[AVBC 2025] Allied Health Therapy Stewardship Programme (AHTSP): Choosing Referrals Wisely
Care Process & Redesign
Appropriate & Value-based Care Conference
National Healthcare Group
27 November 2025
The project aims to target root causes for unwarranted referrals, allowing therapists to deliver quality and value-based. By adopting the framework of the ABIM Foundation's 'Choosing Wisely' campaign, AHTSP targets systemic and local challenges in.
Year Submitted: 2025
Published Date: 27 November 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Productivity, Cost Saving, Access To Care, Referral Rate
About this Content
Aims
The project aims to target root causes for unwarranted referrals, allowing therapists to deliver quality and value-based care while avoiding unnecessary healthcare costs.
Background
The AHTSP in Tan Tock Seng Hospital models after the 'Choosing Wisely' campaign by the American Board of Internal Medicine (ABIM) Foundation, aiming to reduce inappropriate referrals to Physiotherapy (PT) and Occupational Therapy (OT).
Methods
The AHTSP comprises two team tracks: General Medicine (GM) & PT; Geriatric Medicine (GRM) & OT. Clinical Practice Improvement methodologies and change management frameworks were utilized in both teams' project cycles. Stakeholders, including patients, were interviewed to obtain insights into the problem.
Results
The GRM team track observed a reduction in inappropriate referrals to 34% (baseline 35%). The GM team track demonstrated an increase to 92% of appropriate referrals (baseline 89%). Both PT & OT reported increased work satisfaction during the implementation period.
Conclusion
By adopting the framework of the ABIM Foundation's 'Choosing Wisely' campaign, AHTSP targets systemic and local challenges in promoting appropriateness of referrals to PT and OT, thereby increasing value for patients and the multi-disciplinary team.
Lessons Learnt
Some barriers included variability of the doctors working in the piloting wards and the exclusion of suitable patients on contact precautions due to infection control measures. However, there was a positive change in ward culture with improvement in patient participation and staff reporting higher satisfaction.
Keywords
Physiotherapy, Occupational Therapy, Referrals, Quality, Value-based care
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Allied Health |
Applicable Specialty or Discipline | General Medicine, Geriatric Medicine |
Project Lead(s) | Christina Chia Hui Ling |
Project Member(s) | Lim Hui Hui |
Connect with this contributor!
Christina Chia Hui Ling - christinahl_chia@ttsh.com.sg
Project Attachment
911_TTSH_AVBC_2025_Allied_Health_Therapy_Stewardship_Programme_AHTSP_Choosing_Referrals_Wisely.pdf