Overview
Some of NUH's progress in clinical outcomes are :
Cataract
Phacoemulsification (PE) is currently the most commonly performed cataract surgery over other techniques. In NUH, the success rate measured as Best Corrected Visual Acuity (BCVA) of 6/12 or better within the third month after operation is 99.6%. Our excellent safety and success rates are comparable to those of international rates.
read more
Childhood Leukaemia
Leukaemia is a cancer of the white blood cells. It is the most common form of childhood cancer and accounts for 4 out of every 10 children diagnosed with cancer in Singapore every year. Acute childhood leukemias are divided into 2 types:
1. Acute Lymphocytic Leukaemia (ALL)
- NUH has implemented a series of new ALL protocols since 1988
- Resulted in constantly improving cure rates (5 year event-free survival of 62% in 1988-1996, 80% in 1997-2002)
- The latest highly successful multi-centre Ma-Spore ALL 2003 study driven by NUH features personalized therapy where each patient has the intensity of therapy adjusted carefully based on his early response to therapy. The projected 5-year event-free survival of Ma-Spore ALL 2003 study in NUH site is 84%. This is remarkable as 1 out of every 3 child received reduced therapy based on this new regimen.
2. Acute Myelogenous Leukaemia (AML)
- NUH's AML treatment protocols have a shorter timeframe of treatment than conventional ones (5 months instead of 2 years)
- The Ma-Spore AML 2006 study led by NUH is a multi-centre study
- Compared to conventional treatments, it also has a significantly better 3-year disease-free survival (60% vs 31%)
- Patients on this protocol are also more likely to produce a complete remission than the patients not on this protocol
read more
Chronic Obstructive Pulmonary Disease (COPD)
Due to the careful and comprehensive management of COPD patients, NUH has had a progressive and significant decrease in the length of stays (LOS), mortality and intubation rates over the past 8 years. From April 2008 to September 2009, the average length of stay for a COPD patient was 4.1 days and the mortality rate was 2.5%, down from 6 days and 6% respectively in the year 2001. Recent audits of COPD management in UK and US hospitals reported an average LOS of 8.7 and 5.3 days and mortality of 7.4% and 4.4% respectively. Using the St Georges' Respiratory Questionnaire, NUH patients with severe and very severe COPD have also seen an improvement in their quality of life over time.
read more
Computed Tomography (CT) Planning for Radiation Therapy
The success of cancer treatment using radiotherapy (RT) is very dependent on the accuracy and quality of the design and delivery of the radiation beam. All radiation treatment plans depend on patient characteristics and are individualized. Three dimensional (3D) conformal RT and intensity modulated radiation therapy (IMRT) are contemporary methods of delivering accurate treatment, and both rely on CT simulation scans and planning prior to treatment. CT planning, while resource intensive, can improve the quality of radiation therapy delivery by allowing the radiation oncology team to visualize body structures in three dimensions. This technology can be applicable for the majority of cancer sites, especially breast, lung, gastro-intestinal and CNS tumours. In NUH, the rate of CT planning is currently 100%, exceeding international benchmarks set by organisations such as the Australian Council of Healthcare Standards (ACHS). This suggests that the quality of radiation therapy at the National University Cancer Institute Singapore (NCIS) is comparable to other major centres worldwide.
read more
ERCP and Upper GI Bleeding
Despite being a tertiary endoscopy centre and having a higher percentage of complicated cases, NUH still managed to achieve a low mortality rate of 10% for patients with upper gastrointestinal bleeding. This is as low as the international standards reported in the American Journal of Gastroenterology. Our low rate of mortality is related to a dedicated multidisciplinary team comprising of doctors from departments of Emergency, General Surgery, and Gastroenterology, and nurses at operating theatre and Endoscopy Centre.
read more about ERCP's clinical outcome
read more about Upper GI Bleeding's clinical outcome
Gastric Cancer
According to the US National Cancer Institute (NCI), approximately 760,000 cases of stomach cancer are diagnosed worldwide and it is the second leading cause of cancer-related deaths. Thanks to its excellent multidisciplinary treatments, NUH has managed to improve the survival rates of its gastric cancer patients. The proportion of patients with high-risk stomach cancer (Stage II-IV) who are alive at 2 years after surgery and chemo-radiotherapy in NUH is 69.4%. This fares well against the 60.0% reported by the US Intergroup 0116 Study and 40.5% in an Australian multicentre study report.
Hospital-wide Indicators
The Ministry of Health (MOH) has initiated monitoring of several Clinical Quality Indicators based on the Maryland Hospital Association (MHA) Quality Indicator Project (MQIP) and Centre for Performance Sciences (CPS) Quality Indicator Quality Indicator Project since July 1998. At present, NUH monitors 11 hospital-wide clinical quality indicators under the QIP programme.
* Unscheduled ICU Returns
NUH has successfully reduced its unscheduled returns to ICU rates from 7.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.36% to 2.78% in the last four years. NUH current rate is also lower than the average rates in Singapore and in the QIP programme to lower unscheduled returns to ICU. Click here for more details.
* Ventilator-Associated Pneumonia
NUH has decreased its VAP rates from 4.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.dbo.39 per thousand to 0 per thousand in the Coronary Care Units (CCU). This result is also lower than the average rates of other hospitals and teaching hospitals under this same programme Quality Improvement Programme (QIP) to lower Ventilator- Associated Pneumonia. Click here for more details.
read more
Liver Transplant
NUH is the national tertiary referral centre for patients with complicated or severe liver diseases and has performed more than 100 liver transplants. Our 5-year survival is 78%, which is better than international standards (According to the The Organ Procurement and Transplantation Network, the 5-year survival for non-emergency transplant in the U.S. was 68-86%).
read more
MRSA
NUH conducts MRSA surveillance to monitor healthcare-associated MRSA transmission. We develop and promote evidence-based infection control strategies to reduce transmission of MRSA through prevention projects. These projects target various patient populations, which include patients from the orthopaedic and surgical disciplines, as well as the intensive care units (ICUs).
read more
Nasopharynx Cancer
Cancer of the Nasopharynx (NPC) is sixth most frequent cancer affecting Singaporean men occurring at an incidence of 10.8 per 100,000 men per year. It is a cancer that affects younger Singaporeans mostly between 40-65 years of age. The most important immediate outcome of NPC treatment is control of the cancer at the initial primary site the back of the nose. Hence, local control of the NPC is used as a clinical quality indicator at the National University Cancer Institute, Singapore. Our results have shown improvement from 93% to 96% at 2 years after therapy over the last 4 years. These results are also comparable to the major US centres in San Francisco and New York.
read more
Stroke
Stroke is a common clinical condition and the most common cause of disability in adults in Singapore. Optimal outcomes are dependent not only on facilities and skilled staff, but on a multidisciplinary approach for its management. The dedicated multidisciplinary team at NUH includes neurologists, neurosurgeons, emergency physicians, radiologists, rehabilitation physicians, nurses, physiotherapists, occupational therapists, speech therapists, medical social workers, pharmacists, case managers and stroke nurse educators.
read more
Surgical Site Infections
Advances have been made through the years on infection control practices. However, despite these practices, surgical site infections (SSIs) remain a concern among healthcare institutions. This section aims to show the trends in clinical quality outcomes of the hospital with regards to surgical site infections. From these data we take note, analyse, and implement processes and procedures to better improve our patient outcomes.
* Hip Arthroplasty
Hip arthroplasty or hip replacement is an orthopaedic surgical procedure in which the diseased parts of the hip joint are removed and replaced with artificial parts or prostheses. It can be a total hip arthroplasty (THA) or a hemi-arthroplasty. THA involves the replacement of both the head and neck of the thigh bone (femur), and the inner surface of the hip socket (acetabulum). Hemi-arthroplasty replaces only the head portion of the femur. Click here for more details.
back to Quality Measures to read about other excellent clinical outcomes
|
