This book introduces the essential concepts of clinical quality and patient safety, offering a practical reference for healthcare professionals. It outlines widely accepted patient safety principles and emphasizes the importance of a coordinated, system-wide effort to reduce errors and improve care. High-quality care depends on teamwork, diligence, and compassion as core professional values. Everyone involved in patient care, including clinicians, nurses, allied health administrators, and support staff, shares the responsibility of working cohesively as a team to ensure safe and effective care. At the organizational level, leadership plays a crucial role in instituting systems that support staff performance and prevent problems stemming from poorly designed processes. This handbook provides a roadmap for optimizing healthcare processes and systems to deliver the highest standard of care. It presents clear and relevant guidance on the essential practices of detection, analysis, improvement, and ongoing evaluation that underpin high-quality, safe, and reliable patient care. Covering the full breadth of the healthcare system, from governance and leadership structures to frontline care provision, the book offers actionable guidance in areas such as data-driven analysis for problem prioritization and the central role of the Plan-Do-Study-Act cycle. By promoting simpler, less error-prone workflows alongside an open and fair reporting culture, organizations can foster lasting improvements. Ultimately, this book equips healthcare professionals and organizations with the principles and tools needed to embed safety, quality, and continuous improvement at every level of care.
A renowned pediatric cardiologist,
Professor Quek Swee Chye graduated from the National University of Singapore, and completed his residency at the National University Hospital. He is highly regarded for his clinical acumen in treating complex congenital and acquired heart diseases in children. Professor Quek was conferred fellowship of the American College of Cardiology, and served as the only Singaporean to sit on the Council of the Adult Congenital and Pediatric Cardiology Section. He holds fellowships with the Royal College of Paediatrics and Child Health (United Kingdom), the Academy of Medicine, Singapore, and the College of Pediatricians and Child Health, Singapore.
An exceptional clinician, researcher and educator, Prof Quek is also a distinguished administrator. He spearheaded many initiatives in his numerous leadership roles as Head of Medical Affairs, Chair of the Quality Assurance Committee, Chair of the Clinical Directors' Committee at NUH, and Chairman of the Medical Board at the National University Hospital. He is currently the Executive Director at the NUHS Institute of Clinical Quality. Prof Quek is also a visiting senior consultant to the Ministry of Health, Singapore and the School of Health Service at the Health Promotion Board.
For his many outstanding accomplishments in healthcare, Prof Quek was awarded the inaugural NUHS-Mokhtar Riady Pinnacle Award 2013 (Clinical Excellence Award) by the National University Health System, and the Ministry of Health's National Medical Excellence Awards in 2013. In 2022, he was conferred the Public Administration Medal by the President of Singapore, and in 2023, MOH further recognized his contributions with the Public Administration Medal (COVID-19) and the COVID-19 Resilience Medal.
Sophia Ang graduated from NUS medical school in 1990 and obtained her Master of Medicine Anaesthesia in 1995. She specialized in cardiac anaesthesia and completed a year of cardiac anaesthesia training at Massachusetts General Hospital in 1998–1999 and another year at the Texas Heart Institute in 1999–2000.
Sophia is interested in promoting and teaching patient safety. She is the Vice Chairman of the Medical Board for the National University Health System (Clinical Governance and Medicolegal), with an interest in projects promoting patient safety such as critical laboratory test communication, the reduction of failure to rescue and proper handover of care. Currently, she is a member of the Singapore Medical Council and an advisor to the Ministry of Health in Finance and Medisave. She is also the curriculum lead for patient safety at the Yong Loo Lin School of Medicine.
Sophia was awarded the Public Service Excellence Gold award in 2011 and was leader of the team awarded the Singapore National Medical Excellence Team award in 2012 for the communication of critical laboratory tests. She was previously a patient safety consultant with the Ministry of Health and a representative in the WHO High 5 Patient Safety Project, where her NUH team was awarded best poster for the implementation of correct site surgery at the 2012 seminar. In 2020, she received a Bronze National Day Award for Administration work in patient safety.
She was the President of the Singapore Society of Anaesthesia in 2006, and the President of the Patient Safety Special Interest Group for AMEE in 2022–2023 (Association of European Medical Education).
Dr Bhuvaneshwari Mohankumar has over two decades of experience in healthcare quality, patient safety, and clinical governance. She currently serves as the Head of the Medical Affairs Department (Clinical Governance), Head of the Casemix Office at the National University Hospital (NUH), Singapore, and Deputy Director of the National University Health System (NUHS) Institute of Clinical Quality.
She holds a Master of Public Health degree from Newcastle University, Australia, a Postgraduate Diploma in Hospital Administration, and an MBBS degree from India. Her expertise is further bolstered by certifications as an Institute for Healthcare Improvement (IHI) Improvement Advisor and Change Leader. Throughout her career, she has been at the forefront of quality improvement, patient safety and accreditation initiatives in healthcare. Her proficiency in teaching and conducting root cause analyses, failure mode effect analysis, and leading transformative change has significantly contributed to enhancing patient care and safety standards. She is particularly passionate about improving healthcare delivery systems and advancing medical education in the field of quality improvement and patient safety. Since 2018, she has been instrumental in leading the Casemix Office at NUH, where she has spearheaded efforts to improve clinical documentation and Diagnosis-Related Group (DRG) coding.
She plays a pivotal role in developing patient safety curricula and teaching medical, nursing, and pharmacy students within the Interprofessional Education program on patient safety and quality improvement module as part of the Executive Certificate in Healthcare Improvement at the National University of Singapore. Her innovative approaches to patient safety and quality improvement education have fostered a culture of continuous improvement among healthcare professionals.
Her contributions to the field have been widely recognized, with her work featured in numerous publications and presented at national and international conferences. Her expertise and dedication have earned her prestigious accolades, including the Singapore National Day Award – Commendation Medal in 2018 for her dedicated service and invaluable contributions to healthcare, and the National Awards (COVID-19) – Commendation Award for her significant role in Singapore's response to the COVID-19 pandemic. She has also received CE Commendation Awards for her contributions to the NGEMR, ESS and DM Collaborative project.
Dr Sandhya Mujumdar is currently a Senior Specialist, Quality Improvement and Patient Safety (QI & PS) with the National Healthcare Group (NHG), Singapore and a Physician Consultant for the Joint Commission International (JCI).
As Senior QPS Specialist, she supports and leads quality improvement initiatives, including developing robust systems and processes to build capability and capacity for QPS in NHG as a whole. She plays a pivotal role in training programs and courses, developing and designing curricula, evaluating QPS projects and identifying them for potential spread and scale across NHG institutions. As a trained Change Management Leader, she supports and drives overall change initiatives. She is responsible for exploring newer directions and developing toolkits for ease of learning by all levels of staff, including microlearning material and other innovative ways of enhancing knowledge through community of practice. In addition, she helps teams to develop and design proactive systems for clinical risks and conducts audits for NHG institutions using various established standards, providing guidance on corrective actions/action planning and training staff on how to conduct audits and write good reports.
She formerly worked as the Deputy Director of the Medical Affairs Department (Clinical Governance) and Senior Specialist in Quality & Accreditation at the National University Hospital (NUH), Singapore, from 2000 to 2020. She was a part-time lecturer at Yong Loo Lin School of Medicine (NUS), Singapore for 6 years. She continues to work as a Core Tutor for the Inter-Professional Education programme on quality and safety for undergraduate medical, nursing, and pharmacy students as part of the Executive Certificate in Healthcare Improvement at the National University of Singapore. She has also served as a lecturer for the quality and patient safety modules at the Saw Swee Hock School of Public Health (SSHSPH) for the past 10 years. She helped to develop the quality and safety framework at NUH, where she was in charge of quality and safety, clinical policies and performance management, licensing and JCI accreditation.
Her work, experience and contributions in the quality and safety field for over 3 decades have accorded her with recognition nationally and internationally. She has numerous publications and poster presentations to her credit and is a sought-after speaker nationally and internationally. She has won many national and international awards for professional excellence, including the NUHS-Mokhtar Riady Pinnacle Award: Clinical Excellence Award 2015 from the National University Health System; National Clinical Excellence Team Award 2012 (NMEA), MOH Singapore; and Singapore National Day Award: Commendation Medal 2014.
Dr Diana Santos completed her MBBS and specialist training in Internal Medicine in the Philippines. She has more than twelve years of experience working in Clinical Governance, including Patient Safety and Quality Improvement, in Singapore.
Dr Santos has facilitated over 300 clinical quality projects, co-authored publications and conducted PSQI training courses within the region. She is a part-time lecturer at the Yong Loo Lin School of Medicine within the Inter-Professional Education programme.
Her work in developing new services/medical devices and spearheading the EQUIP QI training program for clinicians both garnered her an HMA Excellence Award in 2018 and 2019, respectively. Diana was also a recipient of the NUHS Exemplary Staff Award and the 2019 Singapore National Day Award Commendation Medal.
