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
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
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
The Team
Deliberately built Based on
Good social life Creature comforts Shared values Low hierarchy Mutual respect
CPD Training
Patients
Patient Information Leaflets Meet and Greet Explain tests Humour, compassion, distraction Explain results Give patients copy of report Change pathway sometimes
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
You have just seen
3 Slides
About being nice
to people
IT
Spread sheet In house network, server, admin database Trust IT Commercial admin database Very tight integration Type own reports
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
Queue Management (2)
Microbooking by experienced staff Travel times for elderly Travel times for transport Staff resources
You can have too short a queue
Clinic Management
Physiologist clinics 1 stop shop Extended hours Blitzing (only goodwill) Skill mix & across 2 sites
Need higher grades in small department
Microbooking
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
Finance and Activity Data
Keep an eye on it Question possible errors Time consuming
Quality
Care about people Be flexible Accreditation - IQIPS