[AVBC 2025] Implementation of Peritoneal Dialysis Services in a Community Hospital: A Nurse-Led VBC Approach
Care Process & Redesign
Workforce Transformation
Appropriate & Value-based Care Conference
SingHealth
5 December 2025
This nurse-led initiative aimed to evaluate the implementation, outcomes, and value-based care metrics of a PD service at. Right-siting enabled patients to receive care closer to home and benefit from rehabilitation services.
Year Submitted: 2025
Published Date: 05 December 2025
Tags: Care Process ＆ Redesign, Workforce Transformation, Productivity, Cost Saving, Workflow Redesign, Quality Improvement, Access To Care, Readmission Rate, Value Based Care, Patient Satisfaction, Job Redesign, Upskilling
About this Content
Aims
This nurse-led initiative aimed to evaluate the implementation, outcomes, and value-based care metrics of a PD service at Outram Community Hospital in collaboration with Singapore General Hospital.
Background
Transitioning peritoneal dialysis (PD) patients from acute hospitals to community care remains a healthcare challenge in Singapore, impacting both costs and outcomes.
Methods
A quality improvement project was conducted from July 2022 to December 2024. The intervention included structured training for 16 nurses, development of clinical protocols, and the setup of a support system involving Advanced Practice Nurses (APNs). Key outcomes measured included patient volume, peritonitis and exit site infection rates, service capacity, healthcare resource utilization, readmission to acute hospitals, staff competency, and sustainability.
Results
Since implementation in March 2023, the program achieved positive outcomes. The service successfully managed 32 PD patients with zero cases of peritonitis and exit site infection. Operational efficiency improved with service capacity expanding from 2 to 5 concurrent patients by 2025. A sustainable nurse-led workforce was established, including 4 trained champions. The initiative reduced acute hospital stay, enhanced healthcare resource use, improved patient satisfaction, and achieved zero readmissions for PD-related conditions.
Lessons Learnt
Right-siting enabled patients to receive care closer to home and benefit from rehabilitation services. APNs played a vital role in clinical oversight, digital platform reviews, and coordination with hospital-based specialists, ensuring continuity of care.
Keywords
Peritoneal Dialysis, Community Care, Nurse-Led, Value-Based Care, Rehabilitation
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth |
Organization(s) Involved | Singhealth Community Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Nephrology, Rehabilitation Therapy |
Project Lead(s) | Chua Chiou Hann |
Project Member(s) | Chua Chiou Hann |
Connect with this contributor!
Chua Chiou Hann - chua.chiou.hann@singhealthch.com.sg