Keeping Gout in the Community Reducing admissions for Gout
Care Process & Redesign
National Healthcare Innovation and Productivity Medals
SingHealth
29 January 2026
To reduce the % admission for SKH ED attendances for acute simple gout from 18.1% to ~10% within 12 months. Reduction of admissions for acute gout flare leads to significant cost savings and other benefits for the institution.
Year Submitted: 2025
Published Date: 29 January 2026
Tags: Cost Saving, Clinical Practice Improvement, Care Process ＆ Redesign, Quality Improvement, Productivity
About this Content
Aims
To reduce the % admission for SKH ED attendances for acute simple gout from 18.1% to ~10% within 12 months.
Background
Gout is the most common inflammatory arthritis caused by chronic build-up of uric acid crystals in the joints. It is characterized by unpredictable, intermittent, and excruciating pain and swelling in affected joints. Global prevalence ranges from 0.12% to 11.7%, and 4.1% in Singapore. The burden of gout in Singapore is significant and expected to increase over time.
Methods
PDSA cycles were conducted focusing on co-developing a clinical management protocol through multi-disciplinary-team discussions involving ED & Rheumatology doctors.
Interventions included standardized clinical management protocol and education/CME to HCP.
Results
The % admission of SKH ED attendances for acute simple gout was reduced from 18.1% to 11.1%, amounting to $63,000 of hospital-stay savings per annum.
Conclusion
Reduction of admissions for acute gout flare leads to significant cost savings and other benefits for the institution.
Lessons Learnt
Feedback revealed a general lack of awareness of the protocol amongst ED colleagues. Structured teaching efforts and roll-out of the protocol were extended to other major stakeholders.
Additional Information
Further PDSA cycles planned include modifying the current Gout Orderset to standardize management, standardizing discharge packages, and early-access Virtual Gout Clinic.
Keywords
Gout, Rheumatology, Cost Savings, Clinical Management
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth |
Organization(s) Involved | Sengkang General Hospital |
Platform(s) | National Healthcare Innovation and Productivity Medals |
Healthcare Professional Group(s) | Allied Health |
Applicable Specialty or Discipline | Rheumatology |
Project Lead(s) | Chuah Tyng Yu |
Project Member(s) | Stanley Angkodjojo |
Connect with this contributor!
Dr Chuah Tyng Yu - Chuah.tyng.yu@singhealth.com.sg
Project Attachment
1027_SKG_NHIP_2024_Keeping_Gout_in_the_Community_Reducing_admissions_for_Gout.pdf