Unit Brief v1 ICM Unit Brief Part 1 Hospital Details 1.1 Hospital name William Harvey Hospital 1.2 Full address (you must include postcode) Kennington Road Ashford Kent TN24 0LZ Part 2 1.3 Hospital Telephone number 01233 633331 ICU Department contact details 2.1 Direct telephone number to Department 2.2 Department Email address [email protected] 01233 616744 2.3 Home page of departmental website http://www.ekhuft.nhs.uk/patients-and-visitors/william-harvey-hospital/ 2.4 Faculty Tutor name 2.5 Faculty Tutor Email address [email protected] Dr Debkumar Pandit Part 3 Unit Structure 3.1 Number of Consultants 6 3.2 Percentage of elective vs emergency admissions Elective: 26%; Emergency: 64% 3.3 Overview of case mix within the unit This unit admits over 750 patients per annum in 9 beds. A high proportion (approximately 60%) of these patients is Level 3. Total number of admission is likely to increase with addition of two more HDU beds from January 2014 increasing the total number of mixed ITU & HDU beds to 11 beds, with ability to provide invasive mechanical ventilation to 9 patients at any time. The usual case mix admitted to the unit equally shared between surgical and medical patients. The medical patients come from unselected acute medical intake to the hospital under varied medical specialities including, respiratory, gastro-enterology, neurology, stroke, geriatrics and cardiology. In addition to this WHH is the designated 24/7 primary PCI centre for the whole of Kent, therefore there are a significant number of patients admitted following acute coronary events and/or out of hospital cardiac arrest. The elective surgical cases are usually post-operative major upper and lower GI surgery, Head Neck including maxillo-facial surgery and Trauma & Orthopaedic patients. On average 45-50% patients receive invasive mechanical ventilation and 16% receive Renal Replacement Therapy. Page 1 (of 3) Unit Brief v1 3.4 Details of training opportunities on the unit Exposure to a high volume case mix of emergency general medical patients of varied specialities (including post-primary PCI) and both elective and emergency surgical patients. Organ support provided in the unit includes invasive and noninvasive ventilation, renal replacement therapy, therapeutic hypothermia and IABP. Invasive cardiovascular monitoring, cardiac output measurement with LiDCO & PiCCO devices and advanced mechanical ventilation techniques are used as standard. There are plenty of opportunities for teaching, supervising and mentoring to the many third and fifth year medical students, foundation year doctor and core trainees from different specialities attached to the ICU. In addition higher speciality trainees are actively encouraged to make use of many on-going service development projects to develop their leadership skills. The ICM speciality works in close relationship with other specialities in the hospital. This creates opportunity to learn and develop special skills for ICM trainees in other hospital specialities e.g. Airway skill and Bronchoscopy. 3.5 Names of Consultants, roles and areas of interest Name Dr Christopher Toner Dr Debkumar Pandit Dr Ranjit Dulai Dr Mark Snazelle Dr Ravi Ramaiah Dr Zyad Saeed Role (eg clinical lead, consultant) Director of ITU Faculty Tutor TPD ACCS, Organ Donation Lead Areas of interest Therapeutic Hypothermia Ventilation, Sepsis Airway, Head and Neck, Patient Safety Nutrition Lead Echocardiography, M&M, Trauma ACCS Lead Research, ICNARC, Guidelines Newly appointed as dual Emergency medicine & ICM 3.6 Details of research projects being undertaken within the unit WHH ICU actively participates in national and international collaborative research projects. We are currently participating in the IC-GLOSSARI study: A multicentre, prospective, observational, cohort study designed and conducted by the ESICM Trials Group to investigate the epidemiology and microbiology profiles of Intensive Care Unit. We have also participated in the recently completed SPOT (light) study. In addition we are currently undertaking local research project on “Outcome of Out of Hospital Cardiac Arrest patients undergoing primary coronary intervention” and “Neurological outcome of patients following Therapeutic Hypothermia following Out of Hospital Cardiac arrest”. Part 4 Training 4.1 Details of departmental teaching days Once a week half day protected formal teaching delivered / supervised by dedicated ICM consultants which includes teaching ward round, sit down tutorial on topics mapped to ICM curriculum; supplemented by a micro teaching on statistics, how to read journal article and / or journal club delivered by dedicated clinical librarian. ICM trainees also have the opportunity to join the basic science teaching of the anaesthetic department relevant to the ICM curriculum. In addition ICM trainees are encouraged to attend the weekly medical grand round and radiology meeting. In addition to this there are numerous opportunities of informal teaching on ward rounds including microbiology round. 4.2 Details of clinical governance meetings and / or M & M Once in a month ICM consultant led M&M meeting discusses all cases of death in the unit and other patient care issues. In addition ICM takes part in the bi-monthly all day surgical services divisional audit and governance and education day. 4.3 Details of inhouse courses available Transfer of Critically Ill patients Medium Fidelity Critical care and Trauma Simulation training ALS ATLS Page 2 (of 3) Unit Brief v1 4.4 Details of junior doctor shift pattens (including on call) Full shift 1 in 6 rota with prospective cover. 4.5 Details of senior doctor shift pattens (including on call) Weekdays: 8am to 6pm: Resident ICM Consultant 6 pm to 10pm: Resident Anaesthetic / ICM consultant 10pm to 8am: Anaesthetic / ICM consultant oncall Weekend: 8 am to 12 noon: Resident Anaesthetic / ICM consultant dedicated for ICU round 12 noon to 2 pm: Resident Anaesthetic / ICM consultant 2 pm to 8 am: Anaesthetic / ICM consultant oncall Part 5 Additional information 5.1 Please provide any additional information about the unit WHH is actively seeking to develop a ICM consultant rota to provide 24/7 critical care service led by ICM consultant. We intend to make FICE accredited training available in house to the ICM training in the near future. Page 3 (of 3)