Published on 13 October 2025
At NUH, even small changes count. From fewer finger pricks to more comfort at life’s end, care is being redesigned to truly help patients.
When 48-year-old heart patient Mr Noor was told he could skip two of his four daily finger-prick tests, he didn’t expect much.
But the change meant better rest, less pain — and a glimpse of how National University Hospital (NUH) is rethinking what truly helps patients.
Cutting back, safely
The hospital’s review of blood-glucose monitoring began with a simple question: Does every test help the patient?
Led by Dr Ada Teo, Associate Consultant, Division of Endocrinology, and Advanced Practice Nurse Lim Suan Tee, a pilot in two wards tested reduced daily glucose checks for low-risk patients not on scheduled insulin.
Early adjustments ensured safety. Within months, rates of hypoglycaemia and hyperglycaemia stayed consistently low — even with fewer finger pricks.
The programme has since expanded to 14 wards with clear criteria and nurse-led decision-making. “This empowers nurses to take the lead to make decisions on reducing blood-glucose monitoring with clinical oversight,” said Ms Lim.
“It’s a true win-win,” said Dr Teo. “We still get meaningful data for clinical decisions, but patients experience less discomfort and lower costs.”
Comfort at the end of life
A team led by
Adj A/Prof Samuel Ow, Senior Consultant, Department of Haematology-Oncology, is reducing unnecessary medications and invasive procedures for terminally ill cancer patients.
Patients now take an average of two fewer medicines in their final six months, and three fewer in their last month. Routine charting and blood glucose checks have also been scaled back.
“Patients report less pain and more comfort,” said Adj A/Prof Ow. “By focusing on what truly matters, they can spend meaningful time with loved ones.”
Making change stick
This Apt Care initiative is more than a series of pilots. It’s a coordinated system-wide effort with doctors, nurses, and pharmacists redesigning workflows and embedding change into daily practice.
Nurses champion new routines during shift handovers; doctors share results at meetings; pharmacists deprescribe drugs that no longer add value.
Staff say the streamlined approach has boosted morale. “Nurses now have more time for meaningful care,” said Adj A/Prof Ow. “They focus on what’s critical, not just what’s habitual.”
A mindset for the future
While similar appropriate-care initiatives have existed for some time, the new programme aims to consolidate and formalise these efforts so they can be implemented more swiftly, said
Adj A/Prof Adrian Kee, Head & Senior Consultant, Division of Respiratory & Critical Care Medicine, Department of Medicine, NUH, and Senior Consultant, NCIS.
The initiative is now expanding across NUH. It is jointly led by Adj A/Prof Kee and
Adj A/Prof Amelia Santosa, Head and Senior Consultant at the Division of Rheumatology and Allergy.
“With more patients managing multiple chronic conditions, purposeful consolidation of tests, medications and appointments is essential,” said Adj A/Prof Santosa. “Apt Care is becoming a critical principle for all healthcare institutions.”
The message from NUH leaders is clear: better care isn’t about doing more, but about doing what truly matters.
What’s changing at NUHS- Glucose checks are tailored: Blood sugar checks now match patient risk levels — fewer finger pricks for stable patients, regular checks for higher-risk ones.
- Medications are reviewed: At the end of life, drugs that no longer help are deprescribed to ease side effects and stress.
- Targeted testing: Duplicate lab tests and unnecessary procedures are cut.
- Supplements are reconsidered: For example, vitamin D and calcium are prescribed only when they make a real difference.
- Consolidated care: Appointments are streamlined to reduce patient fatigue and improve coordination.
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In consultation with Adj A/Prof Adrian Kee, Head & Senior Consultant, Division of Respiratory & Critical Care Medicine, Department of Medicine, NUH, and Senior Consultant, NCIS; Adj A/Prof Amelia Santosa, Head and Senior Consultant, Division of Rheumatology and Allergy, Department of Medicine; Adj A/Prof Samuel Ow, Senior Consultant, Department of Haematology-Oncology, NCIS, and Dr Ada Teo, Associate Consultant, Division of Endocrinology, Department of Medicine, and Ms Lim Suan Tee, Advanced Practice Nurse, NUH.
