This Allied Health Professionals (AHPs) Day, learn how AHPs from Changi General Hospital (CGH) make holistic and quality care possible from hospital to home. Collectively, they contribute their expertise — from diagnosis and treatment to rehabilitation in a multi-disciplinary care team — and formulate solutions with patients and caregivers on their journeys to recovery at our Caring General Hospital.
Debunking the dietetic practice
In the course of her daily work, Dietitian Amanda Lim does rounds in the wards or outpatient clinics to review patients and provides dietary assessment and interventions for various health-related reasons such as diabetes, cancer or surgeries. CGH’s dietitians offer counselling on food and drink choices and nutrition support to help patients achieve desirable health outcomes for both acute and chronic diseases.
In adopting a multi-disciplinary approach, dietitians discuss nutrition care plans with doctors and nurses, allowing for medical nutrition therapy to complement medical treatment. They also work with medical social workers, advising patients to maximise their nutrition intake within their budget. “The assessment often goes beyond the diet,” Ms Lim explains. “We take into consideration additional factors such as patients’ clinical and psychosocial conditions in order to prescribe the best nutrition therapy.” Interventions usually involve diet counselling, motivating positive lifestyle changes or prescribing oral or enteral (intestinal) nutritional supplements for those with increased needs.
Dietitians also work closely with the hospital’s Food Services in developing menus for patients and refreshing these regularly. For example, they perform nutrient analyses of menus to ensure that the food prepared mirrors the customised nutrition advice provided to patients with specific diets. Just how closely do they work together? "CGH is one of the few hospitals with Dietetics and Food Services under one department — in fact, our office is nestled right next to the kitchen!" quips Ms Lim.
Seeing patients eating and recovering well is crucial to Ms Lim. Recounting an experience with a patient with pancreatic cancer who required multiple insulin injections for his diabetes, Ms Lim realised that he was struggling with the management of his blood sugar levels. She helped him troubleshoot his diet, and worked with a diabetes nurse educator to measure and adjust his insulin dosage to match his oral intake. “At the end of the consultation, he heaved a sigh of relief with a large smile on his face as he thanked me for helping him,” she shares. “Hearing him say ‘thank you, you have taught me a lot’ reminds me of the responsibility I carry as a dietitian.”
Dispensing more than medication
Senior Pharmacist Bruce Wong works in a range of settings because of the diverse nature of his role. He manages the pharmacy sterile compounding lab at CGH, overseeing orders of compounded medications from the wards, ensuring they are safe, correct and reach the patients in a timely manner.
At the pharmacist-led anticoagulation clinic, Mr Wong titrates medication that prevents blood clots to reduce patients’ risk of developing strokes and heart attacks. He is also part of the inpatient clinical nutrition support team, working with dietitians to manage patients who cannot be fed orally and need to receive nutrition intravenously. Besides that, he dispenses medications at the outpatient pharmacy.
Beyond the common perception that pharmacists mainly dispense medicine, there are lesser-known niche areas within the practice. "In the pharmacy sterile compounding lab, we convert injectables into other formulations such as eyedrops and infusor pumps, which enable patients to receive their treatment at home rather than in the hospital," says Mr Wong. “The products that we produce are not commercially-available or are difficult to dilute in a sterile manner by the bedside. I work with the laboratory team to create formulations based on available evidence.”
Amid his clinical duties, Mr Wong finds that the most meaningful part of his work is the opportunity to develop the budding pharmacists around him. A winner of the Allied Health Professional Young Educator Award 2022, Mr Wong designs the curriculum and manages the development of trainee pharmacists throughout their training at CGH. “Being involved in their journey to become a competent and caring pharmacist drives me to improve myself, and also the training curriculum, so that I can better guide them,” he says.
Going beyond the surface
At CGH, radiographers like Noor Aqilah Bte Abdul Rahhim are rotated among different areas in the hospital such as wards and outpatient clinics, allowing them to work on a variety of cases. Ms Aqilah operates medical imaging equipment such as Computed Tomography, Ultrasound, Magnetic Resonance Imaging (MRI), Nuclear Medicine for bone scanning and X-rays, among others. "We are the first line in providing patients’ diagnoses,” she says. “Depending on the patient’s condition, we conduct imaging scans to investigate what the patient is suffering from. This will allow the doctors and radiologists to diagnose the patient and provide a specific treatment plan.” As part of her work, Ms Aqilah also explains the scans that the patients are undergoing so that they know what to expect, and consistently reassures patients, to help make them feel that they are in safe hands. Throughout the pandemic, Ms Aqilah has been on the frontlines conducting chest radiography, one of the most frequently used tools for triaging and managing COVID-19 patients. Radiographers are often part of a patient’s entire journey and play an important role in the multi-disciplinary care provided to them. “We are the eyes of the doctors,” Ms Aqilah explains. “After performing our imaging and acquiring critical findings, we are able to help expedite the patient’s treatment journey, by highlighting them to the respective clinicians so that they can provide intervention and improve the patients’ prognosis. Knowing that we can make a difference in the patient’s recovery journey makes my work worthwhile.”
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