Offering Transcranial Magnetic Stimulation to Eligible Patients with Treatment-Resistant Depression
Care Process & Redesign
Technology
Yishun Health One Improvement Festival
National Healthcare Group
3 April 2025
We aim to increase the rate at which transcranial magnetic stimulation (TMS) is offered to eligible patients at KTPH. We observed cost and time savings to patients and staff, and better quality of clinical care through effective and sustainable.
Year Submitted: 2025
Published Date: 03 April 2025
Tags: Quality Improvement, Cost Saving, Time Saving, Workflow Redesign, Care Process ＆ Redesign, Clinical Practice Improvement, Technology, Medtech
About this Content
Aims
We aim to increase the rate at which transcranial magnetic stimulation (TMS) is offered to eligible patients at KTPH Psychological Medicine from 15% to 60% over 6 months.
Background
More than 35% of patients do not respond to 2 trials of antidepressants, defined as treatment-resistant depression (TRD). TMS is a brain stimulation procedure that isevidence-based for TRD.
Methods
6 Plan-Do-Study-Act cycles addressed the top root causes on our Pareto chart. Adopted evidence-based, shorter TMS protocols that reduce time to remission from 6 weeks to 2-3weeks. Initiated a novel, nurse-led TMS Counselling Service.
Results
TMS is being offered to about 86% of eligible patients, a significant increase from 15%, following 6 PDSA cycles. 31% of eligible patients took up TMS, and 100% of those patients who took up TMS eventually completed the course. 69% reduction in depression rating scores for patients who completed the TMS course.
Conclusion
We observed cost and time savings to patients and staff, and better quality of clinical care through effective and sustainable interventions which can also be replicated in TMS clinics elsewhere.
Lessons Learnt
Regular email reminders and a revamped leaflet design and display in clinic were simple and effective strategies to remind psychiatrists to consider TMS. TMS video screened on loop in clinic waiting areas increased awareness.
Additional Information
The One Improvement Festival 2025 (Category E - Innovation in Healthcare) – Top 15 Finalists
Keywords
TMS, Depression, Psychiatry, TRD, Quality Improvement
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Khoo Teck Puat Hospital |
Platform(s) | Yishun Health One Improvement Festival |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Psychiatry |
Project Lead(s) | Tay Yi Hang |
Project Member(s) | Ng Kwee Hiang Carol |
Connect with this contributor!
KTPH & YCH Innovation & Improvement (I&I) Office - i-i@ktph.com.sg
Project Attachment
748_KTPH_OIF_2025_Offering_Transcranial_Magnetic_Stimulation_for_Treatment_Resistant.PDF