Ground-up innovations revolutionise healthcare at a Singapore hospital

Singapore’s Tan Tock Seng Hospital fosters a spirit of innovation among its staff, helping them to create new tools and approaches to improve patient care and their own efficiency.

29 August 2022

Innovation as we think of it today is often accompanied by a revolution – an upheaval of the status quo to create something smarter, more efficient and faster. Pfizer-BioNTech’s Covid-19 messenger mRNA vaccine was one such example of healthcare innovation, the first mRNA vaccine authorised for use by the U.S. Food and Drug Administration, which demonstrated 95 per cent efficacy in clinical trials.

MRNA technology offers exciting possibilities, including the faster development of vaccines, and vaccines that are more adaptable to virus variants, according to the US Centres for Disease Control and Prevention.

Yet what seemed to be an invention birthed within a few months had actually been in the works for decades. Research on mRNA drugs dates from the 1960s, but limited knowledge and tools to put the technology to work impeded their development. Over time, advances in nanotechnology and medical research made mRNA technology viable for the development of vaccines, for which Covid-19 served as a catalyst.

It’s that kind of innovation that Tan Tock Seng Hospital hopes to instil in all its staff, devising new ways to improve patient care and improve efficiency.

Ideas come to life

Inside Tan Tock Seng Hospital’s compound is a room with always-open doors that resembles a workshop more than other clinical spaces. Tools line the walls, 3D printers take centre stage, and numerous inventions lie scattered across the room. The Centre for Healthcare Innovation Living Lab, or Chill, as it’s more commonly referred to, is a lab created to help healthcare professionals bring the ideas they have to life, and to equip them with the knowledge and skills to do so.

Before Chill opened, staff with bright ideas were on their own when it came to bringing their innovative healthcare ideas to life, which often resulted in such ideas being shelved as they were otherwise preoccupied with day-to-day work.

Those staff that somehow found the time to work on their ideas would have to source and secure funding for vendors themselves, after which they could end up with a product that fell short as they lacked certain knowledge, says Lynette Ong, Tan Tock Seng Hospital’s Director of Transformation.

Chill fills that gap by working with staff to curate their ideas, develop prototypes, and partner with vendors to create finished products. Since it opened in 2019, many ideas have been explored there, many of which have come to fruition and are used throughout the hospital today.

Unlikely inspirations

“Sometimes, to solve a problem, we have to think of creative ways,” Ong says, a process that involves looking for ideas and inspiration beyond the hospital.

One such invention helped to solve a persistent pain point that speech therapists and nurses faced – tracheostomy patients who were missing their speaking valves. The valves enable those patients, who have had an opening created at the front of their necks to help them breathe, to talk.

The valves are loosely fitted to the patient for their safety so they can be removed easily in the event of choking. However, the loose fit means that whenever patients cough or make sudden movements, they can become dislodged, with many going missing as a result.

A speech therapist who identified the problem brought the problem to the attention of Chill, which worked with staff to devise a solution. Although many ideas were brought up, the eventual solution came from an unlikely source: babies who spat their pacifiers.

Chill worked to create a strap that could be buttoned onto the patients’ pyjamas so even if a speaking valve became dislodged, it would still be attached to their clothing. Since the straps have been used, there have been no reports of missing speaking valves at the hospital, says Chua Jia Xiang, a Principal Service Designer in the hospital’s Division of Transformation.

Covid as a catalyst

As healthcare workers battled on the frontlines during the Covid-19 pandemic, Chill played a key supporting role in creating new innovations that helped them.

A major challenge faced by healthcare workers worldwide has involved face shields, which were not created for all-day use, causing problems such as pressure injuries and dizziness thanks to visual distortion.

“There were healthcare workers who complained that they vomited while wearing the face shield for prolonged periods of time,” Ong says.

With time and materials in short supply, some creativity was needed to solve the problem. “We needed to come up with something that was clear, comfortable, affordable, and diversified some of the supply chain issues in Singapore,” Chua says.

The team worked tirelessly on this project and within a month, managed to launch a pilot with three manufacturers. Chill soon offered face shields catering to staff who wore spectacles and those who didn’t.

The final product was a square-shaped face shield that abandoned the curved design of its predecessors. The angular shape mitigated the refraction of light through the visor, preventing episodes of dizziness.

Additionally, the new design made use of 3D printing technology so that the entire face shield was made with a single piece of plastic, allowing healthcare workers to clean and disinfect the shields more easily as there were no grooves or joints.

The two face shields went on to be distributed to other hospitals in Singapore, and were used at the National Centre for Infectious Diseases, which was at the forefront of Singapore’s efforts to manage Covid-19. They were later distributed to community hospitals and nursing homes across the country.

This new invention even turned out to cost less than traditional face shields, Chua says.

This innovation helped Chill scoop an Exemplary Innovator Award at the Singapore government’s Covid Public Sector Transformation Awards Ceremony earlier this year.

Human-centric

Chill takes a human-centred approach towards innovation that seeks to understand and solve everyday, practical needs. Its approach is also reflected by the Living Lab, which seeks to bridge the gap between problems and ideas, and between ideas and reality.

One way it does so is through workshops held throughout the year. The lab runs basic prototyping workshops to help staff build industry terminology and knowledge so that they can better communicate what they would like to create to outside vendors, Chua says.

For instance, staff can attend 3D printing workshops to better understand different types of 3D printing and what they can be used for. When designing a prototype for an idea, they will then have a better idea of which type of printing to use and will be able to inform vendors accordingly.

Chill also organises design classes led by experts who share their knowledge of design philosophies and considerations. One recent workshop focused on teaching participants how to choose materials that were not only suitable for the job but also sustainable, Ong says.

In addition to workshops, fostering a culture of healthcare innovation at Tan Tock Seng Hospital starts with relationships, according to Ong, adding that Chill builds an environment of trust through its open-door policy.

“We don’t see it as just a project,” Ong says. “We see it as a capability-building opportunity and an opportunity to understand our colleagues better.”

The Chill team hopes that one day, it will be able to “disappear from the organisation”, Chua says. Ong echoes that sentiment, adding that she hopes to instil creativity and capability in every staff member at Tan Tock Seng Hospital and beyond so healthcare workers will one day be able to translate their ideas into reality all on their own.

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