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DeDicateD to excellence in Dermatology anD VenereologyDERMA
Vol 66 Issue No.5 • NoV 2016 -JAN 2017 MCI (P) 091/09/2015
DIGEST
NsC receives Joint Commission International (JCI)
Re-accreditation
On 17-18 November 2016, the National Skin Centre (NSC)
successfully achieved re-accreditation in its triennial Joint
Com-mission International (JCI) survey (Ambu-latory Care
Standards), an international stamp of excellent clinical practices
in pa-tient care and safety. The survey was con-ducted by JCI
surveyors Dr Ramsey Hasan and Dr Steven Matarelli. Since the last
re-accreditation in 2013, staff from all depart-ments have been
consistently preparing to meet the more rigorous standards of JCI.
The successful reaccreditation is testimony to the diligence and
commitment displayed by the Centre’s staff in ensuring that all
as-pects of NSC meet and exceed JCI stand-ards. Both surveyors also
shared their ex-periences gathered from other healthcare
institutions worldwide and that provided learning opportunities for
all staff to con-tinue and seek better quality and safer pa-tient
care.
More than 50 staff from different family groups attended the
exit conference where Dr Hasan and Dr Matarelli shared their key
findings during the two-day visit to NSC. Despite the revised third
edition standards set by JCI which saw major differences from its
previous editions, NSC was found to have met all standards
adequately and satisfactorily. These standards focused on two main
areas - Patient-Centredness and
Dr Martin Chio, Senior ConsultantLee Jun Yue, Quality
Executive
Organisation Management, which were de-veloped by professional
physicians, nurses and experienced staff in administration,
ancillary and allied health.
Dr Matarelli shared, “It is often said that quality is a
journey, not a destination. Learning organizations, such as NSC,
demonstrate their commitment to this journey each and every day.
Our recent survey activities at NSC illustrated that or-ganizations
committed to the people they serve and committed to sustainable
qual-ity processes are organizations filled with professionals
committed to purpose. It was a pleasure to be part of NSC’s
unending quality journey.”
In preparation for JCI-reaccreditation, led by Senior Consultant
Dr Martin Chio, the committee had reviewed the Centre’s cur-rent
processes to meet the new Ambulato-ry Care Standards (3rd Edition)
and closed the gaps identified in previous survey find-ings. The
Centre was active in engaging all staff to understand more about
JCI re-quirements. In the months leading up the accreditation,
several combined talks were given by respective chapter champions
to all staff to familiarise them with the exist-ing and new
requirements. JCI keynotes and interactive quizzes were also used
to further deepen staff’s understanding in hospital-wide
events.
NSC Director A/Prof Tan Suat Hoon lauded the staff for their
hard work in the prepa-ration towards meeting the new standards of
this JCI accreditation. “The successful reaccreditation shows our
commitment to-wards quality improvement and safety in a mature
organisation,” she said.
Being the first ambulatory care centre in South-East Asia to
achieve successful ac-creditation in 2007, NSC continues to strive
for high quality, safe and cost-effective pa-tient care.
NsC Director A/Prof Tan suat Hoon (middle seated), flanked by
JCI surveyors Dr steven Matarelli (left) and Dr Ramsey Hasan
(right), along with NsC staff at the exit conference of the JCI
survey.
Dr Ramsey Hasan presenting A/Prof Tan with the Joint Commission
International (JCI) accreditation certificate.
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NsC NeWs
DeRMA DIGesT • Vol 66 Issue 5 • NoV 2016 - JAN 2017
Team based HMDP in Community Nursing at Bristol, united
Kingdom
HMDP Report: st John’s Institute of Dermatology, Guy’s and st
Thomas’ NHs Foundation Trust, united KingdomNorlaila Binte
Kamarudin, Assistant Nurse ClinicianDr Angeline Yong,
Consultant
It was an opportunity that came at the appropriate timing for
Senior Staff Nurse Charlene Foo and I to be part of a team based
Healthcare Manpower Development Programme on Community Nursing in
Bristol, United Kingdom. Led by the Head of Nursing, Ms Brenda Lim,
SSN Charlene and I, we embarked on a mission to gain in-depth
knowledge on dermatological community nurs-ing practices and
services provided by other healthcare profes-sionals within Bristol
Community Health.
We were warmly received by Ms Lynne Skrine, who led the team of
Dermatology nurse specialist in Bristol Community Health. A
comprehensive programme was prepared for us during the pe-riod of
our visit from 15 August to 26 August 2016. Each of us was
individually posted to different health centres across Bristol.
Various nursing aspects on Dermatology care were discussed with our
counterparts during these attachments. In providing continuum of
care, the dermatology specialist nurses work hand in hand with
members from other disciplines such as the po-diatrists, wound
viability nurses, health visitors and the infection prevention
& control specialist practitioner.
We had a first-hand experience to sit in with the dermatology
nurse specialists during their consultation session with their
patients. The focus was on providing skin care counselling for
patients with Eczema and Psoriasis. We were also given the
op-portunity to do site and home visits with them. The
programme
was indeed valuable to equip us with the knowl-edge in providing
quality care for our patients and prepare ourselves to fit into the
healthcare needs which is moving towards community health.
A group photo after a meet up session with the team.
Ms Brenda lim, Head of Nursing NsC with Ms Julia Clark, Ceo of
Bristol Community Health and Ms lynne skrine, President of the
British Dermatological Nursing Group.
Consultant Dr Angeline Yong (second from left) reviewing
histology slides alongside supervisor and lead for dermatologic
surgery Dr Raj Mallipeddi (right) and fellow colleagues in the Mohs
Micrographic surgery (MMs) unit at st John’s Institute of
Dermatology.
I completed my one year HMDP training in Dermatologic Surgery at
the St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS
Foundation Trust, United Kingdom from 1 January 2015 to 31 December
2015. During this time, I worked with a team of 7 different
dermatologic surgeons which includes my clinical supervisor Dr Raj
Mallipeddi (clinical lead for derma-tologic surgery and skin
cancer; president of British Society of Dermato-logic Surgery), Dr
Richard Barlow, Dr Emma Craythorne (clinical lead for confocal
microscopy) and Dr Nisith Sheth. The dermatologic surgery and laser
unit (DSLU) of the St John’s Institute of Dermatology is the
largest Mohs Micrographic Surgery (MMS) unit in the United Kingdom
and han-dles between 25-30 cases of MMS per week. MMS is carried
out every day alongside other services including lasers and
photodynamic therapy.
Moh Micrographic Surgery (MMS) involves involving skin cancer
one layer at a time and examining these layers under a microscope
immediately af-ter removal to detect cancer cells. This allow a
minimal amount of tissue to be removed while making sure that all
the cancer cells are removed.
During this time I was exposed to a high volume of cases and was
involved in at least 500 cases of MMS for various skin tumours. As
their dermato-logic surgery fellow, I was also responsible for the
reconstructive surgery for most of the patients post MMS, and
developed expertise with various closures including grafts and
flaps.
I was also able to attend laser clinics once a week, and
assisted and per-formed under supervision various types of laser
treatment. Other respon-sibilities include presenting for the
weekly specialist nonmelanoma skin cancer (NMSC) multi-disciplinary
meeting. I was responsible for coordi-nating care for patients
referred to this meeting where a conjoint deci-sion is made between
dermatologists, dermatologic surgeons, plastics surgeons,
occuloplastics surgeons and medical oncologists regarding the most
appropriate treatment options for complex patients with NMSCs. As
there was a lot of interaction with other stake-holders in the
management of skin cancer patients, I was able to learn from the
other specialists in the fields of radiation oncology, plastics
surgery and occuloplastics.
This cross-talk between specialties allowed us to come up with
the best plan of action for each patient and helped me develop a
better under-standing of how to provide the most comprehensive care
for various sub-groups of skin cancer patients.
During alternate weeks, I also ran the skin cancer screening
clinic and skin cancer clinic for renal transplant patients on long
term immuno-
CONTINUED NEXT PAGE
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NsC NeWs
DeRMA DIGesT • Vol 66 Issue 5 • NoV 2016 - JAN 2017
NsC Acne Awareness Day Nathalie Ng, Corporate Communications
Executive
As the second most commonly seen skin condition at the National
Skin Centre, acne is a chronic condition affecting adolescents and
can persist into the twenties. Left untreated, acne can lead to
scarring and pigmentary changes. It can also have an adverse impact
on self-esteem and self-image among teenagers.
In an effort to educate the public and in conjunction with the
launch of the Centre’s new patient guide to acne, NSC held its very
first Acne Awareness Day event on 3 December, Saturday, where
visitors were treated to an array of fun activities and educational
talks on acne.
A tired but happy organising committee of Acne Awareness Day as
the day wrapped up.
Congratulations to three of the Centre’s doctors who were
awarded during the NHG-NUS Medicine Appreciation for Clini-cal
Teachers 2016 held at Tan Tock Seng Hospital on 22 November 2016.
Senior Consultant Adj A/Prof Lim Yen Loo and Consultant Dr Pan Jiun
Yit were awarded the Dean’s Award for Teaching Excellence, which
recognises exceptional teaching by outstanding clinical faculty,
while Senior Resident Dr Joel Lim was awarded the Jun-ior Doctor
Teaching Award for his similarly exemplary teaching to medical
students.
NHG-Nus Medicine Appreciation for Clinical Teachers
(From left) Senior Consultant Adj A/Prof Lim Yen Loo, Consultant
Dr Pan Jiun Yit and Senior Resident Dr Joel Lim receiving their
awards from Associate Professor Yeoh Khay Guan, Dean of Yong Loo
Lin School of Medicine, National University of Singapore.
suppressants. I also had the opportunity to participate in the
multi-disciplinary team meetings for xeroderma pigmentosum
pa-tients where they are regularly screened by a dermatologic
surgeon for new skin cancers.
As a result of the wide range of skin cancer patients and
multiple modalities available, I was able to develop proficiency in
managing skin cancer patients of varying complexities holistically
with a whole range of treatment options ranging from non-surgical
interven-tions including topicals, cryotherapy, photo-dynamic
therapy and surgical interventions such as wide local excisions,
therapeutic saucerisation and curettage and MMS.
During this time, I was also able to observe the utilization of
in vivo confocal microscopy as a pre-op tool to help delineate
margins in patients who are undergoing slow Mohs for lentigo
maligna. Confocal microscopy is a non-invasive imaging technique
that enables in vivo visualisation of the skin cells with a
resolution that is almost comparable to con-ventional
histology.
I hope my HMDP experience will be useful in:1. Developing a more
comprehensive ap-
proach to the management of skin cancer patients of varying
complexities who re-quire a combined approach with both sur-gical
and non-surgical therapeutic options.
2. Working with other doctors in the centre who are trained in
confocal microscopy to utilize confocal microscopy to delineate
margins before starting cases of melano-ma-in-situ which may be
treated by slow Mohs.
Educational forums were held in the morn-ing and afternoon
sessions, where NSC’s dermatologists touched on frequently asked
questions such as the root causes of acne, how to prevent acne
scarring and the significance of diet on the condition. The
Centre’s pharmacists shared on products for oily skin care and
nurses conducted demonstrations on chemical peels.
Visitors also had fun at the various in-teractive game and
activity booths set up throughout the Centre, as well as the
insightful tours around the clinics. It was an enjoyably
educational day for the young and old alike.
“It is a privilege for us to have the opportunity to teach
medical students regularly in NSC. It is important to ensure that
they are trained well, as they will be the future generation of
doctors who will take care of us when we are elderly and ill,” said
Dr Pan.
CONTINUED FROM PREVIOUS PAGE
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sTAFF NeWs
DeRMA DIGesT • Vol 66 Issue 5 • NoV 2016 - JAN 2017
Editorial: Dr Coni Liu, Ms Nathalie Ng Advisors: 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
For NSC Internet Appointment Booking, please login to
www.nsc.com.sg
APPOINTMENT Tel: 6350 6666 Fax: 6258 2475
RECORDED GENERAL INFORMATION
Tel: 6350 6680
Go Green with NsC – Read your Derm Digest online. Help us
conserve the environment by viewing our Dermadigest online, instead
of receiving them in print. send your request to [email protected] and
be notified for our latest online issue via email.
Dr Tan Wee Ping Melissa
From Consultant to Senior Consultant with effect from November
2016
Dr Tey Hong liang
From Consultant to Senior Consultant with effect from November
2016
Dr Michelle liang
From Associate Consultant to Consultant with effect from
November 2016
Medical Promotion
Drs Appreciation: Poke-elections!
The annual Doctors’ Appreciation Dinner took place on 23
December 2016. This year’s theme was ‘Pokemon Go to Polls’, which
was inspired by the Pokemon Go craze in 2016, as well as the US
Presiden-tial Election which took place in the later part of the
year. Some of the Senior Resi-dents and Medical Officers donned
Poke-mon costumes while others mimicked per-sonalities from the US
presidential election to put up an amusing skit for all our NSC
staff. The senior doctors serenaded the audience with a
heartwarming rendition of Michael Jackson’s “Heal the World”.
This year’s event was indeed a special one for Senior Consultant
A/Prof Ng See Ket and Head of Medical Affairs Mrs Alice Chew. At
the Long Service Awards presen-tation, NSC bade farewell to A/Prof
Ng See Ket as he moved on to retirement in 2017. Mrs Alice Chew was
also recognised for her admirable dedication to the centre for 50
years. It was definitely a heart-warming moment as we appreciated
both A/Prof Ng
See Ket and Mrs Alice Chew for their inval-uable contributions
to NSC since its early days in Middle Road Hospital.
The event ended off with a sumptuous buf-fet spread for all
followed by a karaoke ses-sion throughout the evening. What a great
way to end off a wonderful 2016!
(Clockwise from left)senior Consultant A/Prof Ng see Ket
receiving a token of appreciation from the Centre’s Director A/Prof
Tan suat Hoon.Head of Medical Affairs Mrs Alice Chew receiving an
award from A/Prof Tan for her 50 years of service to the
Centre.(From left) senior Residents Dr Bryan Chia and Dr Kong Yan
ling performing a comedic satire of the recent us presidential
elections.Associate Consultant Dr Roland Chu (front in red) giving
his best impression of a pokemon, much to the audience’s
amusement.
Madalene Yeo, Corporate Communications Executive
