170 Building QI capability in primary care network Singapore: improving patient care in primary care setting
Year: 2025
Type: conference-paper
Abstract: Introduction Singapore’s healthcare system faces increasing pressure due to an aging population and chronic disease burden. It is projected that by 2030, one in four Singaporeans will be 65 or older with increasing healthcare needs. To address these needs, Ministry of Health Singapore embarked on a multi-year strategy - Healthier SG 1 to take a life course approach to drive population health. One of the key pillars, is in transforming primary care, activating networks of family physicians and reorganising care delivery. To support this care transformation, the National Improvement Unit (NIU)2 developed the QI Project Consult programme with 11 primary care networks (PCNs) made up of more than 700 clinics,3 to improve preventive and chronic diseases management to operationalise the Healthier SG strategy.Methods The QI Project Consult Programme was designed to foster collaboration, knowledge-sharing, and systematic improvements within the participating PCNs. The programme utilised the Model for Improvement 4 framework and included tailored quality improvement workshops (figure1) for PCN teams, where they developed a theory of change, outlining their desired outcomes and identifying areas for testing through small Plan-Do-Study-Act (PDSA) cycles. Before commencement, baseline data on the performance of the PCNs was collected to assess the current state of chronic care management and preventive health measures. Based on the data, each team identified specific indicators in chronic disease management, vaccination and screening rates that they would work on. Over the six-month programme, the teams engaged in monthly coaching sessions with improvement advisors from NIU. These coaching sessions were designed to provide ongoing guidance and support, helping teams refine their improvement processes. Storyboards, which outlined each team’s QI journey, were shared across various platforms to garner buy-in from early adopters and encourage others to adopt similar change initiatives.Abstract 170 Figure 1Topics included in customised quality improvement workshopResults The programme started with six project teams working with 63 participating clinics on one the following: management of diabetes mellitus, obesity, influenzas vaccination rate, Diabetic foot and eye screening rate. Significant gains in process effectiveness, team capacity, and patient outcomes were reported. Self-reported pre and post measures on QI capability shows an increase from 4.5 to 7.5 on a 10-point scale. To highlight the results from one of the teams working on Diabetic foot and eye screening rate, there was an increase of 28% (from a median of 64 to 82) and 51% (from a median of 49 to 74) respectively (figure 2). Qualitative feedback from the project teams acknowledged that time, resource and data availability continued to pose challenges that slowed the momentum and dampened their will to persevere. There was also a request to extend the six-month programme to 12 months to provide ongoing coaching and support for their improvement efforts. With the preliminary results, NIU learned that a platform for sharing of QI knowledge and best practices is pivotal to sustain improvement work and established its first Improvers Network SingaPore, Community of pRacticE (INSpire) in November 2024 to include the PCN teams and improvers from other public healthcare institutions as a community of practice to share best practices and encourage network learning.Abstract 170 Figure 2Run chart on number of diabetic foot and eye screeningReferences The White Paper on Healthier SG. www.healthiersg.gov.sg. [cited 2022 Sep 25]. Available from: https://www.healthiersg.gov.sg/resources/white-paper/ National Improvement Unit. MOH Office for Healthcare Transformation. 2025 [cited 2025 Mar 23]. Available from: https://moht.com.sg/our-programmes/national-improvement-unit/ Abdullah Z. 712 GP clinics have joined Healthier SG so far: Health Minister Ong Ye Kung. The Straits Times. 2023 Apr 5 [cited 2023 Nov 1]; Available from: https://www.straitstimes.com/singapore/health/712-gp-clinics-have-joined-healthier-sg-so-far-ong-ye-kung Langley GJ, Moen RD, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide. John Wiley & Sons; 2009.
Authors: SG Priya Francis, Eunice Wong
Institution: Ministry of Health
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4410523748