Background: Family presence during adult cardiopulmonary resuscitation is still not widely implemented. Based on empirical evidence, various national and international professional organizations recommend allowing relatives to be present during resuscitation. However, healthcare providers worldwide are still reluctant to make it standard care. Purpose: This paper is a part of an ongoing cross-cultural study that aims to solicit attitudes of healthcare providers working in emergency departments towards family presence during cardiopulmonary resuscitation. This paper reports the qualitative data from surveying healthcare providers working in an emergency department at a university-affiliated hospital in Singapore. Method: Healthcare workers were asked to fill out an online survey, including both quantitative and qualitative questions. Their attitudes were critically analyzed and compared with existing empirical data. Results: Majority of healthcare workers (71.6%) believed that relatives should not be present during cardiopulmonary resuscitation and 52% thought that relatives would not want to be present. Conclusion: Most emergency department doctors and nurses in Singapore do not support family presence during cardiopulmonary resuscitation. Their concerns included: family's possible interruption of patient care, the relatives' wellbeing, and their own interests, as well as limited physical space and resources. Most of these concerns do not stand in the face of existing empirical data or ethical scrutiny. We therefore recommend in favor of family presence during cardiopulmonary resuscitation.

Singapore's healthcare system is under strain from the rising demands of an increasing and ageing population, resulting in delayed specialist care for patients presenting to the emergency department and requiring admission. Acute assessment units have been developed elsewhere but are not well established in local healthcare. Our institution extended our acute medical team to form an acute medical unit (AMU), in which focused internist-led teams are stationed on site to rapidly assess and re-triage patients. All patients (excluding those with very complex conditions) are admitted to the AMU and managed by internists who provide holistic, patient-centric care with better ownership, improved efficiency and less fragmentation. Patients can receive timely access to medical interventions and stable patients can benefit from early supported discharge, anchored by the nursing, allied health and transitional care teams. Given the ageing patient population with multiple comorbidities, this integrated model with exceptional outcomes is highly suitable for Singapore.