Neurophysiology in a Nissen Hut
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Neurophysiology in a Nissen Hut Dr Adrian J Fowle & Elaine Crighton West 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)

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Clinical Neurophysiology? (1)

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Clinical neurophysiology 1

Neurophysiology in a Nissen HutDr Adrian J Fowle & Elaine CrightonWest Surrey Clinical Neurophysiology


Clinical neurophysiology 1

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

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

The Team

Deliberately built

Based on

Good social life

Creature comforts

Shared values

Low hierarchy

Mutual respect

CPD

Training


Patients

Patients

Patient Information Leaflets

Meet and Greet

Explain tests

Humour, compassion, distraction

Explain results

Give patients copy of report

Change pathway sometimes


Other colleagues

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


Clinical neurophysiology 1

You have just seen

3 Slides

About being nice

to people


Clinical neurophysiology 1

IT

Spread sheet

In house network, server, admin database

Trust IT

Commercial admin database

Very tight integration

Type own reports


Queue management 1

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

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

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 / 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

Finance and Activity Data

Keep an eye on it

Question possible errors

Time consuming


Quality

Quality

Care about people

Be flexible

Accreditation - IQIPS


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