Annual Report 2010 - St. James's Hospital

Clinical Service Directorates I ORIAN
Structural Developments 2010
There was considerable structural work during 2010.
In January the theatres in the main complex were sequentially
closed to facilitate rewiring and the installation of more up to
date power back up supplies. This took approximately 6-weeks
and occurred with minimum impact on patient services.
The main ICU fl oor was closed for a well deserved overhaul,
and looks the better for this. A new door was inserted behind
the nurses station to allow access to the new 4-bed ICU area
(known by the staff as the courtyard).
4-new beds were offi cially opened and are isolation room
format which takes pressure of having patients on the open
fl oor and facilitates patient isolation.
The patient waiting area outside the main ICU has been
entirely refurbished and is much improved.
There were 6,516 attendances in the Day Surgery Centre
during 2010. This is a 2% increase on the throughput in 2009.
The graph below shows the growing activity in the procedures
being undertaken by the various theatre departments in the
Orian Directorate.
Orian Activity
No. of Procedures
10000
8000
6000
4000
2000
0
Burns Laser Endovascular
Day
Surgery
Department
Theatre
Theatre
Scope Proc
Total 2005
Total 2006
Total 2007
Total 2008
Total 2009
Total 2010
Pain
Theatre
All surgical specialties, pain medicine, gastroenterology,
Hepatology and cardiology use the theatre facilities and
services. The theatre provides an Endoscopy service for
elective and emergency procedures with 2,086 endoscope
reprocessing episodes. In 2010 there were 8,655 procedures
performed in the main theatre suite, 6,708 elective and
1,952 emergencies. This represents a 6% increase on the
throughput in 2009.
147 procedures were performed in the Burns Theatre and
214 procedures in the Endovascular theatre.
Day Surgery Centre
The Day Surgery Centre is a stand-alone unit with 18 day pre/
post operative patient trolleys. The Centre has two general
theatres, one minor surgery theatre, recovery, an anaesthetic
pre-assessment service, and a pre discharge lounge.
The Day Surgery centre provides services for patients
undergoing day surgery procedures under general, regional
or local anaesthesia for General Surgery, Plastic Surgery,
Gynaecology, Urology, E.N.T., Orthopaedics, Maxillo/Facial,
Vascular Surgery, Pain Management, Cardiology Dermatology
and Bone Marrow Donation. A limited service is also provided
for patients undergoing procedures in Main Theatre and
Diagnostic Imaging Department.
The anaesthetic pre-assessment service is Clinical
Nurse Specialist lead under the direction of a Consultant
Anaesthetist. Patients requiring General Anaesthesia are
Pre-Assessed, ensuring appropriate medically optimised
patients for ambulatory surgery, reducing cancellations on
the day of surgery.
ICU and HDU
The 15 beds in ICU were fully operational in 2010 and a 16th
Bed was opened in September 2010. Bed occupancy was
97%. There were 790 admissions (AVLOS 6.64). The 4 bed
HDU had 608 admissions. The department strives to roster
2-consultants in intensive care daily.
Both ICU and HDU provide medical care for critically ill patients
with potentially reversible conditions requiring organ support.
Pain Medicine
Since Interventional Pain Medicine was established at St.
James’s Hospital in 2004 in-patient referrals have increased
from 116 in 2004 to 1,725 in 2010. Activity is expected to
increase further with the reconfi guration of cancer services.
Activity Pain Management
No. of Procedures
1500
1000
500
0
Epidurals
PCA
Main Theatre Day Surgery
Department
The service offers expertise in the following treatments:
rhizotomy-cervical- thoracic-lumbar, spinal cord stimulation,
pulsed radiofrequency nerve and nerve root therapy,
trigeminal neuroablation, intrathecal therapy and interventional
cancer pain management, in addition to epidural and PCA
therapy, interventional pain therapies, consultant outpatient
clinics, a mindfulness clinic and a nurse-led education clinic.
90