Background Emergency risk communication is a critical component in emergency planning and response. It has been recognised as significant for planning for and responding to public health emergencies. While there is a growing body of guidelines and frameworks on emergency risk communication, it remains a relatively new field. There has also been limited attention on how emergency risk communication is being performed in public health organisations, such as acute hospitals, and what the associated challenges are. This article seeks to examine the perception of crisis and emergency risk communication in an acute hospital in response to COVID-19 pandemic in Singapore and to identify its associated enablers and barriers. Methods A 13-item Crisis and Emergency Risk Communication (CERC) Survey, based on the US Centers for Disease and Control (CDC) CERC framework, was developed and administered to hospital staff during February 24–28, 2020. The survey also included an open-ended question to solicit feedback on areas of CERC in need of improvement. Chi-square test was used for analysis of survey data. Thematic analysis was performed on qualitative feedback. Results Of the 1154 participants who responded to the survey, most (94.1%) reported that regular hospital updates on COVID-19 were understandable and actionable. Many (92.5%) stated that accurate, concise and timely information helped to keep them safe. A majority (92.3%) of them were clear about the hospital’s response to the COVID-19 situation, and 79.4% of the respondents reported that the hospital had been able to understand their challenges and address their concerns. Sociodemographic characteristics, such as occupation, age, marital status, work experience, gender, and staff’s primary work location influenced the responses to hospital CERC. Local leaders within the hospital would need support to better communicate and translate hospital updates in response to COVID-19 to actionable plans for their staff. Better communication in executing resource utilization plans, expressing more empathy and care for their staff, and enhancing communication channels, such as through the use of secure text messaging rather than emails would be important. Conclusion CERC is relevant and important in the hospital setting to managing COVID-19 and should be considered concurrently with hospital emergency response domains.
Background In April 2016, the Singapore Ministry of Health (MOH) declared War on Diabetes (WoD) to rally a whole-of-nation effort to reduce diabetes burden in the population. This study aimed to explore how this policy has been positioned to bring about changes to address the growing prevalence of diabetes, and to analyse the policy response and the associated challenges involved. Methods This qualitative study, using Walt and Gilson's policy triangle framework, comprised analysis of 171 organizational documents on the WoD, including government press releases, organizational archives, YouTube videos, newspaper reports and opinion editorials. It also involved interviews with 31 policy actors, who were policy elites and societal policy actors. Results Findings showed that the WoD policy generated a sense of unity and purpose across most policy actors. Policy actors were cognisant of the thrusts of the policy and have begun to make shifts to align their interests with the government policy. Addressing those with diabetes directly is essential to understanding their needs. Being clear on who the intended targets are and articulating how the policy seeks to support the identified groups will be imperative. Issues of fake news, unclear messaging and lack of regulation of uncertified health providers were other identified problem areas. High innovation, production and marketing costs were major concerns among food and beverage enterprises. Conclusion While there was greater public awareness of the need to combat diabetes, continuing dialogues with the various clusters of policy actors on the above issues will be necessary. Addressing the various segments of the policy actors and their challenges in response to the WoD would be critical.
The Singapore healthcare sector faces a myriad of challenges, including a rapidly ageing population, an increasing burden of chronic disease, and the rising cost of healthcare. The Ministry of Health has called for a restructuring and transformation of the current model of care to one that is more accessible, affordable and of higher quality, by the year 2020. In achieving quality health care, care integration through the Regional Health Systems (RHS) is seen as one approach to improving health and social outcomes, increasing healthcare utilisation and increasing satisfaction with healthcare providers. We conducted a qualitative study involving 31 elites from five policy agent clusters, and analysed organisational documents, to explore how the concepts of policy transfer and policy translation, explain the ways in which integrated care was introduced and developed in Singapore, with a focus on the SingHealth (SGH Campus) Regional Health System (RHS). The findings demonstrate that the development of integrated care is mediated by multiscalar and multi-site networks and contextual features. The multiple and pluralistic interpretations of 'integrated care' and 'policy' are contested spaces or domains requiring further negotiation and debate. Institutional issues in the SingHealth (SGH Campus) RHS, and in the private and ILTC sectors highlight the need to consider spatial and temporal factors, and the multiplexities in the embedding of integrated care policy.
Overall mean age of respondents was 49 (SD, 15) years and 50% were male. Response rate to the question on "willingness to donate kidney while alive" was 96% (1460); 707 (48.4%) were willing to donate a kidney while alive. Respondents who were willing to donate were younger (<40 years; P<.001); had above a secondary level education (P<.001); had monthly household income 2000 SGD (or US$1660; exchange rate at 1 SGD = US$0.83) or higher (P<.001); were not married, single, or divorced (P<.001); and were professionals (P<.001). Fear of surgical risks (86.5% strongly agree or agree) and poorer health consequent to donation (87.5% strongly agree or agree) were the main reasons for not considering being a living kidney donor. Demographic factors and concerns of surgical risks and ill health after transplant influenced willingness to donate a kidney while alive. Addressing these concerns may alleviate anxiety with regard to living kidney donation.
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