# data[].attributes.headline
Triaging for clinical conditions from community 

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Triaging for clinical conditions from community 

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Seamless coordination eg community partners need information from SCH for continuity of care in the community and Vice versa 

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Seamless coordination eg community partners need information from SCH for continuity of care in the community and Vice versa 

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Towards 2030, SCH should position itself as not only as a transitory point of care, but also as an initiator and main provider of certain care services that are relevant for our patient profile. If we are able to define this, we will be able to more accurately identify our key stakeholders.

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Incentivising partners to participate
Use low laying fruits to encourage cooperation
Find ways to highlight partners successes to motivate

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Bringing in our partner needs, validating them against operating landscape and effecting nec changes in processes to make things work. Critical conversations amongst ourselves for regular alignment as the wider envt moves fast.

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Establish workflow to right side for patients/ NOK in the community 

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Establish workflow to right side for patients/ NOK in the community 

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Besides the usual comm service providers, can also engage grassroots in supporting the patients/residents

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DRC , singhealth , ehints , patients and caregivers 

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DRC , singhealth , ehints , patients and caregivers 

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Focus on developing critical green lanes with the right partners for the right conditions 

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Focus on developing critical green lanes with the right partners for the right conditions 

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1. Ill-equipped & lack of resources in some stakeholders will hinder the execution of plans
2. Priority betw partners are not aligned
3. Common goals not hammered in

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Need to see how to equip and resource community partners who may not have the resources of a big hospital system

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Need to see how to equip and resource community partners who may not have the resources of a big hospital system

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Improve digital and health literacy as Singapore is progressing 

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Improve digital and health literacy as Singapore is progressing 

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Identify core partnerships, prioritise which group of patients to work on, test & refine model of care, processes 

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Identify core partnerships, prioritise which group of patients to work on, test & refine model of care, processes 

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Community partners eg AIC, ambulatory primary care physicians (polyclinic, GPs)

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Community partners eg AIC, ambulatory primary care physicians (polyclinic, GPs)

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Building social communities amongst patients to reduce social isolation

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Resources to support community engagement and plans 

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Resources to support community engagement and plans 

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Sharing one another's initiatives to avoid duplicating efforts, and identify gaps

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Need to identify patients who might be better served by community partners instead of in the Comm Hosp, and then connecting them to the community partners. This will also need the CH to map out the community services in the region.

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Need to identify patients who might be better served by community partners instead of in the Comm Hosp, and then connecting them to the community partners. This will also need the CH to map out the community services in the region.

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Provide caregiver training and connect patient and family to community services

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Provide caregiver training and connect patient and family to community services

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To improve accessibility for opportunities and resources prior to patient discharge 

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To improve accessibility for opportunities and resources prior to patient discharge 

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Lack of a centralised EMR to allow better flow of medical informatics 

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Lack of a centralised EMR to allow better flow of medical informatics 

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Leverage on technology such as telemed, AI, etc

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Leverage on technology such as telemed, AI, etc

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Healthcare is a network of providers chained & connected together. Each must play its role or else the system will fail.

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To provide opportunities of participation in production activities, homed relationship, leisure and a variety of interests and lifestyle 

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To provide opportunities of participation in production activities, homed relationship, leisure and a variety of interests and lifestyle 

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Workaround for IT systems in various care settings

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Not knowing all the services available "out there"

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Integration between partners eg Multidirectional Feedback Loop

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Integration between partners eg Multidirectional Feedback Loop

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Define clearly the objectives and outcomes to achieve, identifying the right personal for the various objectives and outcomes 

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Define clearly the objectives and outcomes to achieve, identifying the right personal for the various objectives and outcomes 

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The work-together spirit. Do not divide work too clear cut

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The work-together spirit. Do not divide work too clear cut

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Regular engagement across care settings to coordinate for synergy

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Discharging patients community by helping them adapt post hospitalization

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Discharging patients community by helping them adapt post hospitalization

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CH is the middle man to facilitate and coordinate care delivery

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Bridging patients to support services

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Integration with ext stakeholders. IT connection 

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Integration with ext stakeholders. IT connection 

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Engage Stakeholders to align with role of SCH

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Engage Stakeholders to align with role of SCH

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Willing hearts and minds
Resources

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On top of the above - Must include pt family &/person of interest or influence

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Contribute in alleviating ED load by right siting appropriate pts to CH

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Be a connector

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Stakeholders can include AHs, polyclinics, GPs, AIC, community nursing, DRC/ DCC/ SCC, home care providers, social care providers, etc