[AVBC 2025] Appropriate care at end-of-life (AptEOL): A value-driven multidisciplinary approach at NCIS
Care Continuum
Care Process & Redesign
Appropriate & Value-based Care Conference
SingHealth
21 November 2025
To explore a value-driven, multidisciplinary approach to improve end-of-life (EOL) care by fostering collaboration across. AptEOL demonstrates that a multidisciplinary approach for EOL patients can reduce healthcare utilization and generate tangible savings.
Year Submitted: 2025
Published Date: 21 November 2025
Tags: Care Continuum, Care Process ＆ Redesign, End-Of-Life Care, Palliative Care, Quality Of Life, Productivity, Cost Saving, Time Saving, Quality Improvement, Workflow Redesign
About this Content
Aims
To explore a value-driven, multidisciplinary approach to improve end-of-life (EOL) care by fostering collaboration across healthcare teams to ensure that care aligns with patients' goals of care, promoting more effective and compassionate decision-making.
Background
Cancer patients at the End-of-Life (EOL) are often subjected to interventions that do not improve quality of life. Current ward practices lack a team-based approach to identify EOL patients and de-escalate non-beneficial practices.
Methods
The AptEOL was conducted in a 44-bed haematology-oncology ward in an acute tertiary hospital in Singapore from October 2024. Post-implementation audits were performed to quantify time saved for nurses, cost savings for patients and the healthcare system, with no impact on predicted prognosis.
Results
Implementation of AptEOL resulted in decreased non-beneficial interventions and lower healthcare resource utilization. 33 patients were enrolled in the AptEOL pathway with comfort care measures. 100% deprescribing for lipid-lowering medications and vitamins/minerals/supplements, 33.3% deprescribing for anti-ulcer medications. 2.27 outpatient appointments saved per patient, 75 outpatient appointments saved in total. Increased nurse satisfaction with 100% reporting increased sense of empowerment and focus on patient well-being.
Conclusion
AptEOL demonstrates that a multidisciplinary approach for EOL patients can reduce healthcare utilization and generate tangible savings.
Lessons Learnt
The initiative demonstrates that a multidisciplinary approach for EOL patients can reduce healthcare utilization and generate tangible savings. This initiative is being expanded to additional cancer wards and may be applicable to non-cancer patients.
Keywords
AptEOL, Comfort Care, Deprescribing, Oncology, Nursing Workload, Cost Savings
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth |
Organization(s) Involved | National University Cancer Institute, Singapore |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Oncology, Palliative Medicine |
Project Lead(s) | Wang Yanjun |
Project Member(s) | Liu Hon Jin |
Connect with this contributor!
Wang Yanjun - wang_yan_jun@nuhs.edu.sg