The new SGH Emergency / NNI building on SGH Campus has welcomed its first tenants.

The hospital’s Acute Medical Ward (AMW), which is taking four floors of the building, moved into two of the floors in December 2024, with the other wards opening in the coming months. Housed in different buildings of the sprawling SGH complex before, the acute medical wards have been consolidated to operate in the same building as SGH’s other acute care services — the Emergency Department (ED) and stroke activation neurodiagnostic centre. (Emergency services still operate at SGH Block 1; the ED will only move into the new building later in the year.)

“AMW is designed to support the ED in receiving patients who need acute medical care but are not critically ill, to provide early assessment, diagnosis and treatment. It aims to improve patient journey in the hospital and facilitate early discharge,” said Dr Lim Wan Tin, Senior Consultant, Department of Internal Medicine, SGH.

The AMW offers subsidised multidisciplined care under senior doctors, nurses and allied health professionals to ensure timely decision-making, efficient care, and optimal patient outcomes. Simultaneously starting treatments, including rehabilitation, ensures earlier discharge for patients and and a faster bed turnover rate.

Siting the AMW in close proximity with the ED creates synergies and greater efficiencies through enhanced communications and collaborations. AMW care is under the purview of the Department of Internal Medicine (DIM), the largest medical speciality department in SGH. The department receives a wide range of medical patients with  undifferentiated medical conditions from ED, often presenting with varied symptoms, added Dr Lim.

Diagnostic tests are sometimes necessary, but they can involve long waits, which delay early diagnosis and hospital discharge. Dedicated imaging facilities at the new building, shared with the ED and NNI clinics, help fast-track essential diagnostic imaging. “Reaching an early diagnosis means an earlier  assessment of whether rehabilitation is needed. Under the AMW care model, there is improved ward processes, whereby a multidisciplinary team comprising nursing, allied health, pharmacist, social worker, and patient navigators (ward nurses who facilitate and coordinate patients’ discharge plans) work together concurrently to help patient recover faster and to be discharged back home,” said Ms Hartini Osman, Assistant Director, Nursing, SGH.

Processes have been improved and streamlined to waste as little time and resources as possible since the AMW began in 2015 as a pilot project, said Dr Lim, who leads the team in planning and carrying out the service. Staff, for instance, are trained in acute care protocols, communications, and handling high-pressure situations to promote a healthy, supportive work environment. “With an increasingly aged population, with its higher clinical care complexities, the AMW has morphed to meet the challenges of catering to the individual needs of each patient. Patients who need longer treatment for subacute to chronic care will be transferred out of AMW to the general wards or discharged home to receive further care through programmes like SGH@Home or Hospital-to-Home (H2H),” said Dr Tharmmambal Balakrishnan, Senior Consultant, Department of Internal Medicine, SGH. SGH@Home offers round-the-clock telemedicine access to the SGH medical teams, while H2H’s structured care plans include home visits by multidisciplinary medical teams.

Caregivers are another key feature of AMW care to ensure patients get the same level of care at home. With the larger space in the new building, caregivers are encouraged to stay with patients in the AMW on admission and work alongside nurses and therapists on rudimentary patient care. They learn to feed patients food and medicine, help them with simple exercises, and the proper way of showering and transferring to and from bed to chairs. Patients, too, play their part by taking ownership of their own health. With their caregivers, they are encouraged to walk around the ward, or to sit up in their beds to do exercises to increase their mobility. “We want to empower  caregivers to provide the same level of care that the patient receives in hospital when he returns home. We facilitate the caregiver’s involvement in caring for the patient as soon as they are admitted,” said Ms Hartini.

The hospital is able to offer this service with the larger space available in the new building. Besides dedicated imaging facilities, the new building also has a discharge pharmacy on the first floor, providing greater convenience for patients and caregivers to obtain their discharge medications and medication counselling.