As I am sat in Christchurch airports departure lounge, I’m reflecting on my time here. I’ve loved my time away, and there are some things they do here in Christchurch that if I could slip into my carry on and bring to the UK I would.
1. Departmental radiologists
This is our handover room, and in it sits one of 3 full time radiology consultants who do real time reporting and scan protocolling for the ED. I have seen them leave this room, come out to talk to us about a finding, and EVEN examine patients. They are truly awesome, and every Friday they lead us through a greatest hits of our radiology cases from the week.
2. Full time departmental Social Workers, alongside physio and OT
These guys activate emergency care packages, inform people of voluntary services, help with child protection, vulnerable adult protection, they are present during major trauma Every morning and afternoon, if someone needs help getting back onto their feet, I can call “the MDT” and get my patients MOVING. If they can’t get people home, they get them into respite care or a residential home (with the social workers help).
“Friends of the Emergency Department” or FEDS, talk to and listen to patients, their families, their children. Grab cups of tea, snack boxes, they make the place so much more civilised, and make the ED more pleasant (and less frightening for the patients).
4. Consistent teams!!
We are rota’d together in teams of 7 doctors. I know each individuals strengths, and interests so if someone has a thing for paediatric emergency medicine, or if someone is a proto-plastic surgeon and likes suturing, when it’s busy we can divvy up the tasks, swap patients and keep the department flowing. As I’m working with these people day in day out, I’ve got the incentive to train them well, and upskill them as much as possible, and they can teach me what they’ve learnt from their other placements. THIS SHOULD BE STANDARD IN EVERY DEPARTMENT.
5. An integrated IT system
The CDHB uses something called concerto which means I can look through old discharge summaries, clinic notes, ECGs, bloods, Xray reports, outpatient pharmacy prescribing (both what’s dispensed and what’s prescribed), and GP diagnoses. I can have a patients old ECG, and cardiology clinic letter printed out and by their bedside to compare to their new ECG before they arrive.
6. This is called a nitrous mixer.
It is great for procedural sedation and analgesia, as people don’t need to coordinate the ‘sucking-in’ from an on-demand valve during the painful bit. It’s useful for kids too.
7. This is called Topicaine Gel. It is awesome for wound analgesia (and haemostasis) for kids and adults.
8. Acute Demand (intergration with outpatient diagnostics and primary care)
Outpatient IVs? Outpatient Biliary USS? Home visits? Home GP Visit? If they can keep you out of an acute inpatient bed. They will move heaven and earth to do so. 24/7, just a phone call away (and present at morning and afternoon handover). This is all funded by the local health authority and saves them millions (patients love it too). Who follows these up? The patients own GP, if they don’t have a GP, Acute Demand’s GPs follow them up.