BetteR carE for severe community acquired pneumoniaA paTients in Hospital (BREATH)
Care Process & Redesign
Workforce Transformation
National Healthcare Group Quality Improvement
National Healthcare Group
31 December 2019
To reduce unplanned transfers of patients with severe community-acquired pneumonia (SCAP) from General Ward to ICU within 24. Objectivity in assessing pneumonia severity reduced delays, improved care, and achieved measurable cost savings.
Year Submitted: 2019
Published Date: 31 December 2019
Tags: Care Process ＆ Redesign, Workforce Transformation, Quality Improvement, Workflow Redesign, Clinical Practice Improvement, Value Based Care, Safe Care, Risk Management, Adverse Outcome Reduction, Productivity, Cost Saving, Job Redesign, Upskilling, Multi-Disciplinary
About this Content
Aims
To reduce unplanned transfers of patients with severe community-acquired pneumonia (SCAP) from General Ward to ICU within 24 hours of admission, from 12% to less than 5% in 6 months.
Background
SCAP has high mortality (20-50%). Delayed recognition and treatment increase ICU admissions. Early detection through objective data and protocols can reduce severity.
Methods
Provided guidance for ABG checks and PaO2/FiO2 ratios. Used IT triggers for Pneumonia Severity Index (PSI) scores and aligned thresholds for ICU admissions. Educated ED staff and implemented visual aids.
Results
Reduced unplanned ICU transfers from 12% to 0%. Estimated annual cost savings: SGD 72,000.
Conclusion
Objectivity in assessing pneumonia severity reduced delays, improved care, and achieved measurable cost savings.
Lessons Learnt
Multidisciplinary collaboration, IT integration, and education were critical to success. Small workflow changes resulted in significant impact.
Additional Information
Recipient of the 2019 NHG Quality Improvement Award (Merit).
Keywords
Clinical Improvement, Safe Care, Cost Savings, Multi-Disciplinary Care, Emergency Medicine, Pneumonia, Respiratory, ICU, IT Solutions
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | National Healthcare Group Quality Improvement |
Healthcare Professional Group(s) | Allied Health, Nursing, Medical |
Applicable Specialty or Discipline | Respiratory Therapy, Pulmonology, Epidemiology, Emergency Medicine, Intensive Care Medicine |
Project Lead(s) | Lew Jin Wen Sennen (Co-lead), Quek Yong Jing Daniel (Co-lead) |
Project Member(s) | Situ Wangmin Jacqueline |
Connect with this contributor!
Dr Quek Yong Jing Daniel - Daniel_yj_quek@ttsh.com.sg
Project Attachment
348_TTSH_NHG_QI_Award_2019_BetteRcarE4comm_acquired_pneumoniA_paaTients_in_Hospital_combine.pdf