[AVBC 2025] Improving Time to Sputum Collection for Respiratory Medicine Patients Isolated for Suspected...
Care Process & Redesign
Appropriate & Value-based Care Conference
National Healthcare Group
6 November 2025
To increase the timely collection of sputum samples from Respiratory Medicine patients in General Ward isolation beds with. The interventions show promise for improving the timely collection of sputum samples and reducing unnecessary isolation, thereby.
Year Submitted: 2025
Published Date: 06 November 2025
Tags: Care Process ＆ Redesign, Workflow Redesign, Quality Improvement
About this Content
Aims
To increase the timely collection of sputum samples from Respiratory Medicine patients in General Ward isolation beds with suspected pulmonary tuberculosis from 14% to 60% (stretch goal 80%) in 6 months.
Background
Pulmonary Tuberculosis (PTB) is an airborne disease. Inpatients with suspected PTB are isolated until 2 sputum samples are collected. Timely sputum collection enables early diagnosis and treatment for TB cases, or prompt deisolation for non-TB cases. Delays can prolong isolation unnecessarily, affecting outcomes, bed availability, and hospital resources.
Methods
Interventions included creating a Smartphrase, creating a nursing workflow, and collaborating with the Emergency Department to improve the upstream process and collect sputum prior to admission.
Results
The percentage of patients with the 2nd sputum collected within 24 hours increased from a pre-intervention median of 14% to a post-intervention median of 40%, with a goal of 60%. Patient isolation duration reduced from 96 hours to 76 hours, saving 95 isolation bed-days and $99,370 in monetary terms.
Conclusion
The interventions show promise for improving the timely collection of sputum samples and reducing unnecessary isolation, thereby improving patient care and hospital resource utilization.
Lessons Learnt
True change comes when systems, practices, and culture are changed. Change is never easy, but even simple interventions can make a difference to hospital bed wait time and speed up patient care. The importance of multidisciplinary and multidepartment collaboration was highlighted. The PDSA cycle is useful to come up with the most suitable interventions.
Additional Information
Strategies for sustaining the improvements include working with EPIC to build collection instructions into an order set, creating a nursing workflow and formalizing a work instruction, and focusing on ED sputum collection with posters in different languages and instructional videos.
Keywords
Tuberculosis, Isolation, Specimen Collection
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) | Medical, Nursing |
Applicable Specialty or Discipline | Pulmonology |
Project Lead(s) | Caroline Choong |
Project Member(s) | Wang Xiao Na |
Connect with this contributor!
Caroline Choong - caroline.v.choong@nhghealth.com.sg