to model how interventions and policies affects individual’s health trajectories.

In this talk, A/Prof Girosi will cover basic concepts behind microsimulation modelling and how it can be applied in health policy making. He will present different types of microsimulation models and discuss the conditions under which they are appropriate in the health domain. Microsimulation models are complex, and therefore he will also discuss the alternatives available and the trade-offs involved when trying to decide between when a microsimulation and a simpler type of modelling.  HeI will also discuss the data requirements, the methodological challenges involved during modelling practice and the potential benefits of microsimulation. The presentation is not technical and based on easy-to-understand examples, making it suitable for a wide audience.

Moderator:
Adj Asst Prof Tan Cher Heng

Panelists:
1. Dr Shawn Vasoo
2. Dr Goh Wei Leong
3. A/Prof Federico Girosi