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SMP - Barry Klassen
 

SMP - Barry Klassen

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    SMP - Barry Klassen SMP - Barry Klassen Presentation Transcript

    • Adult Emergency & Trauma Centre QECTH Blantyre Malawi Barry Klaassen Emergency Medicine NHS Tayside
    •  
    • NHS Tayside
      • Numerous individual projects
      • Formation of Tayside Malawi Group
      • Strong Health Board and Executive support
    • Tayside Malawi Group
      • Aim bring together projects and share knowledge and expertise potential for collaboration/co-operation
      • Chair Prof Frank Carey( Pathology)
      • Now NHS Tayside Int. Heath Links Group
    • NHS Tayside Group
      • Anaesthesia
      • General Practice
      • Obstetrics and Gynaecology
      • Pathology/laboratory Science
      • Plastic Surgery
      • Emergency Medicine
      • also PAMS and St.Andrews/Dundee Medical Schools
    • Emergency project
      • Anaesthetic/critical care training led by Dr Catriona Connelly Oct 2007 Part of that team
      • Consulted on feasibility of Adult ED by Prof Malcolm Molyneux and Prof Rob Heyderman Director of Malawi Wellcome Trust
    •  
    • Queen Elizabeth Central Teaching Hospital
      • Malawi’s largest 1,120 beds
      • for local population approx 1 million
      • Teaching hosp for single Medical School
    • Problems for QECTH
      • 3 fold population increase
      • urbanization
      • HIV epidemic
      • ALL increase GREATLY clinical workload
    • QECTH in 2006
      • 400,167 attendances A&E/OP… 1500+/day
      • on average
      • 302 Paeds emergencies/day with 70 admissions/day
      • 530 adult emergencies/day max1010/day with 70 med /20 surg admissions
      • bed occupancy in med admissions 252%
    • Problems with existing A&E facility
      • Makeshift access
      • few small rooms/confined space
      • no triage facility/triage non-existent
      • no resuscitation facility
      • no capacity for major incident
      • no capacity to stabilise patients prior to admit to wards
    •  
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    • Establishment of Paediatric A&E Unit ( PAEU) 2001
      • New build for rapid registration
      • immediate triage
      • on site immediate care
      • resuscitation facility
      • records and data store
      • senior clinical supervision
      • ability to deliver 1st treatments rapidly
    •  
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    • Impact of PAEU
      • DRAMATIC….
      • Reduction death rate among admissions from 19% to 9%
      • improved research on acute conditions
      • improved teaching/support of staff and Med/Nurse students
      • improve morale of all on-site staff
    •  
    • THERE IS NO EQUIVELENT PROVISION FOR…….
      • Adult acute Medical
      • Adult Surgical
      • Adult Orthopaedic and Trauma
      • or Gynaecological Conditions
    • Proposal
      • Purpose built Adult Emergency & Trauma Centre
      • QECTH/COM heads of Dept agree need for such
      • appointed steering group
      • identified site at Hospital
      • Architects appointed / drafted initial plan
    •  
    • Requirements of Centre
      • Capacity for 500-1000
      • immediate reg/triage
      • separate minor/majors
      • resuscitation facility
      • specialist evaluation
      • ability to isolate I.D
      • Short stay facility
      • ability to initiate 1st treatment
      • Capacity for data store
      • open plan waiting area
      • optimise flow to treat
      • minor/major theatres & plaster areas
      • lab facilities
      • x-ray facilities
      • dispensing pharmacy
    • Further requirements
      • Suitable to senior supervision all areas
      • teaching/training facilities/seminar room
      • amenities for staff rest/refreshment
      • Adequate toilet/wash facilities for patients
      • max air flow & natural light throughout unit
      • ready access for Amb.
    • Funding
      • Malawi- Liverpool-Wellcome Trust pledged excess of £500,000
      • THIS REMAINS CONFIDENTIAL BUT IS CONFIRMED.
      • This covers new build costs
    • Require further funding for ..
      • Initial key set up personnel
      • Equipment costs
      • Training Costs
    • Scottish support
      • Recruit Experienced Scottish EM Consultant to oversee initial operation
      • Support re equipment purchase
      • support re training Malawian clinical staff
    • Tayside EM dept involvement
      • Support project and provide a link for new dept akin to Twinning arrangement
      • share good practice and equipment
      • allow senior Malawian Clinical staff to come and observe our EM practice
    • Tayside EM Benefits
      • Opportunity to share some of our expertise with others
      • contribute collectively as a unit in framework of Scottish Gov policy to Malawi
      • opportunity to use the link to generate research and audit collaboratively
      • Develop improved understanding of EM as practised in other country
    • Funding
      • Scottish Gov. International Development Fund
      • NHS Tayside funds with Malawi support group
      • Local Fund raising
      • Others…
    • Scottish Gov IDF Grant
      • Not payable to individual need to be organisation
      • NHS Tayside Director of Finance very supportive
      • Have created NHS Tayside Malawi-EM project endowment fund
    • Additional Expenditure
      • Recruit a Clinical Lead for Unit -College of Medicine responsibility
      • Recruit Nursing Staff , New Clinical Officers and Eventually Medical Staff - Ministry of Health responsibility
    • SOMEONE CANNOT DO EVERYTHING… …BUT EVERYONE CAN DO SOMETHING.
    • ANY QUESTIONS?
    •