Development of Joint Clinical Services

The creation of an Academic Medical Centre brings significant benefits in three main areas - patient care, research and educating and training.  In establishing Trinity Health (Ireland) we are creating an academic health care system which seeks to integrate a medical school and two hospitals and extend into the community for provision of chronic disease management.  While this constitutes a complex and ambitious initiative it brings additional potential benefits in allowing us to reconfigure the delivery of patient services and thus enhance the quality of patient care.   It also delivers the benefits of an institution in which research and education/training are critical to the size and scope of the resulting organisation.

Our core objective is to build a world class patient care model, operating on multiple sites but working seamlessly as one entity with each site developing a complementary set of core competencies to address the total portfolio of patient needs.

The domain of the development of joint clinical services not only includes the integration of services across multiple sites but has a focus on the following key areas;

  • Strengthening of links to catchment areas and community
  • Strengthening of links with other affiliated Hospitals Integration of Coombe Hospital into overall planning structure and possible integration of other institutions into the overall structure of THI
  • Creation of Framework Group for evaluation of clinical performance and assessment of clinical interventions
  • Interactions with external academic partners regarding evaluation both at quantitative and non-quantitative level leading to input to evaluation framework
  • Development of change management framework for adaptation  to evaluation results
  • Planning analysis of requirements to develop full trauma services
  • Creation of gynaecological triage centre to evaluate appropriate service development

There is good progress in relation to the following two patient services described briefly below;

Diabetes/Endocrinology

The Departments of Endocrinology and Diabetes at Tallaght, St. James's and Naas Hospitals provide comprehensive specialist services for patients in South-West Dublin, Kildare and Wicklow. THI Endocrinology provides a wide range of clinical services in both endocrinology and diabetes in addition to playing a significant role in teaching and research.  We liaise closely with the Departments of Chemical Pathology and Paediatric Endocrinology and provide combined clinics in association with the Departments of Nephrology, Gynaecology and Vascular Surgery. Diabetes Nurse Specialists, Dieticians and Podiatrists provide patient-centred diabetes care within The Diabetes Day Centre. Recently developed services include group education sessions for patients with Type 2 diabetes, insulin-pump clinics and structured education programmes for patients with Type 1 diabetes. Further information about this exciting development can be found at www.endodiab.ie

Trinity Academic Gastroenterology Group (TAGG) 

The aims of TAGG are to;

  • Develop an integrated centre of excellence for clinical and academic gastroenterology within Trinity Health Ireland
  • Provide high quality secondary, tertiary and national diagnostic and therapeutic care for patients across all major fields of gastroenterology
  • Foster an environment where clinical excellence is supported and maintained by ongoing bi-directional academic achievement
  • Excel in both undergraduate and postgraduate gastroenterology teaching programmes for medical and allied health care students

Phase one will focus initially on integration among the sub-group of academic appointments currently in place and new Trinity Health Ireland joint positions to be approved. Outlined below in phase one of the implementation programme are elements which could commence with immediate effect.

Phase One - TAGG Implementation Programme

THEME

GOALS

PROPOSAL

Clinical

Improved patient access to specialist services (IBD and Endoscopy)

Design future job specifications with shared SJH and AMNCH sessions to optimise clinical co-operation and integration

Improved 24 hour access to emergency endoscopy services (ERCP)
Consultant provided subspecialty care (IBD)

Academic Consultants to commence complimentary sessions in their sister campus in accordance with clinical needs. DMcN – Tuesday Endoscopy SJH / NM Wednesday IBD Clinic AMNCH

Improved oversight and quality assurance of sub-speciality care

Development of a joint Multi-disciplinary Monthly Meeting (Biologics Board) for IBD

Development of new services provided by a dedicated team

Academic consultants to develop a joint implementation plan for a Bowel Screening Service in accordance with national guidelines

Academic

Development of a Centre of Excellence for Medical Devices

See attached document

Further develop our expertise in translational GI Cancer Prevention research

Additional new joint programmes to compliment and advance existing projects including the Tallaght-Trinity College Colorectal Cancer Screening Pilot. Wireless technology (PillCam) and Proteomic (M2PK) assessment in Bowel Cancer Screening

Maximise our potential for IBD Basic and Translational Research

Development of a specific IBD database and bio-bank
Joint Pharmaceutical Clinical Trials

Teaching

High quality postgraduate training in endoscopy and gastroenterology with an intercalated PhD /MD

Combined SJH / AMNCH SpR rotation on the National Higher Specialist Training Scheme

Discussions are ongoing in relation to the establishment of a joint Gynaecological Triage Centre, THI Kidney Centre, THI Trauma Centre and THI Neurology Centre.