Case Study: The Impact of Effective Support Services at Singapore General Hospital (SGH)

Introduction
In the dynamic and complex healthcare industry, support services play a crucial role in ensuring
smooth operations and delivering high-quality patient care. At SGH, a 500-bed tertiary care facility,
the integration and optimization of support services have been pivotal in achieving excellence in
patient outcomes. This case study examines the roles of key departments such as Food & Beverages,
Blood Bank, Material Management, Ambulance Services, Central Sterile Services (CSS),
Biomedical/Clinical Engineering, Pharmacy, and Housekeeping & how these services contribute to
patient satisfaction and operational efficiency and provides insights into addressing associated
challenges.

Key Support Services and Their Impact:

 Food & Beverages (F&B):

 Role in Patient Satisfaction: SGH's F&B department provides nutritious and culturally
appropriate meals to patients, catering to diverse dietary needs and preferences. This not only
enhances patient comfort and satisfaction but also contributes to their recovery. Diet is an
essential part of recuperating from a major illness or surgery, and hospital catering services
play a crucial role in providing a suitable diet/food. Patients appreciate the variety and quality
of meals, contributing to a positive hospital experience.
 Role in Operational Efficiency: Streamlined meal delivery systems and efficient kitchen
operations minimize disruptions to patient care and optimize staff time. Certified ingredients,
efficient handling and distribution of meal orders, expert management of food at appropriate
temperatures, modern food preparation methods, and specialized human resources ensure
seamless operations.
 Positive Influence: The hospital food environment positively influences dietary intake not
only for patients but also for employees and visitors, promoting healthy food and beverage
options.

 Blood Bank:

 Role in Patient Satisfaction: SGH's blood bank ensures a safe and reliable blood supply for
patients undergoing transfusions. Timely access to blood products is crucial for critical care
and emergency situations, directly impacting patient outcomes and satisfaction. Rapid
response in providing blood and blood components during emergencies, coupled with
rigorous quality checks, ensured trust and reliability.
 Role in Operational Efficiency: Efficient inventory management and blood component
separation techniques optimize blood utilization and minimize wastage. Advanced inventory
management systems minimized shortages and overstocking, while cross-matching and
compatibility testing were streamlined to save time.

 Material Management:

 Role in Patient Satisfaction: SGH's material management department oversees the

procurement, storage, and distribution of medical supplies and equipment. The availability of
essential medical supplies ensures that patients receive timely and appropriate care.
  Role in Operational Efficiency: Just-in-time inventory management and efficient supply
chain logistics minimize stockouts and reduce costs. Implementation of inventory analytics
tools further optimized storage space and reduced carrying costs.

 Ambulance Services:

 Role in Patient Satisfaction: SGH's ambulance service provides timely and efficient
emergency medical transportation. Equipped with advanced life-support systems and skilled
paramedics, the ambulance service offered timely and safe transport for patients. Prompt
response times and high-quality pre-hospital care ensure patient safety and comfort during
emergencies.
 Role in Operational Efficiency: Effective dispatch systems and well-trained paramedics
optimize ambulance utilization and minimize response times. GPS tracking and route
optimization reduced response times and fuel consumption.

 Central Sterile Services (CSS):

 Role in Patient Satisfaction: SGH's CSS department ensures the proper cleaning,
sterilization, and packaging of reusable medical instruments. Consistently sterile surgical
instruments and equipment improved patient safety by reducing infection rates.
 Role in Patient Safety: Sterile medical instruments are crucial for preventing infections and
ensuring patient safety.
 Role in Operational Efficiency: Automated cleaning and sterilization processes enhance
efficiency and minimize the risk of human error. Automation of sterilization processes and
adherence to standard protocols reduced turnaround time and enhanced productivity.

 Biomedical/Clinical Engineering:

 Role in Patient Satisfaction: SGH's biomedical engineering department maintains and

repairs medical equipment, ensuring its safe and effective operation. Prompt maintenance and
calibration of medical devices ensured accurate diagnostics and uninterrupted patient care.
 Role in Patient Safety: The proper functioning of medical equipment is critical for patient
safety and treatment outcomes.
 Role in Operational Efficiency: Proactive maintenance and timely repairs minimize
equipment downtime and reduce operational costs. Predictive maintenance schedules further
minimized downtime and repair costs.

 Pharmacy

 Role in Patient Satisfaction: The pharmacy department plays a vital role in ensuring that
patients receive the correct medications at the right dosages and on time. Proper medication
management directly influences patient recovery and satisfaction. The pharmacy is also
integral to ensuring that patients have access to necessary medicines throughout their
treatment.
 Role in Operational Efficiency: Efficient pharmacy operations reduce medication errors,
streamline the prescription process, and avoid stockouts of critical drugs. The hospital's
pharmacy also works closely with the medical staff to ensure that prescriptions are
appropriately managed.

 Housekeeping

 Role in Patient Satisfaction: Cleanliness and hygiene are crucial factors in patient
satisfaction. Housekeeping ensures that patient rooms, common areas, restrooms, and
 operating rooms are spotless, reducing the risk of infections and creating a pleasant
environment for patients and visitors.
 Role in Operational Efficiency: The housekeeping department contributes to the efficient
functioning of the hospital by maintaining cleanliness in high-traffic areas, including
corridors, restrooms, and patient rooms. Their work ensures that the hospital remains
compliant with health regulations and standards. Use of eco-friendly cleaning technologies
and proper waste segregation streamlined operations and minimized environmental impact.

Challenges Faced and Solutions Implemented

1. Food & Beverages:
o Challenges: Managing diverse dietary preferences, ensuring timely meal delivery,
and maintaining quality standards.
o Solutions: Implemented an AI-driven meal management system and hired specialized
dietitians. Insisted on certified ingredients, efficient handling and distribution of meal
orders, expert management of food at appropriate temperatures, modern food
preparation methods, and specialized human resources. Regular audits and feedback
mechanisms ensured continuous improvement.
2. Blood Bank:
o Challenges: Occasional shortages during peak demand.

o Solutions: To combat this, the hospital introduced awareness campaigns to encourage

blood donation and built partnerships with external blood banks for emergencies.
Efficient inventory management and advanced techniques like blood component
separation ensured optimal utilization and minimized wastage.
3. Material Management:
o Challenges: One challenge was occasional mismanagement of inventory, leading to
overstocking, understocking of medical supplies.
o Solutions: Adopted advanced inventory management system that uses barcodes and
RFID tags to track supplies and predict future needs and trained staff in lean
management practices. The integration of JIT (Just-in-time) inventory systems
ensured the consistent availability of critical supplies while reducing storage costs.
4. Ambulance Services:
o Challenges: A challenge faced by the ambulance services was traffic congestion &
lack of coordination, which occasionally led to delays in reaching patients.
o Solutions: Integrated GPS tracking with hospital operations and partnered with local
traffic authorities for emergency route clearances. Effective dispatch systems and
well-trained paramedics further ensured timely response and optimized ambulance
utilization.
5. CSS:
o Challenges: A major challenge was the coordination of sterilization schedules with
surgical departments to ensure the availability of clean instruments when needed.
 o Solutions: Upgraded to automated sterilization equipment and employed a dedicated
CSS audit team. Automated cleaning and sterilization processes enhanced efficiency
and minimized the risk of human error, addressing delays effectively.
6. Biomedical/Clinical Engineering:
o Challenges: The challenge faced by the biomedical department was managing a
diverse inventory of medical equipment with varying maintenance requirements,
leading to frequent equipment downtime and potential disruptions to patient care.
o Solutions: implemented a computerized maintenance management system (CMMS)
to track equipment performance and schedule preventative maintenance. This,
combined with advanced training for technical staff, enabled proactive maintenance
and timely repairs, minimizing equipment downtime and ensuring the uninterrupted
availability of critical medical devices for patient care.
7. Pharmacy:
o Challenges: Prescription errors and stockouts.

o Solutions: To mitigate these, the hospital implemented an electronic prescription

system and regular audits to ensure the accuracy of medication dispensation. The
pharmacy also introduced automated dispensing systems to improve the speed and
accuracy of dispensing medications.
8. Housekeeping:
o Challenges: A challenge faced was the need to maintain consistent cleanliness in
high-demand areas during peak hospital hours and waste management.
o Solutions: The hospital addressed this by implementing a shift-based cleaning
schedule, ensuring that housekeeping staff were available during busy times. The use
of high-efficiency cleaning equipment also helped speed up the cleaning process
while ensuring high standards of hygiene. Conducted regular training programs and
employed IoT-enabled cleaning devices for better monitoring.
Conclusion
The case of SGH demonstrates the transformative impact of effective support services on patient
satisfaction and operational efficiency. By addressing challenges through innovation and strategic
planning, the hospital not only improved its service delivery but also set a benchmark for other
healthcare institutions. This case study underscores the importance of investing in and optimizing
support services as a cornerstone of holistic healthcare delivery.
Recommendations
1. Regularly assess support service performance through patient feedback and operational
metrics.
2. Foster interdepartmental collaboration to address systemic inefficiencies.
3. Invest in training and technology to continuously improve support service capabilities.
Summary of the Case Study

The case study examines the impact of effective support services at Singapore General
Hospital (SGH), a 500-bed tertiary care facility. Key departments analyzed include Food &
Beverages, Blood Bank, Material Management, Ambulance Services, Central Sterile Services
(CSS), Biomedical/Clinical Engineering, Pharmacy, and Housekeeping.

 Role of Support Services: These services are instrumental in enhancing patient

satisfaction by providing timely, quality, and patient-centered services. Operational
efficiency is achieved through streamlined processes, effective inventory and resource
management, and technological innovations.
 Challenges and Solutions: Common challenges included inventory mismanagement,
equipment downtime, traffic delays, prescription errors, and maintaining cleanliness.
SGH addressed these issues using advanced technologies (e.g., AI-driven systems,
GPS tracking, CMMS, automated sterilization), partnerships (e.g., with traffic
authorities and blood banks), and continuous training.
 Outcomes: These measures enhanced patient outcomes, improved hospital efficiency,
and set a benchmark for effective healthcare management.

The case study underscores the importance of investing in support services to deliver
holistic healthcare and improve the overall patient experience.

Possible Viva Questions

Here’s a list of questions that could be asked in your viva, along with tips to answer them:

1. General Questions About the Case Study

1. What is the primary focus of this case study?

o The study focuses on the role and impact of support services in enhancing
patient satisfaction and operational efficiency at SGH.
2. Why were these support services chosen for analysis?
o These services are crucial for the smooth functioning of hospital operations
and directly affect patient care and satisfaction.

2. Department-Specific Questions
 1. How does the Food & Beverages department contribute to patient recovery?
o By providing nutritious, culturally appropriate meals tailored to patient needs,
F&B aids recovery, improves comfort, and contributes to overall satisfaction.
2. What measures were taken by SGH to ensure a consistent blood supply?
o SGH introduced awareness campaigns, partnered with external blood banks,
and implemented advanced inventory management systems to minimize
shortages.
3. How did the hospital address equipment downtime in the Biomedical/Clinical
Engineering department?
o By implementing a Computerized Maintenance Management System (CMMS)
and scheduling predictive maintenance, the hospital minimized equipment
downtime.
4. What challenges did the Housekeeping department face, and how were they
resolved?
o The main challenges were maintaining cleanliness during peak hours and
managing waste. These were resolved through shift-based schedules, IoT-
enabled cleaning devices, and regular training programs.

3. Operational Efficiency Questions

1. How did SGH improve operational efficiency in Material Management?

o By using Just-in-Time (JIT) inventory systems, advanced analytics, and
barcoding/RFID technology to track and predict supply needs.
2. What role did automation play in enhancing efficiency at SGH?
o Automation was key in departments like CSS (for sterilization), Pharmacy (for
dispensing), and Biomedical Engineering (for maintenance scheduling),
reducing manual errors and saving time.
3. How did ambulance services improve response times?
o SGH utilized GPS tracking, route optimization software, and partnered with
local traffic authorities for emergency route clearances.

4. Patient Satisfaction Questions

1. How do support services directly impact patient satisfaction?

o Services like timely medication (Pharmacy), sterile surgical instruments
(CSS), and culturally appropriate meals (F&B) enhance comfort, safety, and
recovery, improving overall patient experience.
2. What steps were taken to improve patient feedback integration?
o Regular audits and feedback mechanisms were implemented in departments
like F&B, CSS, and Housekeeping to continuously align services with patient
expectations.

5. Innovation and Technology Questions

 1. What advanced technologies did SGH adopt to address challenges?
o AI-driven meal management, CMMS for maintenance, GPS for ambulances,
and IoT-enabled cleaning devices.
2. How does predictive maintenance improve operational efficiency?
o It reduces unexpected equipment failures by scheduling maintenance based on
usage patterns and performance analytics.

6. General Knowledge and Opinion-Based Questions

1. What do you think is the most critical support service in a hospital and why?
o Example response: "While all services are vital, Central Sterile Services (CSS)
is critical because it ensures infection control, directly affecting patient safety
and surgical outcomes."
2. **What lessons can other