Patient centricity and teamwork in an organisation

Find out how Singapore’s National Healthcare Group Polyclinics ensures good clinical outcomes for its patients.

The National Healthcare Group Polyclinics (NHGP) is a primary healthcare service provider that is faced with a high volume of patients daily, each with different needs. Given the high patient load, it is possible for healthcare personnel to view things with a single dimension that is – seeing patients as statistics and as workload. This viewpoint can de-humanise patients, making some staff view service initiatives as a superficial effort that could be just about exchanging pleasantries with patients and nothing more.

It was thus a challenge to ensure that every patient receives holistic and efficient clinical care that is delivered, with sincere concern and empathy. NHGP also needed to provide our patients with a good and genuinely caring experience. It is not easy to constantly meet these challenges but NHGP has started to take its first steps via a transformational journey which aims to change every employee’s mindset through its culture programme.

Embedding Values for Change

To break away from old ways of thinking and move more towards patient-centricity, NHGP sought better processes to optimise our resources, help us to function efficiently and ensure good clinical outcomes for our patients. While many organisations rely on various service initiatives, quality improvement projects, and key performance indicators (KPI) to motivate staff to provide better services and improve work processes, NHGP management believed that it was more important to engage their staff holistically through a values framework.

“We needed to constantly remind our staff of their purpose of joining the healthcare sector. Most people, if not all, join the sector because they wanted to care for others. Somehow, people forgot about it along the way due to the heavy workload. Our corporate culture called the Culture DNA, reminds staff that, good care could not be about complying with the company’s rules or meeting KPIs; it has to stem from an innate desire to look beyond personal agenda and boundaries, and take initiatives to do what is right and empower others instead of serving one’s own interest. This sustains the meaning at work,” explained Mr Simon Tan, Director of Human Resource and Finance at NHGP.

This is a system of thinking that encourages staff to put others first, focus on relationships, and emphasises the ‘right’ outcomes and results, which may not be of the usual statistical variety. It encourages employees to base their decisions from a perspective that puts another person first and to design work processes to meet their needs. NHGP calls this the ‘Way of Being’ (WOB) which is an overarching framework to encourage its staff to ‘see people as people’, putting themselves in another’s shoes.

NHGP’s senior management team takes an active lead in this transformation journey. 16 of them, including senior staff like its Chief Executive Officer (CEO), Mr Leong Yew Meng, personally train NHGP’s staff through the WOB workshop programme. Mr Leong Yew Meng adds, “The difference starts from us, inwardly. To see everyone we meet (be it a patient or co-worker) as an individual with different needs and challenges, and to pause a moment so as to understand their behaviour instead of being judgmental. This helps us to take ownership and rise above our challenges to help them.”

Today, most, if not all of NHGP’s staff has attended the culture workshop programme. All new and existing staff are introduced to the key concepts of our culture during orientation with NHGP’s CEO or at staff engagement sessions. To better the service for every patient, all service staff have also undergone training in the service framework called iCARE, which reminds them to be Confident, Attentive, Respectful, and Empathetic. Every clinic also has a network of iCARE service leaders and ambassadors, who encourage staff to keep practising NHGP’s key service principles.

Embracing values for patient-centricity and teamwork, naturally leads to the next pillar of NHGP’s Culture DNA, known as OurCare. Through OurCare, teams are inspired to implement Work Improvement Projects to do better for our patients and their co-workers. Some projects have explored how patient information can be shared with the next clinician better, improving workflows between colleagues and bettering outcomes for the patient. Others focus on how we can improve a clinic visit for the patient, making each visit pleasanter and more effective. The number of such projects within NHGP has grown by over 50% in just one year, from 55 in 2011 to 87 in 2012.

NHGP management also embarks on monthly walkabouts in clinics to look at issues ranging from service to safety and improving operations. During each visit, service “stars” are recognised and quality efforts encouraged as they are spotted in action or practise.

Mr Leong and his team also visit the nine polyclinics to conduct lunchtime talks for staff, to share plans, insights and stories to inspire staff. These serve to constantly energise staff in making a difference to every patient. Staff stories are also shared through a culture newsletter, where trainers give tips and staff contribute their own experiences in practicing NHGP’s Way of Being to encourage each other. NHGP also celebrated its Culture DNA Days, on 31 October 2012, and 5 September 2013 where recognition was given to staff who have consistently improved our care either through great service or process improvement.

Resonating Values

The NHGP Culture Transformation programme has resonated well with its staff’s internal values, and helped them realise their desire to contribute effectively as a team and help patients. Through these efforts, NHGP has improved in its Employees’ Climate Surveys (ECS) and Patient Satisfaction Surveys. In its ECS conducted in early 2013, overall staff rating for the organisation went up by five percentage points to 72%. This is a testament that the organisation is moving in the right direction. Good care also touches the hearts of patients as evidenced in NHGP’s score of 82.2% in the Ministry Of Health’s Patient Satisfaction Survey in 2012. This is an improvement of about 2% from the last survey in 2010.

NHGP understands that this is a long-term journey and management continues to share culture principles among staff. As NHGP keeps pressing ahead, it hopes to touch the lives of even more patients and staff.