Prof. Aymeric Lim

What are the most important elements of a successful hospital? And how is NUH achieving those standards?

A hospital has only one proposition. And the single proposition that a hospital has is patient care. All efforts must be directed to that, but there's no way you're going to achieve excellent patient care if you don't support your staff. To me, the most important element is giving a sense of purpose to your staff—all of them. We have 9,000 [people on] staff; some are frontline, some are support and they often work long hours in difficult circumstances. If we don't give our staff a sense of purpose, why would they be motivated to take care of patients?

How do you give your staff a sense of purpose?

First, they should be treated fairly. One thing that we really hate is bullying and so when they come to work, they should be treated fairly.

They should also have a sense of hope when they come to work, that they can have advancement [in] whatever job they do. You can improve when you're with us, not just [be] stagnant in a dead end. We want to give them the opportunity for growth.

Then we take care of health—actual health [and] money health. We give financial counseling, and at an early age. I always remember that, "If only I had listened to this advice when I was 30, I'd [have] done much better."

One of the programs we are most proud of is [our] overweight management program. In Singapore, we call it "Obesity Management Program." Any of our staff with a BMI above 28, they are encouraged to sign up for this program. The program is basically based on diet and food choices, and we've gone through four or five rounds, and it's been life-changing for some of our staff.

How do you measure success?

We have our hard outcomes, our patient outcomes—coronary intervention, stroke rates, transplant survival outcomes—and they're important because it's necessary to measure success. We also have to be as good as we can possibly be, and for Singapore, this means world-class.

We do measure our employee engagement and scores, which every hospital in Singapore does on a regular basis. And those are good markers of how engaged our employees are. Another [outcome] is outpatient experience. That's also important to use, it's another objective measure of how well we're doing as a hospital.

Lastly, and possibly the most important, the one with the longest impact would be culture. The culture of the hospital is quite intangible. It's like the culture of any organization, but you can generally feel it and it's what you would feel, say, if you came to the hospital at 2 a.m. and people were still very motivated and taking care of you. [If that's the case,] I'd say that you'd have good culture.

Can you think of a time when your team inspired you?

The National University Hospital is in the Guinness Book of World Records for having delivered the smallest baby that survived.

When this baby was born, I think she was 212 grams—the size of an apple—and we thought this was the big deal. She was born at 25 weeks, she spent 13 months in our ICU during COVID and she was discharged. Now she's doing pretty well, and she's three years old. She celebrates her birthdays with us. And there are very few complications from this very early birth; I think she has some lung complications, [but] otherwise she's done really well. We have a number of low-birth-weight babies that survive with very good survival rates, but she was the smallest.

And our head of neonatology said that's not our big achievement. I said, of course it is. He said "No, we've had 416 days in which there has not been a single nosocomial infection [a hospital-acquired infection] in the neonatal intensive care unit." And during those times, our occupancy in the NICU was usually about 150 to 170 percent. And I said, "How did you do that?" And he said, "We involved our parents in the care."

Before, we would always think parents would be a risk, but he said parents, along with the nurses, are the people who are going to take best care of the babies.

How do you maintain a work-life balance, and what advice do you have for people who want to make that more of a priority?

Being the CEO of this great hospital is an incredible privilege. And sometimes I think that I'd be crazy not to give it everything I have.

Having said that, I don't stay until 10 p.m. every night, I go home. I don't see it as a competition. And so, when I'm happy at work, my wife's happy and my kids are happy and they're happy at home. It's synergistic.

I think "work-life harmony" is a healthier term. Staff can find joy and great satisfaction at work while facing challenges outside work. We work in a health care organization, [so] there is definitely a sense of duty that our staff have with respect to one another and our patients, and this involves some element of sacrifice. That is what health care is all about.

So this brings us back to purpose at work. If this is the deal we have with our staff, it is our responsibility to ensure that we support them as much as we can in all aspects of their life, [like] physical fitness, hobbies, financial literacy, mental wellbeing. As far as leaders on all levels in NUH are concerned, we regard it as their duty to ensure that their people are able to thrive in a healthy environment.

"Harmony" implies co-existence of these two very important aspects—work and life. They overlap, they do not negate each other. My advice would be not to see them as extremes, a zero-sum game. For my experience in the hospital, some of the staff with the worst jobs on paper have one of the highest levels of engagement. It is because they are close-knit teams that support each other.

What are your favorite aspects of being a professor and working at a university hospital?

University hospitals are unique in that the practice of medicine is intertwined with teaching and research. We are not-for-profit and while we need to be good stewards of our resources, we focus on the patient and our students.

Teaching students and residents is one of the most fulfilling aspects about working in a university hospital. It is like watching your favorite soccer team score a goal when you see your students understanding a concept and watching a resident develop into a specialist with the right skills and values.

This interview has been edited and condensed from two conversations, for the sake of length and clarity.