Thirty years from the intensive care unit to the group HR office

Mandate

Make three national hospital businesses one employer without erasing what works locally, lead the people side of the Wiralaksa acquisition and reduce the group's dependence on agency nurses.

Outcomes

• Cut Johor Bahru nurse turnover from 31% (2022) to 16% (2025) through a priced cross-border pathway; 34 of 40 closed beds reopened.
• Retained 41 of 44 Wiralaksa nursing leaders at twenty-four months; specialists holding privileges rose from about 900 to 970.
• Reduced first-year nurse turnover in Singapore from 29% to 15% with the 2022 night-shift rules.
• Reduced agency nurse spending in Singapore by S$5.8m a year.
• Introduced a licence register that blocks lapsed professionals from clinical rosters in all three countries.

Decisions in context

I took the group role when Aravelle decided to grow in Indonesia and needed one people function rather than two national ones. The first year went on foundations: a single licence register, one HR system for Singapore and Malaysia and a group view of nurse vacancy and agency spending by ward type. In 2023 the acquisition of Wiralaksa added five hospitals and 4,900 people, and I led the people integration, from retention of nursing leaders to grade mapping and the secondment programme. At the same time I ran the Johor pathway and extended the night-shift rules to Malaysia. I prepare the remuneration committee's papers on executive pay and on the annual nurse pay review, and I report to the clinical governance committee each quarter on staffing exceptions and licensing. I am not a director of the company or of any of its subsidiaries.

Reason for the move

Current appointment; completing the three-country nursing career ladder and the Indonesian integration.

Mandate

Stabilise nurse supply in Singapore and Malaysia, reduce reliance on agency nurses and modernise HR operations that still ran on hospital-by-hospital systems.

Outcomes

• Introduced the employer-pays model for foreign-trained nurses in 2020; their first-year attrition fell from 26% to 11% by 2023.
• Found eleven nurses working on lapsed practising certificates in 2020 and built the register that now prevents it.
• Cross-trained 610 nurses for intensive and isolation care in 2020 and 2021.
• Commissioned the roster analysis behind the 2022 night-shift rules.

Decisions in context

I came back to hospitals after six years in manufacturing because Aravelle's chief executive for Singapore and Malaysia wanted someone who had worked on a ward to fix nurse supply. The first months were spent on numbers nobody had brought together: vacancies by ward type, agency spending, first-year turnover and what newly arrived foreign-trained nurses had paid to reach us. The recruitment survey led to the employer-pays model. A licensing audit I commissioned in early 2020 found eleven nurses who had kept working after their practising certificates lapsed; we reported it to the clinical governance committee and built a register linked to rostering. Then the pandemic arrived, and much of 2020 and 2021 went on cross-training 610 nurses for intensive and isolation care and keeping exhausted teams together. Late in 2021 I commissioned the roster analysis that showed who was working our nights.

Reason for the move

Appointed group chief human resources officer when the group combined its national HR functions ahead of expansion into Indonesia.

Mandate

Staff a second manufacturing building with qualified aseptic operators on schedule and redesign the site's continuous shift pattern.

Outcomes

• Hired and qualified 310 people for the second building by 2017, in time for regulatory inspection of the new lines.
• Replaced rotating twelve-hour shifts with fixed shift teams; operator turnover fell from 19% to 9%.
• Linked training qualification records to cleanroom access, so a lapsed qualification stopped entry automatically.
• Set up a shared HR service for three Asia-Pacific manufacturing sites.

Decisions in context

I moved into manufacturing to learn how an industry with a strict quality system treats people's competence, and it taught me more than I expected. Operators at the site needed documented training and qualification before they could work in aseptic areas, and the plant's quality system treated that record as seriously as any batch record. Hiring 310 people for a second building meant working with the quality and production heads on a qualification plan that set the hiring calendar, rather than the other way round. I also redesigned the site's shift pattern after finding that rotating twelve-hour shifts were driving operator turnover. The lesson I took back to hospitals was simple: a qualification that matters for safety should control whether someone can start work, automatically, not be checked during an audit. I left when Aravelle offered me the chance to apply it to nurses.

Reason for the move

Recruited by Aravelle to lead people for its Singapore and Malaysian hospitals.

Mandate

Reduce nurse turnover across six hospitals acquired at different times, build a career structure for employed doctors and bring the hospitals onto one grade system.

Outcomes

• Reduced group nurse turnover from 27% to 18%, although the Johor hospital barely improved.
• Built a four-step career structure for 230 resident medical officers.
• Moved six hospitals onto one grade and pay structure by 2012.
• Started in-house post-basic courses in critical care and theatre nursing with a local nursing college.

Decisions in context

Kuala Lumpur gave me my first general HR leadership role and my first view of nurse migration from the side that loses. Seri Andalan had grown by buying hospitals, each with its own grades and habits, and its nurses left for Singapore, the Gulf and newer Malaysian hospitals. I unified the grade structure, built post-basic courses so that nurses could specialise without leaving, and created a career path for resident medical officers, the employed doctors who keep a private hospital running between consultants' visits. I also learnt how Malaysian private hospitals work with consultants who are independent practitioners rather than employees. Group nurse turnover fell, but our Johor hospital continued to lose nurses across the causeway whatever we did with pay. I treated it as a pay problem, which it was not, and that lesson waited ten years for a use.

Reason for the move

Wanted experience outside hospitals and joined a vaccine manufacturer to learn how a quality system manages competence.

Mandate

Run the surgical intensive care unit; then, from 2006, plan nurse staffing and international recruitment for the whole hospital.

Outcomes

• Reduced intensive care nurse vacancies from 9 posts to 2 by 2005.
• Recruited about 260 nurses from the Philippines and India between 2006 and 2008.
• Wrote the hospital's first adaptation programme for foreign-trained nurses.
• Introduced acuity-based staffing on surgical wards with the director of nursing.

Decisions in context

Running the unit I had trained in taught me how much a ward depends on the roster and the people on it. I joined interview panels in Manila and Chennai in 2004, and nurses who came to my unit later told me what they had paid to reach us; I raised it, and was told, truthfully, that it happened before they reached our door. In 2006 the hospital asked me to move into HR as its nursing workforce manager, responsible for staffing plans, roster rules and international recruitment. I wrote the hospital's first adaptation programme for foreign-trained nurses and introduced acuity-based staffing on surgical wards with the director of nursing. I studied part time for a master's degree in human resource management and finished it in 2008. By then I wanted to run HR for a whole organisation, and the opportunity came in Malaysia.

Reason for the move

Moved to Kuala Lumpur to lead HR for a Malaysian hospital group.

Mandate

Serve the three-year bond owed for a sponsored nursing traineeship, then develop as an intensive care nurse.

Outcomes

• Completed the three-year service bond in 1999 and stayed.
• Completed an advanced diploma in critical care nursing in 1999.
• Acted as preceptor to about 30 newly registered nurses.
• Introduced a structured bedside handover checklist adopted across the unit.

Decisions in context

I arrived at Kinloch Bay as a sponsored trainee from Surabaya and began work on the surgical intensive care unit in July 1996. As the newest nurse I worked the nights others declined, and one of them, in March 1997, produced the error a senior colleague caught and the question she asked me about my roster. I served my three-year bond, took an advanced diploma in critical care and became a nurse clinician in 2001, leading shifts and acting as preceptor to newly registered nurses. With two colleagues I introduced a bedside handover checklist after a patient's allergy was missed between shifts. I also studied part time for a nursing degree, which I completed in 2002. These years gave me the vantage point I still use in HR: what a policy looks like to the nurse who has to carry it out at night.

Reason for the move

Promoted to nurse manager of the unit.