​Esther Network Singapore is a person-centred care network started by SingHealth Regional Health System to meet the medical and social needs of individuals who require integration between different care settings to address their needs, or “Esthers”.

Named after an 88-year old lady who inspired the Esther Network in Sweden, the aim is to enable people to live independently and confidently in the community, close to their loved ones.

Esther Coaches are trained to support and guide improvement work towards person-centred care within and beyond their organisations.

Reflections by Eunice Gwendolene Chua, Occupational Therapist, SGH and Esther Coach

I first saw Mdm Helen Yeo as her therapist during her inpatient stay. She was 68 years old, had gangrene in her right foot, anaemia, diabetes, and end stage renal failure. I trained her sisters, who were her main caregivers, to take care of her after discharge. The focus was on basic self-care, such as assisting her to get out of bed and sit on a chair.

When I visited Mdm Yeo at home recently as part of my Esther Coach training, I found that she was housebound. Her sisters were keen to take her out, but were not confident of pushing her wheelchair around the neighbourhood or accessing public transport with it.

I suggested that we take Mdm Yeo for a trip around the neighbourhood for a start. At the end of it, her sisters felt more confident to take her out more often while Mdm Yeo shared that she was happy to get out of the house.

Going beyond basics

Seeing how they enjoyed that outing, I realised that patients need more than just training to cope with basic care. During my visit, I found out that Mdm Yeo was an outgoing person who used to attend church regularly and enjoyed going on overseas mission trips before her health issues cropped up.

If I had known this, it would have helped shape my sessions with her. For instance, I would have incorporated more skills that allowed her to go out, such as simulating kerbs in the ward so that her sisters could try maneuvering the wheelchair with confidence.

Since my days as a student, I have been trained to put patients’ needs first and to set person-centered goals. However, in an acute hospital with high caseloads, it can be challenging to always remember to ask patients what they need and what is important for them. The visit to Mdm Yeo struck me as a timely reminder.

Placing Esther in the centre

Sometimes, patients feel disempowered and left out of the decision making process because healthcare professionals can appear didactic and authoritative when they speak to patients.

Patients appreciate having a listening ear or a helping hand. During a pre-workshop interview, a patient shared how he felt supported when the medical social worker followed up with him after his discharge. He took comfort that he had someone to turn to if he had problems or questions after he left the hospital.

Talking to Esther Coaches from different organisations, I realised how interconnected our jobs are. If we work together, it can empower our patients and ensure they are well taken care of throughout the different phases of their recovery journey.

It may take time for all of us to really put patients at the core of what we do. However, the Esther training has reminded me to start small, by helping a few first and eventually reach out to more. In addition, it’s important to build on available resources and not be afraid to FAIL, as it is really just the First Attempt In Learning.

Most importantly, let’s start by listening to Esther. What does Esther really want?

Currently, there are 60 Esther Coaches in SingHealth, another 40 will be trained in 2017. If you are interested in becoming an Esther Coach, sign up at http://goo.gl/jn3Rjr