Tricia Chang
National Healthcare Group Polyclinics, Singapore
Posters & Accepted Abstracts: J Diabetes Res Endocrinol
The prevalence of Diabetes Mellitus in Singapore is 11.3% based on a National Health survey in 2010 and is increasing year on year. People with diabetes mellitus may be at risk of developing foot and eye problems. They should go for annual screening for the monitoring and identification of any changes in the patient�s foot riskstatus. A quality improvement project was carried out in 2016 aiming to achieve 80% Diabetic Foot screening (DFS) and Diabetic Retinal Photography (DRP) screening rates for empanelled patients in Ang Mo Kio Teamlet A within 6 months (by end Q3 2016) from the current (as of end Q4 2015) screening rates of 48% for DFS and 34% for DRP respectively. Implementation: Visual cues like patient education materials with photographs were utilised to explain to patients regarding potential complications. Efforts were also made to engage patient�s next-of-kin to encourage compliance. The Care coordinator of the team actively checked if DFS/DRP were done at other centers and highlighted to the Doctors and Care managers if patients were resistant to screening. Teamlet staff personally went through the DFS/DRP process to better empathize with patients. Timely referrals to the financial counselor, arrangements to pair with other services when making appointments and same-day transfer of suitable patients were also implemented. Results: Patients found materials useful and easy to understand and were more willing to undergo screening tests to avoid complications. Doctors and care managers developed a better understanding of the entire screening process and waiting time. Screening rates increased steadily each quarter and continues to increase after the project has ended. After 6 months, the DFS and DRP rates increased to 50 and 53% respectively. This also boosted the clinic�s overall screening rates to be one of the highest among all the other polyclinics in the same cluster. This translates to early detection of complications and timely referrals where needed.
Tricia Chang is a Family Physician under National Healthcare Group polyclinics. He is a graduate from Yong Loo Lin School of Medicine at National University of Singapore in 2008. He completed his Family Medicine Residency in 2014. He teaches for medical students and junior staff on top of clinical work. His main areas of interest is in Chronic disease management and women’s health.
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