The modified wheelchair with double layer metal casing speeds up patient transfer in a safe and secure manner. 

Mdm Teo has completed her open-heart surgery two days ago and was warded at the Cardiothoracic Intensive Care Unit (CTICU). During the doctor’s visit rounds at 10am, her doctor assessed her condition to be stable and approved her to be transferred to the step-down ward. At around 10.34am, Mdm Teo was settled into the ward, safe and sound. 

The whole process of transferring to the step-down ward was done in less than 40 minutes and by only one nurse - which is a significant improvement prior to the roll-out of the initiative by team REVIVORS. 

Before: A dangerous and time consuming task 

“Previously, we had to call and wait for the porter to assist the nurse in transferring patients to the step-down ward. We
had to manoeuvre the entire bed from CTICU, in and out of the narrow lift, and cautiously navigate through the corridors to the step-down wards,” shared team leader, Assistant Nurse Clinician (ANC) Lew Chee Kwong, CTICU. 

During transfer, staff have to also pay special attention to the tubes and equipment that are hooked onto the patients, and prevent them from knocking against the side of the narrow lift or rolling into the wheels of the bed. 

After: Safe and fast transfer 
Patient safety is the key consideration in this initiative. “Our priority is to ensure that our patients are moved safely with the chest tubes intact throughout the transfer. Having tested various methods and many rounds of Plan-Do-Check-Act cycles, using a wheelchair to transfer had proved to meet all the safety measures and criteria,” said Nurse Clinician (NC) and co-leader, Wu Wing Yin.
The team went through repeated rounds of Plan-Do-Check-Act cycles to address the concerns raised by nurses, doctors and patients. The many testing and trials finally led to the creation of a modified wheelchair with double layer metal casing. Not only can it fit two chest tubes securely, one staff is all it takes to transport the patient smoothly to the step-down ward without any delay. 

From the previously two staff and 83 minutes spent to prepare and transfer the patient from CTICU to the step-down ward, the team slashed the time taken by 59% and manpower by half. More significantly, the improved process* is safe, with zero harm to patient.

Quality improvement team Heartbeat
For their excellent initiative, Team Revivors took home the Team Excellence Symposium^ STAR Award (L-R, front to back row): NC Yang Yang, Ward 44; NC Wu Wing Yin, CTICU; Senior Nursing Manager Yeoh Lee Shien, CTICU; Prof Terrance Chua, Medical Director; ANC Wong Pui Kuan, Ward 56; ANC Rosnita Binte Ismail, Ward 56; Senior Staff Nurse Abegail M Domalanta, CTICU; Dr Tan Ann Kheng, Senior Resident Physician, CTICU; and ANC Lew Chee Kwong, CTICU.
*Only patients assessed by doctors to be suitable for wheelchair transfer are to follow the enhanced protocol.
^The Team Excellence Symposium is organised by the Singapore Productivity Association as part of the Innovation and Quality Circles movement to enhance organisations' innovative capacity and value.