neurophysiology in a nissen hut dr adrian j fowle & elaine crighton west surrey clinical...
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Neurophysiology in a Nissen Hut
Dr Adrian J Fowle & Elaine CrightonWest Surrey Clinical Neurophysiology
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Clinical Neurophysiology? (1)
We run a diagnostic service EEG / EMG / EP Used by all disciplines
Orthopaedics, GP, Rheum (Carpal tunnel etc) Paediatrics (Epilepsy, N-ICU) Neurology (MND, Epilepsy, Neuropathy etc) Medicine / Elderly Care Psychiatry ITU
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Clinical Neurophysiology? (2)
Provided by physiologists and doctors Shortage of both nationally. Made worse by MSC – no training places
Patient facing Neonate -> Elderly Autism / Schizophrenia / Seizures / Apnoea Wheelchairs OPD, but also NICU / ITU / outlying hospitals
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The Team
Deliberately built Based on
Good social life Creature comforts Shared values Low hierarchy Mutual respect
CPD Training
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Patients
Patient Information Leaflets Meet and Greet Explain tests Humour, compassion, distraction Explain results Give patients copy of report Change pathway sometimes
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Other Colleagues
Referrers Management Commissioners Trainees
Medical Physiological Other
Regional group National group
Be Nice Meet their needs Coffee Newsletter Engage
Be Tough Say No! Ask again
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You have just seen
3 Slides
About being nice
to people
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IT
Spread sheet In house network, server, admin database Trust IT Commercial admin database Very tight integration Type own reports
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Queue management (1)
NHS Modernisation Agency Single queues, post office not supermarket No carve out Be tough “Demand Capacity matching” DNAs are important
18ww – Reduced interdepartmental wait Fax then letter Report to patient when possible
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Queue Management (2)
Microbooking by experienced staff Travel times for elderly Travel times for transport Staff resources
You can have too short a queue
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Clinic Management
Physiologist clinics 1 stop shop Extended hours Blitzing (only goodwill) Skill mix & across 2 sites
Need higher grades in small department
Microbooking
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Single site / multi site
Single site Economies of scale Cover for leave Sufficient expertise in rare tests Mutual aid of staff
Multi site Near patients Use of IT to bridge gap
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Finance and Activity Data
Keep an eye on it Question possible errors Time consuming
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Quality
Care about people Be flexible Accreditation - IQIPS