With the philosophy of handholding and improving patient’s confidence level, the team was formed to embark on the need for Quality Improvement Project Escalation by extending cluster support services to the 5 Communities of Care (CoC) in Singapore. The team aim to increase patient’s confidence level, reduce readmissions, facilitate smooth care transition from acute care to the community and strengthen social and health partnerships. Results shown an improvement in patient’s confidence level, readmission rates, average bed days and cost savings. Patients verbalized lower stress, felt more well-supported to manage their own health and increased satisfaction with the collaboration between hospital and community team. Healthcare staff were more motivated to continue improving work processes with tighter collaboration with community team. Results was presented in Virtual Esther Graduation Festival 2020 and gained the support and from Regional Health Services (RHS) and the hospital.