DeDicateD to excellence in Dermatology anD VenereologyDERMA

Vol 66 Issue No. 9 • seP-oCT 2017 MCI (P) 091/09/2015

DIGEST

Introducing Hair Transplant Service in NSC Nathalie Ng, Corporate Communications Executive

A New Tool On-board – Hand Held Doppler in Wound Clinic Nathalie Ng, Corporate Communications Executive

Effective 1st October, patients in search of hair restoration solutions to overcome hair loss can now seek treatment with our new hair transplant service. Helmed by Consultant Dr Angeline Yong and a team of trained nurses, this ser-vice provides hair restoration surgery for suitable candidates via two follicular unit transplantation methods – the strip har-vesting method and the Follicular Unit Extraction (FUE) method. The former re-quires removal of a strip of tissue from the safe donor zone in the occipital region of the scalp, which is then microscopically dissected into individual follicular units for transplantation. The latter method utilises a small, sharp cylindrical punch (generally 0.9mm to 1.2mm in diameter) to incise the skin surrounding each individual follicular unit before they are carefully teased out with forceps.

While the strip harvesting method yields more robust grafts with higher graft sur-vival rates and is also more cost effective, FUE’s advantages include decreased heal-ing time and no need for suturing. The in-dividual follicular units are then placed into tiny recipient sites created in the area of hair loss. For further information, please contact us at (65) 6253 4455 or drop a query at our website.

Patients with leg ulcers can now expect to have their wounds diagnosed, screened and treated all under one roof at the National Skin Centre.

A Hand-held Hadeco Bidop ES-100V3 doppler, which is commonly used as a screening tool to estimate the rate of blood flows through blood vessels by bouncing high-frequency sound waves, is now available in the Wound Clinic (Clinic H).

Top photos: our staff nurses undergoing training for air restoration surgery under the supervision of Dr Angeline Yong.Bottom photo: The hair transplant clinic is helmed by Consultant Dr Angeline Yong (third from left) and supported by a team of trained nurses.

Previously, these patients had to make an addi-tional trip to Tan Tock Seng Hospital for screen-ing of their leg ulcers before they can receive pressure bandaging in NSC. With the availabil-ity of the hand-help Doppler in the Centre, this will save traveling time and costs for patients and afford them a higher level of convenience.

This screening test is currently available to our existing patients in the wound clinic.

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DeRMA DIGesT • Vol 66 Issue 9 • seP-oCT 2017

NHG Quality Day – Recognising Quality and Service Excellence in HealthcareNathalie Ng, Corporate Communications Executive

Singapore Health and Biomedical Congress 2017: Dr Tey Hong Liang wins Singapore Clinician Investigator Award and NSC Exhibits Skin Imaging AppNathalie Ng, Corporate Communications Executive

NsC Director A/Prof Tan suat Hoon (centre in black), alongside NsC awardees on NHG Quality Day.

senior Consultant Dr Tey Hong liang (right) receiving his singapore Clinician Investigator Award (Gold) from the Minister of Health, Mr Gan Kim Yong.

The annual Singapore Health and Biomedi-cal Congress (SHBC), held on 12-14 Octo-ber 2017 this year at Singapore Expo and NTU Lee Kong Chian School of Medicine, saw several NSC staff clinching awards for their scientific projects.

Senior Consultant Dr Tey Hong Liang was awarded Gold under the Singapore Clini-cian Investigator Award for his work on employing non-invasive skin imaging for real-time diagnosis and treatment of hy-perhidrosis (inability to sweat). Our re-

search teams have also achieved gold in the Best Poster Award in the Basic Sci-ence, Translational Research category for their work on devising the Psoriasis Area and Severity Index (PASI) – an automated system which allows for more objective and accurate assessment of psoriasis in pa-tients. Finally, the team from Department of Sexually Transmitted Infections (STIs) Control (DSC) clinched bronze in the same category for their project on initiating a self-swab collection process for screening of STIs such as gonorrhoea and chlamydia,

affording male patients a higher level of comfort and privacy while reducing time spent for nurses and allowing them to at-tend to patients with more pressing needs.

Meanwhile, a skin imaging mobile app to assess the risk of pigmented skin lesions for skin cancer was exhibited at the event. A collaboration between Singapore Univer-sity of Technology (SUTD) and our Centre, the app aims to provide a portable and accurate tool of assessment for non-spe-cialists to analyse pigmented skin lesions for risk of melanoma and Basal Cell Car-cinoma (BCC). The mobile app captures an image via the phone camera and provides a risk assessment of malignancy and rec-ommendations for medical attention if in-dicated. It also allows for serial monitoring of pigmented lesions.

Currently in its clinical testing stage, the team is using the capture of live images for validation of the app. Collaborations are also being made to work with general prac-titioners in Australia which has the highest rate of melanoma in the world.

Mr Gan testing out the mobile skin imag-ing app at the sHBC exhibition area.

The annual Quality Day, organised by the National Healthcare Group (NHG) to rec-ognise both staff and staff-driven initiatives that have played a part in achieving better and safer care for patients, was held at the Lee Kong Chian School of Medicine Auditorium on 6 October 2017.

Attended by more than 400 participants, the event saw some of our staff and patients awarded for their contributions towards ensuring constant quality improvement in both patient care and in the workplace. We congratulate the following winners for their well-deserved awards:

Excellence in Action Awards (EIAA) Individual (Allied Health):Ms Winnie Choo, Senior Pharmacist

Individual (Nursing):Ms Foo Pei Ling, Senior Staff Nurse

Exemplary Patient AwardMr Benjamin Goh Lye Huat

Quality Improvement Awards (QIA) Category: (D) BUILDING STRONG PART-NERSHIPS IN IMPROVEMENT WORK Improving Operational Efficiency of Manag-ing Stelara Patient Assistance Programmes for Dermatology Outpatients in National Skin Centre (Benny Li and Winnie Li)

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DeRMA DIGesT • Vol 66 Issue 9 • seP-oCT 2017

NSC Quality Day 2017Lee Jun Yue, Quality Executive

HMDP Report: Nurse-led training for Dermatology atDundee, ScotlandSenior Staff Nurse Leong Hui HuiStaff Nurses Ang Lin Feng and Eunice Tan

It has been a great opportunity for the three of us to be part of the team based Healthcare Manpower Development Programme (HMDP) on Nurse Led Training for Dermatology at Dundee, Scotland. The hospital and unit that we were attached to was Ninewells Hospital Dermatology outpatient clinic. We embarked our learning journey as a group to gain insight and knowledge on how nurse led services were carried out in Dundee, Perth and Fife.

We were warmly welcomed by Miss Karen Stephen, the lead Dermatology nurse at Ninewells Hospital with a group of specialist nurses, staff nurses and healthcare assistants under her care. A wide range of curriculum was prepared for us during the period of our attachment from 19th June 2017 to 30th June 2017. We were assigned to different areas across the clinic, including

From left: senior staff Nurse leong Hui Hui, lead dermatology nurse Ms Karen stephen, Ms Polly Buchanan, Ms Barbara Page, staff Nurses eunice Tan and Jacelyn Ang.

NsC’s service Champions together with Director A/Prof Tan (centre) and Deputy Director A/Prof Chua sze Hon (centre right).

treatment, surgical, phototherapy and sit in with doctors during consultation.

Various nursing aspects on Dermatology care were discussed within ourselves during these attachments. We had first-hand experiences sitting in with different nurse specialists during their nurse led consultation sessions with their patients and observing their delivery of care to patients, as well as their clinical processes. Other than Ninewells Hospital, Miss Karen sees patients at a Dermatology outpatient clinic in Perth as well and we had the fortunate opportunity to follow her to Perth to observe one of her sessions there.

We were also able to experience one session of community care nursing at Fife with Miss Polly Buchanan during our last day

of attachment. On the same day evening, we were invited to Miss Barbara Page’s house where we enjoyed ourselves with her delicious home-cooked specialties.

The programme was indeed valuable and fruitful to us as it equipped us with better know-how on how to provide a higher quality of care for our patients. We hope to apply the knowledge that we have gained to create more nurse-led services in National Skin Centre.

The Centre held its annual Quality Day on 17 October 2017. In her opening address, Director A/Prof Tan Suat Hoon highlight-ed one of the three key shifts in the MOH Healthcare Transformation plan - mov-ing beyond quality to value - and what this implied for quality initiatives on the institution level. A/Prof Tan stressed that a shift to value does not mean a deempha-sis on quality but rather a stronger focus on providing high quality care at a lower costs to both patients and the Centre. She listed four main areas in which this can be achieved - by ensuring appropriate delivery of care through cost-effective drugs and streamlined care practices, continuous im-provement to patient safety, job redesign for staff to increase productivity rates, and high quality research.

Adj A/Prof Leow Yung Hian, Assistant Di-rector of Clinical Governance & Quality, presented an overview of the achievements in quality related work in FY2016. By fo-cusing on building staff capability, quality improvement courses are extended to all departments. Furthermore, Quality De-partment also kick started two different courses (1. Continuous QI – Diagnostic Tools (Foundation), 2. Data Training) which are both conducted in-house. NSC has also reduced the waiting time for new subsi-

dised clinic appointments by implementing initiatives from different departments.

Prof Leow’s presentation was followed by the Service Champion Awards ceremony. This award recognises individuals who have provided excellent quality service and who received patient compliments. 15 staff received the Silver award and eight staff received the Gold Award. Dr Melissa Tan, Ms Wang Danling and Ms Tina Yap were awarded the Star Award. Congratulations to all our Service Champions!

To close the event, Mr Johnny Foo, Clinic Operations Manager, shared the updates on Tele-DERM collaboration with National Healthcare Group Polyclinics (NHGP) and Institute of Mental Health (IMH). He ex-plained that with this initiative, it reduces the need for patients to go for unnecessary appointments at NSC if the concerns can be managed by polyclinics. This also allows patients to receive appropriate care at poly-clinics in a timely manner. Tele-DERM also empowers family physicians and nurses to manage and treat common dermatological conditions

DeRMA DIGesT • Vol 66 Issue 9 • seP-oCT 2017

Editorial: Dr Coni Liu, Ms Geraldine Soh, Ms Nathalie NgAdvisors: Clinical A/Prof Tan Suat Hoon, Mrs Tang Lee Foon

This is an in-house publication for staff information only. Contents can be quoted or reproduced with permission of National Skin Centre (S) Pte Ltd.

Designed and Printed by : Ease Communications

NATIONAL SKIN CENTRE 1 Mandalay Road Singapore 308205 | Website: www.nsc.com.sg | www.facebook.com/NationalSkinCentre

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Continuing Medical Education (CME) EventsDate Title Seminar for Fees

* Early bird rate of $450 applies to registrations made at least one month before the workshop.For enquiries on our seminars and forums, please call the Training Department at Tel: 6350 8476 or Fax: 62533 255. You may also register online at www.nsc.com.sg.

NSC Aesthetic Forum Public Free18 Nov 2017

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our Pharmacy team armed with ready smiles as they prepare to meet the semi-nar’s participants.

Pharmacists’ Seminar 2017Lauw Xiu Ting, Senior Pharmacist

The annual Pharmacists’ Seminar on “Der-matology within the Pharmacy: Appro-priate use of Topical Steroids and Topical Acne Products”, chaired by Ms Germaine Chua, was held on 19 August, from 2pm to 5pm at Level 5 Auditorium. The Seminar was well-received with a full-house at-tendance of 150 attendees comprising of Pharmacists and Pharmacy Technicians from various institutions.

Dr Lee Hwee Chyen presented on Skin Physiology and Pathology, which included an introduction to skin anatomy and its functions, causes of skin diseases, and the differences between acute and chronic skin conditions. Dr Agnes Chan shared her expertise on Skin Conditions Responsive to Topical Steroids, highlighting the need to balance steroid potency for therapeutic ef-fect versus unwanted side effects. She also

discussed the range of skin conditions respon-sive to topical steroids, and recommended the use of topical steroids according to potencies and dosage forms. In her talk on Acne and its Treatment, Dr Hazel Oon included interesting case studies to showcase various grades of acne severity, and presented on treatments to prevent scarring, topical and systemic treatments for acne, acne cosmeceuticals, and treat-ment of acne in special populations such as pregnant or lactating women.

Our Pharmacist, Ms Winnie Choo, conduct-ed a quiz using case studies to help the at-tendees to reinforce their learning and un-derstanding of the day’s topics. Miss Janice Ling Yan Jing rounded up the programme

with her talk on Oil or Nothing – Products for Oily Skin, sharing on retail skincare products recommended for acne prone and oily skin.

The attendees went home with a better un-derstanding of appropriate use of topical steroids, and recommendations for effec-tive treatment of acne.

Eczema Support Group Forum 2017Ng Jing Feng, Senior Social Work Assistant

Held on 9 September at NSC, the Eczema Support Group Forum saw participants en-joying an educational afternoon of learning and sharing from both eczema specialists and patients on how to manage the chronic condition effectively.

Consultant Dr Eugene Tan kick started the forum with a guide on how to use different types of moisturisers effective for eczema-prone skin. Using a brick wall as an anal-ogy, Dr Tan explained the inherent defects in the skin barrier in patients with eczema and shared some practical tips to guide se-lection and application of topical steroids and moisturisers to optimise treatment of the condition. Dr Tan also encouraged the participants to adopt a proactive approach as opposed to the traditional reactive ther-apy for long term control of their eczema conditions.

eager participants had their queries addressed by our panel of doctors during the Q&A session.

Consultant Dr Yew Yik Went followed by sharing tips and tricks on how to adopt life-style habits that are conducive in managing the condition. Highlighting the increasing prevalence of Atopic Eczema among young children in South East Asia, Dr Yew point out that the increasing relevance healthy lifestyle habits has with keeping eczema under control. Climate, environment ir-ritants, dietary habits and even obesity

among other factors were brought up as potential triggers of the condition.

Next, Visiting Consultant Dr Roland Chu spoke on how to identify contact dermati-tis, and some of the common substances that causes allergy. He highlighted four im-portant points: avoid, protect, treat and re-pair. He also pointed out the need to avoid allergens - citing gloves as an example of a form of protection, treating with steroid creams and repairing skin barriers using moisturisers.

The forum rounded up with a personal sharing session by one of the Centre’s pa-tients, Justin Lee. He shared his personal life experiences on how he had effectively managed his condition with a positive out-look. Having gone through National Service, working life and marriage afflicted with eczema, he was able to share some of the challenges he faced and how he overcame them. Justin encouraged the participants in a light-hearted manner to look on the bright side of having eczema and stressed the importance of seeking social support.