Partnering for a SMART Future

CONFIDENTIAL

Dr CHAN Kay Fei CEO, Orange Valley Healthcareckf@Orangevalley.sg

Caring for LifeWith over 20 years of experience in Singapore,

Orange Valley manages five nursing homes island-

wide and provides comprehensive eldercare

services to cater to all your senior needs.

1 Introduction1 Introduction

Singapore is ageing rapidly...

By 2030

More than 900,000 elderly

2015

Vulnerability goes beyond low income

By 2030

Seniors with disabilities will double

Seniors requiring assistance with

activities of daily living

2015 62,000

2030 117,000

Yet family support is shrinking

By 2030

More than 320,000 seniors will be living

alone or are empty nesters

1 in 3

B u i l d C o m m u n i t i e s o f C a r e

10

Changi120 bedsRetrofitted

Simei242 bedsPurpose Built

Clementi267 bedsPurpose Built

Marsiling234 bedsPurpose Built

Sims46 bedsRetrofitted

5 homes with 900 beds (not

including Balestier)

600+ beds located in

optimally sized

purpose built facilities

located on 30-year

leasehold properties

Remaining av. bed

tenure > 15 years(1)

Only private nursing home

fully run by professional

managers

Vertically integrated

operations

Employs c.500 people

Orange Valley at a Glance

1. Average age calculation assumes the loss of 104 beds related to Bukit Merah and an addition of 116 new beds from Balestier.

Balestier116 bedsA&A

11

Established Scalable and Institutionalised Platform Capable of Rapid Growth

Installed experienced,

motivated and professional

management team

Systematized protocols and

processes

Professionalized work

culture

Strengthened internal

controls

Enhanced brand awareness

Key initiativesOne of the only private nursing home operators in Singapore run by a professional

a professional management team

Zena Low

VP (Human Resources)

Fiona Chua

VP (Corporate planning & quality assurance)

Andy Tan

VP (Operations)

Dr Chan Kay Fei

CEO

Lyn Edel Yip

DCEO/GCON

Mahan Krishnan

CFO/SVP (Business Development)

12

Broaden care capabilities: developed highly differentiated care capabilities

Procedural capabilities2014 vs. 2016 Benchmark vs. peers

2014 2016 Private Public

Advanced wound care -

Dementia

Dialysis (CAPD) -

Infectious diseases - / /

Male urinary catheterisation -

Multiple drug resistant organism -

Palliative care -

Psycho geriatrics -

Tracheotomy - /

Ventilator (BiPAP, CPAP) -

Substantial investment over the past 2 ½ years to attain highly differentiated care capabilities for servicing high acuity residents

2 Our Processes

74%

26%

30%

70%

Recognising the need to

Innovate

Increased regulatory standards and licensing requirements

Increasingly vocal customers and heightened expectations

Increased competition and cost pressures

Shortage of specialised talent to meet evolving customer requirements

Manpower constraints due to regulatory quotas

Limited availability of land allocated for nursing home use

Innovation Capabilities

14

15

Innovation Capabilities

Informal Platforms

Formal Platforms

Ideas generated through Conversations amongst staff, residents/ NOKs, suppliers & partners

Ideas generated at Management and department Meetings; Dialogues, Surveys and Forms with NOKs, Suppliers & Partners

Ideas discussed and evaluated at

various formal platforms

Ideas approved for

implementation, resources allocated

Evaluation and endorsement of Ideas through/ at:

• Initial Project Evaluation Form

• Management Meetings

Ideas implemented at

• Organisational Level

• Department level

Resources allocated and cross-functional teams established (where appropriate)

Ideate Evaluate Implement

OV’s Innovation Process

15

16

Innovation Capabilities

Type Innovations/ Improvements Implemented/ To be Implemented

Benefits

Strategic Nursing Training Institute[FUTURE PLANS]

• Ensure up to date clinical practice in NH

• Specialised and higher acuity nursing

care

MOTOmed Letto 2 Bed Therapy Unit @

Balestier• Leverage technology to provide

cutting-edge therapy solutions for

both mobile and bedridden residents

Robotics Therapy Systems

“Andago” [TRIAL]

Gaming for Health

[TESTED]

• Improve balance and reduce the risk of

falls in residents

Innovations & Improvements in OV

17

Innovation Capabilities

• OV staff were performing physical, manual

therapy

• Sub-optimal interaction with residents (e.g.

due to language barriers) led to limited

rehabilitation benefits

• Under the direction for transformational and

intensive rehab care, a vendor was

approached by RHD to explore equipment

for passive/ bed-bound residents

• Trials were conducted at Simei NH for 3

weeks, and yielded favourable results

• Equipment will be procured by MMD and

deployed at Balestier NH upon

operationalisation

Problem Statement & Innovation Process

• MOTOmed Letto Bed Therapy Unit is used in

Intensive Care Units in hospitals and other critical

areas for residents who are bed-bound, and/or on

long-term care.

• It ensures bed-bound residents get good

mobilization and stretching of both upper and

lower limbs.

• Outcomes can be measured more effectively, which

is an improvement from the current practice of

visual monitoring

• Higher quality of care

for OV residents

Features and Benefits

Case Study 1 – MOTOmed Letto Bed Therapy Unit

20

Games for Health eg Mototiles

23

Innovation Capabilities

• Human error in the manual packing of medication

• Introduced Packer-Checker system in 2015 to minimize human error

• Idea to automate medication packing was proposed and evaluated to be feasible

• Medication Packing Device was introduced in 2016

• Mechanical inaccuracies were fine-tuned together with the vendor

• Staff were trained on how to use the machine

Problem Statement & Innovation Process

• Resident medication information was captured and extracted from InfoCare

• Dispensing data was entered into the packing machine system to generate medicine sachets

• Improved packing efficiency by 72.5%:

• Improved packing rate from 8 to 13.8 residents per packer-checker pair per hour

• Reduced packing error rate by 37.5%

• Reduced medicine packing error from 8 per month to 5 per month

• Able to service a greater number of residents while ensuring quality

Features and Benefits

Conventional way of serving medicines

· Dangerous for nurses to prepare medicines • Time-consuming in ward level where they can get distracted • Lack of second check by every single need of residents • No standardization to adhere to ENHS

· After checking, packer load the small columns into machine one by one

· Packer will load medicines into columns on trays as seen above, according to medication record

Previous Multi-Dose Packing System

Morning

Noon

Night

Current Multi-Dose Packing System

De-blistering machine

Automatic Tablet Dispensing and Packaging System (ATDPS)

De-blistering machine and Automatic Tablet Dispensing and Packaging System (ATDPS)

· Funded by AIC Healthcare Productivity Fund · Man-hour saving of 36.7% · Better work-health and safety environment · Higher job satisfaction

De-blistering machine

De-blistering machine and Automatic Tablet Dispensing and Packaging System (ATDPS)

· De-blistered tablets are fed into canister of automatic packing machine in large batches

De-blistering machine and Automatic Tablet Dispensing and Packaging System (ATDPS)

Manual:· Rare medicines which are

used by few residents· Medicines that need to be

cut halved

Canister:· Common medicines which

are used by many residents· Whole batch of de-blistered

medicines is fed each time

10

Comparison of multi-dose packaging using two different Systems

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0.25 Madopar 250mg tab

0.25 Quetiapine 25mg

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Previous unit-dose packing machine Current unit-dose packing machine

De-blistering machine and Automatic Tablet Dispensing and Packaging System (ATDPS)

Information on sachet:

· Nursing home name

· Medication administration date and

time

· Current sachet over total number of

sachets

· Current sachet over total number of

sachets for this serving

· Drug name, strength and quantity

32

Innovation Capabilities

• Manual monitoring of vital signs

required man-hours which could

be better utilized

• Data on manpower utilization for

manual monitoring of vital signs

was collected and analysed by

NUD & QMD

• Initiative to leverage technology

to increase efficiency of vital

signs monitoring was endorsed

by Management Team and

presented to AIC for funding

approval

Problem Statement & Innovation Process

• Reduced the number of man-hours

required by more than 50%

• Increased accuracy in data collection

and analysis through the elimination

of human error during recording

• Systematic archiving of data allows

for easy data retrieval and

subsequent analysis

• Improved productivity, and staff

could be better utilised for other

nursing duties

• Greater convenience for customers

Features and Benefits

33

Process Management

Key Business Processes

Key Support Processes

Vision and Mission

Nu

rsin

g H

om

es

Nu

rsin

g H

om

es• Customer Care

(Including Registration &

Admission)

• Nursing & Medical Care

• Rehabilitation

• Pharmacy

• Food & Nutrition

• Home Care

• Socio-recreational

activities

• Facilities & Environment

• Laundry

• Human Resources

• Nursing (Training) [NEW]

• Finance

• Information Technology

• Materials Management

• Auditing

Knowledge Management

[SQC] Collects and manages information for strategy development, decision-making and

organisational learning

Does your organisation have a knowledge management policy in place? How is organisational learning, decisions,

strategies captured, classified and shared throughout the organisation to create new knowledge? Are there knowledge

management IT systems and processes that have been established to support the collection, classification, sharing, co-

creation, and knowledge creation?

34

Technology Enablers to Manage

Knowledge• InfoCARE is an Enterprise Resource Planning system used to collect, store, manage

and interpret data from different departments

• This facilitates transactions within OV, as well as with its suppliers and partners

• Users are given different access rights depending on job function

Knowledge Management

[SQC] Collects and manages information for strategy development, decision-making and

organisational learning

Does your organisation have a knowledge management policy in place? How is organisational learning, decisions,

strategies captured, classified and shared throughout the organisation to create new knowledge? Are there knowledge

management IT systems and processes that have been established to support the collection, classification, sharing, co-

creation, and knowledge creation?

35

InfoCARE Modules and Interfaces

Recent improvements include:

• Enhancement of InfoCARE to comply

with ENHS requirements

• Introduction and integration of the JVM

packaging machine and Vital Signs

Equipment with InfoCARE

• Optimize Workforce Management

System (Duty Roster System) fully

installed and synchronized with Infocare

infoCARETM

GIROCPF

Board

IRAS

Web Svcs

eCommerce

WelschAllyn HL7

Life-Medic IRMS

ILTC Portal

OWM

JVM/ MPS

3 Our Collaborations(with government, public agencies, VWOs and private firms)

Collaborations with Government Agencies

74%

26%

30%

70%

39

As the leading provider of eldercare services, we have the following partnership.

• Ministry of Health

Portable Subsidy Scheme (PSS)

Nursing Home Respite Care Subvention (NHRC)

Manpower Resourcing and Training Initiatives

• Agency for Integrated Care

Patient referrals under MOH’s Portable Subsidy Scheme and

Nursing Home Respite Care Subvention program

Approved provider of caregiver training under Caregivers Training Grant (CTG)

Healthcare Productivity Fund (Automatic Tablet Dispensing &

Packaging System and Vital Signs Monitoring Device)

Fellowship Scheme

Job fairs

40

Restructured HospitalsPatient Referrals

Changi General Hospital Provide tracheostomy training to OVNH care staffChronic Sick Unit (CSU) Patient Referrals

Khoo Teck Puat HospitalGeriCare@North

National University Hospital SingaporeGeriatric Dentistry Care

Collaborations with Government Agencies

41

• SPRING Singapore

Capability Development Grant

(Customer-Centric Initiative & Business Excellence)

SME Talent Programme

• Workforce Development Agency

Traineeship program

Job fairs

• National Parks Board

Community Gardening with schools (Upcoming)

• Singapore Civil Defence Force

Annual Fire Drill

Collaborations with Public Agencies

42

Partnership with Private Firms

• NTUC Unity Denticare Mobile Dental Truck

• Abbott and Nestle Collaborative training partnership to

provide nutritional training to OVNH care staff

• Baxter Continuous Ambulatory Peritoneal

Dialysis (CAPD) on-site training to OVNH care staff

• Omni-Health Technologies Implementation of Automatic Tablet

Dispensing & Packaging System

• aAdvantage Consulting Provision of Customer-Centric Initiative

(CCI) Singapore Service Class (SSC) and Singapore Quality Class (SQC)

• Raffles Hospitals, ECON Medicare Centre, Pacific Healthcare Nursing Home Patient Referrals

43

Collaborations with Voluntary Welfare Organisations

• St Luke’s Hospital, Bright Vision Hospital, Dover Park Hospiceo Patient Referrals

• Salvation Army’s Peacehaven Nursing Homeo Upcoming Dementia Care training programme for OVNH care staff

• Cat-Assisted Therapy Singapore (CATS)o Once a month, volunteers from CATS, together with their cats visit our residents

4 Academia

45

On-going Training

• Basic Skill Set Training

• Tracheostomy Training

• First Aider Training

• PPE Training

Trainings provided by RHS/ Internal training department

46

• Tele Geriatrics consultation and geriatrician physical visit with KTPH

• Tele CNE case presentation for continuous education

• Basic first aider training conducted by internal training team.

47

Food preparation in Central Kitchen

Central Kitchen

6 Bringing back memories (our DIY works)

49

The Old Singapore Style

• Gardening• Re-creating the “Kampong”• Pet therapy• Playground• Mind-body activities• Community activities

50

The Old Singapore Style

Built an “Old Singapore” bus stop, kachang putei store and a hut with recycled materials in our homes.

Q & A

Thank youckf@orangevalley.sg