Singapore's experience in managing the COVID-19 pandemic: Key lessons from the ground.

IF 2.5 Q1 MEDICINE, GENERAL & INTERNAL Annals of the Academy of Medicine, Singapore Pub Date : 2023-10-30 DOI:10.47102/annals-acadmedsg.2023160
Eugene Tc Koh, Kok Yong Fong, Si Jack Chong, Yvonne Koh, Joshua Wx Tan, Raymond Chua, Yock Young Dan, Derrick Heng, Kenneth Mak
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Abstract

Singapore managed the COVID-19 pandemic in the past three years and gleaned valuable lessons on patient management when the public healthcare system was inundated with COVID-19 patients. There were several initiatives, which included setting up of community treatment facilities to help hospitals manage in-patient loads that did not require acute monitoring, leveraging telemedicine, and developing heuristics to sort patients based on their clinical disposition to various care pathways and to effectively manage patients of different medical needs. These initiatives were implemented in the second year of the epidemic in 2021 and did not include the dormitory-based migrant workers and migrant workers in the construction, maritime and production sectors who were under the care of the Assurance, Care and Engagement Group (ACE) in the Ministry of Manpower that had its own set of treatment management measures. The different care pathways ensured that patients received appropriate levels of care and allowed healthcare facilities to focus on more acute cases. In 2022 alone, 23,159 patients were discharged from community treatment facilities against the background of 1.9 million COVID-19 patients. These initiatives would not be possible without the oversight of an advisory board comprising senior leadership from the healthcare clusters and the Ministry of Health to align clinical governance with medical policies, and prompt and immense support from medical specialist panels. The strong public-private partnership forged in the process was instrumental in the successful operation of community facilities and implementation of patient care protocols, coupled with harnessing information technology and leveraging on emerging data to refine care protocols.

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新加坡管理 COVID-19 大流行病的经验:当地的主要经验教训。
新加坡在过去三年中管理了 COVID-19 大流行病,并在公共医疗系统被大量 COVID-19 病人淹没时总结出了病人管理方面的宝贵经验。新加坡采取了多项措施,包括建立社区治疗设施,帮助医院管理不需要急性监测的住院病人,利用远程医疗,以及开发启发式方法,根据病人的临床情况将其分类到不同的护理路径,并有效管理不同医疗需求的病人。这些举措是在 2021 年疫情爆发的第二年实施的,并不包括在宿舍工作的外来务工人员以及在建筑、海事和生产部门工作的外来务工人员,他们由人力部的保障、护理和参与小组(ACE)负责护理,该小组有自己的一套治疗管理措施。不同的护理路径可确保患者获得适当程度的护理,并使医疗机构能够专注于更严重的病例。仅在 2022 年,在 190 万 COVID-19 患者的背景下,就有 23 159 名患者从社区治疗机构出院。如果没有一个由医疗保健集群和卫生部高层领导组成的咨询委员会的监督,使临床管理与医疗政策保持一致,以及医疗专家小组迅速而巨大的支持,这些举措是不可能实现的。在这一过程中建立起来的强有力的公私伙伴关系,对于社区设施的成功运作和病人护理规程的实施,以及利用信息技术和新出现的数据完善护理规程,都起到了至关重要的作用。
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