Mastering the Decision-Making Capacity Assessment: A Toolkit for Providers
Care Process & Redesign
Yishun Health One Improvement Festival
National Healthcare Group
2 April 2025
We aim to increase the rate at which decision-making capacity (DMC) assessments are performed independently by the referring. The introduction of a DMC toolkit led to cost and time savings for patients, improved quality of clinical care, and increased staff.
Year Submitted: 2025
Published Date: 02 April 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Cost Saving, Time Saving
About this Content
Aims
We aim to increase the rate at which decision-making capacity (DMC) assessments are performed independently by the referring inpatient team at Khoo Teck Puat Hospital from 0 to 20% over a year.
Background
Decision-making capacity (DMC) assessments can be performed by any healthcare professional, with guidance from the Mental Capacity Act. The project was initiated to empower referring teams in conducting their own DMC assessments.
Methods
A DMC toolkit was implemented in the inpatient setting. A DMC template was crafted and 4 Plan-Do-Study-Act (PDSA) cycles were carried out. Feedback from patients, psychiatrists, and doctors from other specialties was sought. The template was initially accessed on KTPH Intranet, then made available as a SmartPhrase when Epic was rolled out.
Results
There was a 0% to 43% increase in DMC assessments with quality documentation performed independently by the referring team from July 2023 to October 2024. The toolkit resulted in 100% complete documentation in accordance with the Mental Capacity Act.
Conclusion
The introduction of a DMC toolkit led to cost and time savings for patients, improved quality of clinical care, and increased staff productivity and well-being. These benefits have been sustained, and the toolkit can be easily introduced to other hospitals.
Lessons Learnt
The assessment rate dipped to 0% after the 2nd PDSA, possibly due to the switch to Epic in Nov 2023. Incorporating the DMC toolkit into Epic facilitated a smooth transition.
Additional Information
1. For every DMC referral performed by the referring inpatient team, the cost savings to the patient is $200, totaling $6000 savings from July 2023-October 2024. Time saved by the Psychiatry consultation-liaison team allowed for more timely and thorough reviews of other patients, equating to 30 man-hours saved. 2. The One Improvement Festival 2025 (Category C - Developing a Resilient & Sustainable Workforce) – Top 15 Finalists
Keywords
DMC, Toolkit, Assessments, Quality, Productivity, Savings
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Khoo Teck Puat Hospital, Ministry of Health Holdings |
Platform(s) | Yishun Health One Improvement Festival |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Psychiatry |
Project Lead(s) | Tay Yi Hang |
Project Member(s) | Tay Yi Hang |
Connect with this contributor!
KTPH & YCH Innovation & Improvement (I&I) Office - i-i@ktph.com.sg
Project Attachment
742_KTPH_OIF_2025_Mastering_the_Decision_Making_Capacity_Assessment_A_Toolkit_for_Providers.pdf