Case Report Health and Primary Care Volume 3: 1-3 ISSN: 2515-107X Health Prim Car, 2019 doi: 10.15761/HPC.1000169 Development of a patient-centred model of community- based OPAT (CoPAT) service in Singapore Xu Yi 1 *, Lim Su Fee 2 , Fazila Aloweni 3 , Chua Ying Ying 4 and Huang Jie Ying 5 1 Senior Nurse Clinician (Community Nurse), RHS-Community Nursing, Singapore General Hospital, Singapore 2 Assistant Director of Nursing (Advanced Practice Nurse), RHS-Community Nursing, Singapore General Hospital, Singapore 3 Nurse Clinician, Nursing Division, Singapore General Hospital, Singapore 4 Consultant, Department of Infectious Diseases, Singapore General Hospital, Singapore 5 Senior Staff Nurse, Department of Infectious Diseases, Singapore General Hospital, Singapore Abstract Tere is a growing trend of expanding Outpatient Parenteral Antibiotics Terapy (OPAT) services to the community as it is more cost-efective for both patients and healthcare organisations. At the Singapore General Hospital (SGH), frail patients requiring intravenous (IV) antibiotics often have to prolong their hospitalisation to complete the course of treatment. Community OPAT (CoPAT) service is a joint efort between SGH Community Nursing and Department of Infectious Diseases. With the new CoPAT service, patients have the options of receiving their IV antibiotics at home rather than receiving treatment at the hospital or outpatient clinic. Tis case study described the process of providing CoPAT services in the community, its challenges and learning points and the positive outcomes of cost saving and improved patient experience. Early preliminary screening of suitable patients and good communication link among hospitals and community teams are essential in ensuring its success. *Correspondence to: Xu Yi, Senior Nurse Clinician (Community Nurse), RHS- Community Nursing, Singapore General Hospital, Singapore, E-mail: xu.yi@ sgh.com.sg Received: August 27, 2019; Accepted: September 09, 2019; Published: September 12, 2019 Introduction Outpatient Parenteral Antibiotic Terapy (OPAT) refers to the approach for delivering intravenous (IV) antimicrobials in the outpatient setting or community [1]. OPAT service was frst described in the United States in 1974 and was subsequently introduced to Singapore in 2002 [2]. Tis service requires a multidisciplinary team with expertise and experience in antimicrobial therapy for safety and long-term sustainability [3]. It is further recommended that the OPAT team provides an extension of services including laboratory testing, catheter care, regular nursing and physician assessments, follow-up, and adjustments as part of the optimal care to the existing primary illness, comorbidities and emerging complications [2]. Globally, there is a growing trend of expanding OPAT services to the community as it is cost-efective, and it also provides greater comfort to the patient when he/she receives the IV antibiotic at home [4]. OPAT improves patient’s satisfaction as it provides him/her the advantages of being able to resume his/her daily activities and having greater freedom and control at a familiar environment [5]. In additon, administering IV antibiotic at home reduces the risk of nosocomial complications as a result of prolonged hospitalisation [4]. In Singapore, OPAT services are mainly provided at specifc outpatient clinics within acute hospitals. Tis service may not be accessible to patients who are frail or with limited mobility as it requires them to travel daily to the outpatient clinic and also incurs transportation costs. As a result, many of them would prefer to remain in the hospital till they receive the full course of IV antibiotics. Tis paper aims to describe the development of a patient-centred model of community-based OPAT (CoPAT) service in Singapore using a case study approach. Background Community Nursing programme (funded by the Ministry of Health, Singapore) is envisaged as a key anchor for population health management and an enabler for person-centred care beyond hospitals’ walls, into the community. Singapore General Hospital (SGH) Community Nursing Programme was ofcially launched on 28 February 2018 as part of the Regional Health System (RHS)’s ongoing eforts to strengthen community care across the fve Communities of Care (CoC) Zones, i.e. Bukit Merah, Chinatown, Telok Blangah, Tiong Bahru and Katong (Figure 1). Communtiy Nurses aim to bridge the gap between care in the hospital and community and complement the services provided by the hospital, primary care sector and community service providers. One of the challenges faced by the acute care hospital was discharging frail patients who required prolonged IV antibiotics. Tese patients were unable to utilise the OPAT services in the hospital due to their limited mobility. Hence, the CoPAT service was developed in SGH