Improving Time to Sputum Collection for Respiratory Medicine Patients Isolated
Care Process & Redesign
National Healthcare Group Quality Improvement
National Healthcare Group
24 December 2025
To increase the timely collection of sputum samples from Respiratory Medicine patients in General Ward isolation beds with. The interventions show promise in improving the timely collection of sputum samples and reducing unnecessary isolation, thereby.
Year Submitted: 2025
Published Date: 24 December 2025
Tags: Care Process ＆ Redesign, Workflow Redesign, Cost Saving, Time Saving, Quality Improvement, Productivity, Access To Care, Waiting Time
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 in collection can prolong isolation unnecessarily, affecting individual patient outcomes and reducing isolation bed availability, straining hospital resources.
Methods
Interventions included creating a Smartphrase, a nursing workflow, and collaboration 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%. Patient isolation duration reduced from 96 hours to 76 hours, saving 95 isolation bed-days in one year, equating to $99,370 in monetary terms.
Conclusion
The interventions show promise in improving the timely collection of sputum samples and reducing unnecessary isolation, thereby improving patient outcomes and hospital resource utilization.
Lessons Learnt
True change comes when systems, practices, and culture are changed. Importance of multidisciplinary and multidepartment collaboration. The PDSA cycle is useful to come up with the most suitable interventions.
Keywords
Sputum Collection, Tuberculosis, Respiratory Medicine, Isolation
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) | Nursing, Medical |
Applicable Specialty or Discipline | Respiratory Therapy |
Project Lead(s) | Caroline Victoria Choong, Wang Xiao Na |
Project Member(s) | Mathew Sachin Philip |
Connect with this contributor!
Group Quality - nhggroup.QRM@nhghealth.com.sg