I have a few friends and family members who have succumbed to cancer, yet I’ve never been to the National Cancer Centre Singapore (NCCS) before. The NCCS is one of the finalists for this year’s Singapore Service Excellence Medallion Award, and I was invited to visit the Centre and discover for myself how the care for patients is their staff’s top priority. In the picture above, I am reading one of the many ‘thank you’ cards given to staff by their patients. I was also brought on a tour of the premises.
Contrary to popular belief, it is not just patients diagnosed with cancer who go to the NCCS. Dr Terence Tan from NCCS shared with me that some people come here for genetic testing, for instance, so as to get peace of mind if they are at high risk of getting cancer. Early detection and early treatment helps save lives!
NCCS receives about 135,000 patient visits a year and provides purely outpatient service – there are no beds here. If patients have to be hospitalized, they go to SGH next door and the doctors go over to look after them.
The NCCS has the most advanced radiotherapy equipment in this part of the world and while Clinical Quality is important to them, they hold Service Quality close to their heart as well.
I was surprised to note that Patient Relationship Officers greet and welcome patients at the entrances to the clinics. In fact, the NCCS has an in-house service quality program ‘NCCS Cares’ which they developed together with the Disney Institute. The aim is to keep staff happy and satisfy their customers. Thus, their Service Quality mission is to provide the “Best Experience through Compassionate Care”.
Dr Terence Tan shared with me that patients are with the NCCS for life – they do not get discharged, and do still come back even after the end of the treatment cycle. “We have a unique opportunity to develop a long-term relationship with them, and that’s what our staff do.” For instance, patients who require radiotherapy come to the NCCS every day for 7 weeks, and develop a bond with the people who help treat them.
I also had the privilege of speaking with a Senior Staff Nurse, Audrey Quek, whose animated gestures and infectious bright smile, along with cheery chuckles, clearly helps lighten the atmosphere in any room. Audrey has 35 years of nursing experience!
My photographer pal, Max Clyne, sent me a hilarious caption for the photo below:
Nurse: “I know Kungfu ok”
Grace: “I note it down”
Audrey was actually explaining to me about how doctors can sometimes get too taxed with the patient load (there is an increase in the number of new patients year on year) so nurses help spend time with the patients, befriend them, share about surgical procedures, let the patient know what to expect in the operation, and also how to cope with the pain after, etc.
The aim, she says, is to help the patient feel relieved and assured of getting good service and anything else they may need during the course of their treatment, e.g. financial assistance or counselling. There is also a Cancer Helpline they can call.
[Me, Audrey and Dr Tan]
The NCCS sends the top 3 or 4 staff each year to Disneyland to see a world-class service organization at work, so they can come back and infect the rest, according to Dr Tan. Audrey was one of the winners of the annual trips.
“I asked myself why is everyone so happy there? I compared the two different clientele. Disneyland is for pleasure; people go there to enjoy themselves. Patients here hope somebody can help them in all aspects – finance, mental and emotional support, and hope that they can get comfort and assurance. The principle is the same – find out what is the client’s objective.”
~ Chemotherapy Unit ~
There I met another two of NCCS’s staff: Chia Chor Hoon and Simon Chen.
Chor Hoon shared with me that the place can get quite cold sometimes so the staff will offer patients some warm water and blankets – “We cannot take away the pain, but we can give them some comfort and reassure them that we will take good care of them.”
Simon, who has worked in NCCS since 2010 shared…
Our mood can influence our patients’ mood. Why not make a difference in their lives by suggesting ways they can cope with the disease, how they can lift themselves up? Bring in their family members to encourage them e.g. by sharing about the positive things in their prognosis. Whenever I see any signs of good news, e.g. a decline in cancer markers, straightaway I will tell them so they have something to look forward to… A glass can be seen as half-filled or half-empty. Even if the doctor tells you there is only 30% chance of recovering, tell yourself you are 1 of the 30% instead of focusing on ‘oh dear, the odds are against me’.
Simon’s belief is that besides treating patients, staff have to help give them hope too.
~ Radiotherapy Unit ~
At the Radiotherapy unit, I got to meet Yusnita Bte Omar, the Assistant Manager for Education and Training. She has been at NCCS for 19 years! She showed me how they prepare patients for the treatments.
In radiotherapy, patients have to be immobilized, e.g. for treating brain tumors and such. The sheet she is holding has to be warmed up, and quickly placed on the patient’s face, and contoured to the shape of the patient’s head, and made into a “mask”. This is especially tricky when the patient is a child or is claustrophobic. Yusnita says they have to first understand the patient’s fear and demonstrate to them the procedure first – either on other patients who have given their consent, or on one of the medical officers.
Mask-making takes 20 minutes and patients have to wear the mask every day of treatment. Yusnita shared that during training, they have all undergone the mask-making procedure and know that the contouring around the neck region feels like someone is strangling you. This helps them empathize with patients, and they will sometimes hold the patient’s hand, put him/her at ease, and once the mask hardens, cut it open around the eye region so the patient can ‘see’ and feel less afraid.
With kids, they use play therapy. They will wrap a piece of the material around the child’s wrist first, “like a Ben 10 super watch”. They will also print cutouts of the cartoon character and paste them over the “watch”. This process helps the children feel how warm the mask will be, and how it “grabs your skin”. Only as a last resort will general anesthesia be used.
Because they have made what is a usually-scary procedure fun for the children, Yusnita shared that “some run in and say I’m ready. Can I have my mask today?” as it makes them feel like superheroes.
Radiation Treatment Room:
The radiation treatment room has in-room music, and sometimes patients bring in their own music selection too. Each treatment room comes with a ceiling in a special theme – garden, waterfall, sky, etc.
The beautiful ceilings play a role in helping to calm them down. One of their patients was a diver. Before starting her treatment, she went on a holiday then she came and laid down on the treatment bed and made the comment that “oh, I’m still holidaying”. :)
Yusnita shared with me about the importance of Passion in her job – “Know why you are here, who you are working for, keep on track. Burn that passionate flame. It’s important to love what you are doing.”
And because her department is located in the basement of the NCCS, colleagues who work at level 1 and above joke about not knowing they exist. Yusnita shares with a smile:
“There’s no sunshine so we bring along the sunshine with our personality. If not, the place will be cold. We need warm people around.”
Indeed, the staff that I met at NCCS are warm, cheerful and optimistic people. Like Dr Tan shared, “it takes a special kind of nurse to work here”.
Key Takeaway: I found the visit an eye-opening experience. I had expected an atmosphere of ‘doom and gloom’ but what I noticed was an upbeat, cheerful atmosphere. And staff selection is so crucial for organizations handling patient care – you need motivated, friendly, and optimistic people to spread a message of hope among patients who could be feeling very helpless. Thus, the company culture of care and respect among the staff, and the shared mission of delivering the best experience through compassionate care, has resulted in a situation whereby happy staff continue to delight and serve patients every single day.