Bon secours 2017 by Ashville Media Group

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CONTENTS

Contents 3

Welcome

Standards, Quality and Accreditation

Infection Control

10 Information Technology 13

Cavan Outreach Clinic

Cardiology

Dermatology

Diagnostic Imaging

Endocrinology

Dietetics

ENT Surgery

Gynaecology

Gastroenterology

Endoscopy

Laboratory

38 Medical Assessment Unit Editor: Tiernan Cannon Editorial Manager: Mary Connaughton Creative Director: Jane Matthews Layout: Antoinette Sinclair Advert Design: James Moore Production Executive: Nicole Ennis Production Manager: Mary Connaughton Managing Director: Gerry Tynan Sales Director: Paul Clemeson Chairman: Diarmaid Lennon Published by: Ashville Media Group, Old Stone Building, Blackhall Green, Dublin 7. Tel: +353 1 432 2200 Fax: +353 1 676 7100 Email: info@ashville.com Web: www.ashville.com All articles ÂŠ 2017/2018. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without written permission from the publisher. Opinion and comments expressed herein are not necessarily those of Ashville Media Group.

Oncology

Ophthalmology

Orthopaedic Surgery

Podiatry

Plastic Surgery

52 Respiratory and Sleep Medicine & Sleep Apnoea 57

Rheumatology

Surgery

Urology

Vascular Surgery

64 Health Insurance and Self-Payer Packages 67

Consultant Directory

Patient Information

BON SECOURS HOSPITAL

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WELCOME

Vision for Growth Mike Tonery assumed the role of Hospital Manager in September 2015, bringing with him a vision for growth at Bon Secours Hospital Dublin along with a commitment to guarantee ongoing excellence in patient care.

rior to stepping into the role of Hospital Manager at the Bons Secours Dublin, Mike Tonery worked as a chartered accountant at Deloitte in Dublin, followed by a senior financial role in the food manufacturing sector. He entered the hospital world in 2006. After a number of years spent in varying senior positions in the Mater Hospital, and a stint at the helm of their Cork facility, Mike returned to Dublin to take the post of General Manager of Bons Secours, Dublin in September 2015. As he settled into the role, Mike found that he relished the variety and challenges it brought to him. Moreover, the sense that he was making progress in the role and bringing about positive change for the hospital was certainly gratifying. “I am on board almost two years now, and in that time I have worked with the team here to develop new services across Medicine – our Medical Assessment Unit – and Urology, among other areas,” he beams. “In addition, I worked with our Endoscopy team to gain JAG accreditation – we are the first Private Hospital in Ireland to achieve this accreditation, and I am very proud of the staff in the unit.” Mike has recently overseen the opening of a new outreach clinic in Cavan, which allows patients living in areas in and around the clinic to visit consultants locally – eliminating the need for travel and time away from their schedules. The Bons is also currently upgrading its orthopaedics theatre – a major job, but an important part of maintaining the hospital's high quality standards. At a community level, local initiatives have seen the funding of a new library for Child Vision and a garden in a nearby home for people suffering from dementia. On top of these major changes, Mike has also attempted to improve the manner with which his staff works and

“I believe that team communication is important to us all, and we cannot ignore this – no matter how busy the hospital becomes!” communicates with one another, with the introduction of daily huddles and regular heads of department meetings. “I believe that team communication is important to us all, and we cannot ignore this – no matter how busy the hospital becomes!” he says. The hospital has found itself the recipient of many different awards and and accolades in recent years. In May this year, the hospital once again received JCI accreditation, as well as the JAG accreditation of its endoscopy unit, the gold standard for an Endoscopy Unit. Furthermore, the quality of the hospital's catering and housekeeping staff has also been recognised, with both departments winning a Gold CAP Award for excellence. Though proud of the progress the

hospital has made under his management, Mike is not one to bask in past glories, and continuous development is always on the agenda. Refurbishments and new facilities and equipment to help improve the services at the hospital are constantly in the works, and will ensure the hospital maintains the quality with which it has been celebrated. “Going forward, we are keen to further develop a number of our services, not least our urology service, and to become a leading centre for urology and provider of care in all things urological for both male and female patients,” he says. “We also wish to develop our chest pain and diabetes services, and look forward to sharing these and other developments in the coming months.”

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STANDARDS, QUALITY AND ACCREDITATION

Standards, Quality and Accreditation Best Practice Facilitator, Sheila Oâ&#x20AC;&#x2122;Leary explains how Bon Secours Hospital Dublin leads the way in quality improvement and patient safety.

e took our first formal step in December 2000 into the, new to us, world of Quality Accreditation. Looking back we now appreciate how far we have come. Bon Secours Hospital Dublin was the first hospital in Ireland to achieve international healthcare accreditation. Best Practice Facilitator, Sheila Oâ&#x20AC;&#x2122;Leary explains how they are the leaders in quality improvement. CLINICAL GOVERNANCE Clinical governance defines the culture, the values, the processes and the procedures that must be put in place in

As part of Bon Secours Health System, Clinical Governance starts at the top of the organisation with the Board. Structures and processes are in place that permeate throughout the organisation to ensure excellent patient care.

order to achieve sustained quality of care in healthcare organizations. Clinical governance involves moving towards a culture where safe, high quality patient-centered care is ensured by all those involved in the patient journey. - Report of the Commission on Patient Safety and Quality Assurance 2008. As part of Bon Secours Health System, Clinical Governance starts at the top of the organisation with the Board. Structures and processes are in place that permeate throughout the organisation to ensure excellent patient care. This is validated through Hospital Accreditation by Joint Commission International (JCI)

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STANDARDS, QUALITY AND ACCREDITATION

and more recently the achievement of JAG accreditation of the Endoscopy Unit, the first private hospital in Ireland to achieve this standard. JCI AND THE BON SECOURS In 2002, Bon Secours Hospital Dublin was proud to become the first internationally accredited hospital in Ireland. The hospital is re-surveyed every three years against a revised set of standards. The standards are revised by JCI to ‘raise the bar’ and keep pace with evidencebased practice. We are proud to have maintained our accreditation through each of these tri-annual surveys. The next survey will take place in May 2017. JCI provides the hospital governance with an independent, objective, external review of the systems and processes in place to assure safe, quality patient care. On a daily basis, the hospital seeks to maximise the quality of care that is

In 2015, the hospitals housekeeping and catering department achieved a rare double by winning a Gold Cap award for excellence in both housekeeping and catering.

provided to patients whilst reducing the risk. We see quality improvement and risk management as two sides of the one coin. This is a continuous journey, where we learn from and share best practices with other healthcare organisations. We are fortunate to be part of the largest independent healthcare group in Ireland, which enables us to benchmark internally. We also participate in, the National Infection Control Projects and also benchmark with other independent hospitals in Ireland. JAG ACCREDITATION OF THE ENDOSCOPY UNIT In 2016, the Bon Secours Hospital Dublin achieved another first accreditation when it became the first private hospital in Ireland to achieve JAG accreditation of its Endoscopy Unit. JAG accreditation is widely recognised as the gold standard for endoscopy units with almost 600 organisations currently accredited/ participating in the accreditation process across the UK, New Zealand and Ireland. JAG accreditation is a formal independent assessment of and recognition that the unit has demonstrated its competence to deliver the highest standard of endoscopy care. As part of the accreditation process, the teams were assessed against 313 standards, including staffing, quality of care, privacy and dignity for patients and training staff. In particular, the Assessors praised the units for their strong clinical,

nursing and administration leadership and dedication to patient care. OTHER AWARDS In addition to JCI accreditation, in 2015 the hospital's housekeeping and catering department achieved a rare double by winning a Gold Cap award for excellence in both housekeeping and catering. The CAP Awards (the Continuous Advancement Programme) measure the quality of cleaning and housekeeping in healthcare facilities across Ireland and the UK and are regarded by patients and their families as a mark of high quality. The CAP inspectors were particularly impressed by the relentless desire of the management team to keep improving. Our catering department has received the Happy Heart Eating Award and we have recently won a NISO award for Health & Safety. WHAT DOES THIS MEAN TO THE CUSTOMER? The voice of the customer is important to us and we use customer feedback to improve our services. Our 2015 customer satisfaction survey shows that 97% would be happy to return to the hospital with 98% happy to recommend the hospital to friends or family. As one participant commented: ‘You can be trusted to produce good health outcomes appropriate to any case and with a positive experience that is life giving in itself.’

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INFECTION CONTROL

Hand Hygiene Education and Protection At Bon Secours a dedicated Infection Prevention and Control Team focuses on identifying and reducing the risk of infection transmission among patients, staff and visitors to the hospital.

he aim of the dedicated Infection Prevention and Control Team (IPCT) at The Bon Secours Hospital Dublin is to identify and reduce the risks of acquiring and transmitting infection among patients, staff and visitors within the hospital. Their focus is on continually improving standards to ensure the delivery of high quality, safe patient care. The team is led by a consultant microbiologist and includes two fulltime IPC clinical nurse specialists with

dedicated administrative support. Advice on infection control is available on a 24 hour basis. The IPC committee is multidisciplinary and is chaired by the consultant microbiologist. INTRODUCTION OF THE SUREWASH SYSTEM In Autumn 2014, the hospital introduced the SureWash system as part of their infection prevention and control programme. Cleaning hands properly, whether with soap or alcohol rub, is the

single most important action to prevent infections in a hospital. According to the WHO (2009), Health Care Associated Infections (HACIs) in Europe are acquired annually by 5 million patients, resulting in 50,000 deaths each year and 25 million extra bed days costing ď&#x20AC;Ą13 â&#x20AC;&#x201C; 24 billion annually. Hand Hygiene (HH) is the single most important procedure in preventing HCAI. Their consequences can be reduced by up to one third if HH is performed correctly. SureWash uses gaming technology to train and assess

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INFECTION CONTROL

LEVELS OF HAND HYGIENE Social Hand Hygiene - Using 3 - 5mls of soap and water for 40 - 60 seconds after most daily tasks. This removes transient micro-organisms, preventing cross infection. ASEPTIC HAND HYGIENE Using 3 - 5mls of an antiseptic such as Chlorhexidine Gluconate 4% for 40 - 60 seconds. This is particularly important prior to conducting aseptic procedures and contact with immunosuppressed patients. Alcohol hand gel may be used for social and aseptic hand hygiene for 30 seconds once hands are visibly clean. Please note alcohol hand gel is not sporicidal therefore hand washing with soap and water is recommended in cases where C difficile infection is suspected. SURGICAL HAND HYGIENE Using an antiseptic for 2 - 5 mins prior to surgical procedures. This removes resident skin flora and prevents surgical site infection.

WHO Guidelines on Hand Hygiene

the hand hygiene technique of healthcare workers, patients and visitors. Developed in Trinity College Dublin and used in 20% of Irish hospitals, SureWash is a mobile unit that can be moved to train staff on the ward and is available 24/7. Using the World Health Organization recommended hand hygiene technique, SureWash allows a person to practice their technique in the same order each time, enhancing muscle memory so it becomes an unconscious competency – like tying your shoelaces! SureWash is used in hospitals across the United Kingdom, Europe, the Middle East and the United States and medical schools are now incorporating it as part of their curricula for training medical staff. BON SECOURS AND NATIONAL HYGIENE COMPLIANCE AUDITS The Bon Secours Hospital Dublin has been participating in the National Hand Hygiene Compliance Audits since 2010. The average compliance rate over the period from Nov 2015 - Nov 2016 is

93.3%. This figure far exceeded the HSE national target rate of greater than 90%. HOSPITAL VISITORS AND HAND HYGIENE A recent survey was carried out by the Bon Secours Health System to promote good hand hygiene and to get a better understanding of hand hygiene amongst the general public and in particular amongst visitors to hospitals. The national survey revealed interesting facts about general hand hygiene and despite 94% of those surveyed rating washing their hands when visiting a hospital as being ‘extremely important’ or ‘very important’ the research revealed that 36% do not always wash their hands when visiting a hospital. Bon Secours is committed to the very highest hygiene levels; we continually remind staff, patients and visitors of the importance of washing their hands and strive to make it as easy as possible for them to access antibacterial gel dispensers. The Sure

Wash system is regularly available in the main reception area in the hospital allowing patients and visitors to practice their hand washing techniques.

The Bon Secours Hospital Dublin has been participating in the National Hand Hygiene Compliance Audits since 2010. The Average compliance rate over the period from Nov 2014 – Nov 2015 is 91.2%. This figure far exceeded the HSE national target rate of greater than 90%.

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INFORMATION TECHNOLOGY DEPARTMENT

Information Technology at Bon Secours Cliona Byrne, IT Manager talks about some of the more recent IT updates at the Bon Secours Hospital.

he IT journey at Bon Secours Dublin is ongoing, with every opportunity taken to avail of process and quality improvements. IT plays a key role in ensuring that the patient's pathway through the hospital runs as smoothly and as easily as possible. We also ensure that we support GPs as much as possible in the care of their patients in their practices. DEVELOPMENT OF GP APP The Bon Secours Health System has developed a free phone app which provides GPs and consultants with instant access to

many of the services available at the Bon Secours Hospital Dublin and the other four hospitals across the Bon Secours Health System. It has been designed to ensure information on consultants and individual department information is easily accessible and available at the user's fingertips. The homepage also features a newsfeed, which provides information such as new services and treatments available in the hospital and also details about new consultants as they join the hospital. The next version of the app is already under development and will be launched in early 2018 and will include a section

for patients with practical information on all aspects of their visit to the hospital, what to expect, what they need to bring with them, visiting hours, insurance information, and whether a patient is covered for different procedures/ treatments within the hospitals. For GPs, the updated version will also include downloadable forms which can be used to refer patients to the hospital for outpatient treatments or to consultants. E-REFERRALS From early 2015, GPs using the Socrates patient management software system

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INFORMATION TECHNOLOGY DEPARTMENT

have been able to refer patients to our consultant team and outpatient department through an e-referral platform called Zeus. Zeus is Ireland’s first private e-Referrals and communications platform and the Bon Secours Hospital Dublin and our consultant team are the first hospital in Ireland to be in a position to receive and manage referrals this way. Zeus allows GPs, consultants and hospitals to seamlessly refer and discharge patients in a fully safe, secure and traceable environment. Referrals are received securely within seconds and the processing and appointment confirmation times are greatly reduced to the benefit of the patient and all concerned. The follow-on report and / or consultant letters can be sent directly back to the GP through Zeus and is stored directly into the patient file. CONNECTING TO HEALTHLINK By early 2018 it is planned that GPs will be able to request appointments and receive results and discharge summaries/letters via Healthlink and/ or an alternative solution. This will significantly benefit patients ensuring their GP has a more streamlined referral pathway and quicker access to results which can be downloaded into their Patient Management System. PATIENT ADMINISTRATION SYSTEM The backbone of the hospital’s IT infrastructure is our Patient Administration System. This allows the Hospital to manage the patient’s journey electronically. It also provides information to other connecting systems ensuring there is continuity in patient identification and clinical information across all diagnostic and treatment areas. One such connection is the Radiology

Information System (RIS) and Picture Archiving and Communications System (PACS). This technology allows radiologists to view scanned images as soon as the scan is complete. They can then report on these images dynamically using voice recognition technology enabling the hospital to deliver highly efficient turnaround times for the final report to be provided to the attending or referring clinicians. These reports are available at the point of care in the hospital or via remote access for authorised users. RIS/PACS also allows for images acquired to be viewed at any screen throughout the facility by the care team. ENDOSCOPY INFORMATION SYSTEM Another key important development and step towards moving the hospital to full system integration has been through the introduction of the EndoRAAD system. EndoRAAD has helped to improve the patient journey through the Endoscopy Unit to the extent that reports once signed off by the consultant are now reaching the recovery area even before the patient. Existing patient reports can be quickly recalled and displayed during a patient's visit to compare previous and current conditions. With the introduction of EndoRAAD, the hospital is the first and only private hospital in Ireland to fully engage with the National Quality Improvment Programme in GI Endoscopy. Quality data is uploaded quarterly to the National Quality Assurance Intelligence System (NQIS) based in the Royal College of Physicians. The NQIS system develops quality assurance reports based on National Quality Indicators, providing opportunities for the department to benchmark its performance and to

Another key important development and step towards moving the hospital to full system integration has been through the introduction of the EndoRAAD system. EndoRAAD has helped to improve the patient journey through the Endoscopy Unit to the extent that reports once signed off by the consultant are now reaching the recovery area even before the patient.

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continuously review processes to ensure patient care is optimised, whilst also providing patients and their consultants with increased confidence in diagnosis. IT SUPPORT, TRAINING AND DEVELOPMENT There are also other IT systems within the hospital which do not have a direct role in patient care but do ultimately support service delivery. For example, staff utilise hand held devices to support the delivery of services such as stock requisitioning, infection control audits and endoscope validation. On-going training and development is important to Bon Secours, Dublin. IT training is provided in-house for administration staff, nursing and other care disciplines who participate in an IT certification programme specifically designed for healthcare workers. The hospital is a recognised centre for the Health Informatics Training System (HITS). The HITS programme was developed by the Irish Computer Society and has been designed to provide a basic understanding of the use of IT in healthcare, for those who work in the sector, at any level.

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CAVAN OUTREACH CLINIC

Medical Consultant Clinic in Cavan Town The Cavan Outreach Clinic is a new community based service seeing patients prior to and post operatively following treatment in the Bon Secours, enabling local people from Cavan, Monaghan and surrounding areas to have easier access to some of the country’s leading medical and surgical consultants.

he Bon Secours Hospital Dublin opened a Medical Consultant’s Clinic in Cavan Town in November 2016. Located just metres from the gates of Cavan General Hospital, the clinic enables local people from Cavan, Monaghan and surrounding areas to have easier and quicker access to expert medical opinion. Having a clinic in the local community means those patients who would otherwise have to travel to Dublin for their pre and post procedure appointments now only have to travel to Dublin once, for their procedure. This not only reduces costs and time off work for patients, but for older and less mobile patients it adds a huge element of convenience. The Clinic is located in a bright, purposely designed consulting clinic on the Farnham Road adjacent to Cavan General Hospital. With ample parking available on-site, the Clinic is a very convenient and easily accessible option for patients. Appointments

Having a clinic in the local community means those patients who would otherwise have to travel to Dublin for their pre and post procedure appointments now only have to travel to Dublin once, for their procedure.

(all GP referred) to the clinic are coordinated by our dedicated Clinic Administrator Sarah Mc Glade. The Clinic currently provides access to five specialities: Gastroenterology, Orthopaedics, Plastic Surgery, Urology and Vascular Surgery. The Vascular Consultant team are supported by two Vascular Technicians who carry out ultrasound and/or ABI scans as necessary before the patient sees the Vascular Surgeon. It is planned to expand this list of specialities in the next twelve months.

CONSULTANT ATTENDING THE CAVAN CONSULTANTS CLINIC • Gastroenterology Dr Aoibhlinn O’Toole • Orthopaedics Mr Philip O’Connor (Hip and spine), Mr James Walsh (Foot and Ankle) • Plastic Surgery Mr Barry O’Sullivan • Urology Mr James Forde, Mr Ijaz Cheema • Vascular Surgery Mr Peter Naughton, Mr Daragh Moneley APPOINTMENTS: Tel: 049 4332697 Fax: 049 4325023 Email: cavanclinic@bonsecours.ie www.bonscours.ie/cavan-clinic

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Managing Adverse Events By Dr Gordon McDavid, Medicolegal Adviser at the Medical Protection Society (MPS)

hankfully, errors in healthcare are relatively uncommon. However, it is inevitable that things will occasionally go wrong, so it is vital that we are well equipped to act promptly and effectively when an adverse event occurs to ensure patient safety and to learn from any mistakes. An adverse event is regrettable and will often be upsetting for those involved. When something goes wrong, patients and their families are entitled to honest, open and prompt communication, as well as an appropriate apology. Effective management of an adverse event and good communication and care will help to ensure patients feel supported. It can also reduce the risk of being sued or receiving a complaint. The following points may help you to manage an adverse event if you are faced with one: IF SOMETHING GOES WRONG If something goes wrong, you should always start by ensuring the patient’s safety. You should also be open and honest about what happened so the patient receives a full and sincere apology. While it may take some time to fully understand what happened after an adverse incident, this should not hinder a prompt apology - although speculation should be avoided. It may be helpful to advise the patient of what investigation will be undertaken to establish the facts, if these aren’t immediately apparent. It is likely that patients will be worried, and should therefore be provided with: • An explanation of what happened and why • Acknowledgement and an apology including an expression of regret or sorrow • Information on what will happen

next to investigate and, if possible, an outline of any corrective measures that will be put in place • A mutually agreed plan for ongoing care and follow-up • The patient must also have opportunity to ask questions and voice any worries.

same as saying “I’m sorry I caused this to happen to you and it’s my fault”. Be vigilant about whether you are accepting responsibility for the incident, as would be the case with the latter example above. The interaction should then be comprehensively documented in the patient’s records.

OPEN DISCLOSURE All doctors have a professional and ethical duty to have an open and honest discussion with patients following an adverse event. This is emphasised in the Medical Council’s Guide to Professional Conduct and Ethics for Registered Medical Practitioners, at paragraph 64. We must aspire to developing an open culture in healthcare; where any adverse incident is discussed and learned from. As well as the obvious benefit to patients and staff, in MPS’ experience, effective communication and open discussion following an error actually helps to reduce the risk of patients taking action after an adverse outcome.

LEARN FROM MISTAKES Although unwelcome, errors provide a fertile ground for reflection and an opportunity to improve practice, and therefore we would always advocate a full and objective review of any adverse event. The patient should be informed as to any lessons that can be learnt for future and changes that are made to practice. The importance of reporting an adverse event cannot be overstated – it is essential that the root-cause of any error is established so that helpful changes can be made and learning disseminated. MPS has considerable expertise on these issues and has worked with the HSE on its open disclosure guidelines. MPS also recently hosted a seminar titled ‘Open Disclosure – Creating an Open Learning Culture in Healthcare’ at the Royal College of Physicians of Ireland (RCPI). The seminar was attended by key experts from the healthcare community to consider what more can be done to promote a culture of openness. It also launched MPS’s enhanced range of open disclosure workshops, including the clinical incident management (CIM) programme. This focuses on the following two key components: the procedures and documents required for the administrative aspect of the response and training inhouse specialists (CIM consultants) in open disclosure communication who can assist the treating clinician with difficult post-adverse event communications.

TONE OF THE CONVERSATION Conversations following adverse incidents can be some of the most challenging interactions that doctors face in their career. However, it is important to understand that an apology, expressing regret about the patient’s experience or emotions, is not an admission of liability if phrased correctly. Each patient is unique and, like with any patient interaction, the conversation should be individualised. You must ensure that the patient understands what you are telling them and that they have the opportunity to ask questions. The wording of the apology is also very important. For example, saying “I’m so sorry this happened to you” is not the

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CARDIOLOGY DEPARTMENT

Cardiology Services at Bon Secours Cardiology at Bon Secours has undergone monumental change over the last number of years and the department is now at the forefront of cardiology services in Ireland.

ince April 2016, cardiology services within the Bon Secours hospital have undergone huge developments. The consultant cardiologist team has expanded to seven and an additional cardiologist will be joining the team in Autumn 2017. This expanded team improves both the breath and depth of the services that the department provides. Seán Hendley joined the team as

Cardiology Manager in April 2016. Working alongside Jude Uy, the cath lab manager, and Helen Broderick, CNM2 of St. Brigid’s Cardiac Ward, the focus was on the development of existing cardiology services and the expansion of new ones, bringing the department to the forefront of cardiac care nationally. Support of this development was provided by a dedicated administration team lead by Sharon Kearney and an

admissions department managed by Gillian Grant. This has culminated in a significantly streamlined and timely service, with a reduction of waiting-lists and provision of on-the-day cardiology testing for outpatients attending the clinic. March 2017 saw recognition of the team’s hard work in the form of the 2016/17 Bon Secours Quality Improvement award. This recognised

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the team’s efforts in supporting the Bons Secours health system goals of quality; improving patient safety, care and experience in line with the Bon Secours Health System’s Guiding Values. INCREASED DEMAND The increased demand in private healthcare across the country has seen a surge in patients attending the cardiology department for a range of diagnostic testing. The diagnostic department now operates with a team of nine cardiac physiologists, one ECG technician and two careassistants. Dr. Brendan Doyle, Consultant Cardiologist, joined the specialist team bringing, with him a practice-manager and clinical nurse specialist, establishing his clinic rooms within the department. In order to meet the demands of patients requiring echocardiography, a second echo

room was built and became operational in September 2016. This allowed for, not only the support of the existing transthoracic and transoesophageal services, but also the introduction and development of new services, such as a carotid doppler scanning service for cardiology patients and a dobutamine stress echocardiography service lead by Dr. Angie Brown. The purchase of two new echo machines with 3D technology, four new ECG machines and an upgraded echo reporting system ensures that the department has the most up-todate equipment at its disposal for the diagnosis and treatment of all its cardiac patients. New technological

advances in echocardiography, such as strain imaging, are now being utilised routinely for all oncology and heart-failure patients. PACING SERVICE The pacing service at Bon Secours, headed by Dr. Gumbrielle, has also seen great changes. All patients are now registered on a secure national database, allowing for quick retrieval of all implant and follow-up details. In addition, all loop-recorder and ICD patients are set up on the home-monitoring service, which is checked daily. This allows the team to interrogate the patient’s device, even when they are in the

“This has culminated in a significantly streamlined and timely service, with a reduction of waiting-lists and provision of on-the-day cardiology testing for outpatients attending clinic.”

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comfort of their own home. This is another step in guaranteeing patient safety. The range of cardiac diagnostic tests offered in the Bon Secours Dublin includes: • ECG • Trans-thoracic echocardiography • Trans-oesophageal echocardiography • Dobutamine stress echocardiography • Holter monitoring, (1-5 days) • Event monitoring • Ambulatory BP monitoring • Tilt-table testing • Exercise stress testing • Loop recorder, pacemaker and ICD interrogation and device optimisation with home-monitoring service.

“The purchase of two new echo machines with 3D technology, four new ECG machines and an upgraded echo reporting system ensures that the department has the most up-to-date equipment at its disposal for the diagnosis and treatment of all its cardiac patients.”

In addition to the diagnostic cardiology department, there have been huge increases in patient numbers attending the cath lab for invasive procedures. Jude Uy and his team of eleven cardiology nurses and one care assistant run the cath lab five days a week. The range of cardiology procedures include: • Coronary angiography • Right-heart catheterisation • Percutaneous coronary intervention • Loop recorder, pacemaker and ICD implantation. • EP studies. The cath lab team also provides a service for invasive vascular cases on a weekly basis. The cardiology team works closely with the medical assessment unit, lead by Dr. Ger Hosny and clinical nurse specialist, Suzanne Donlon. Plans are already in place for the development of a dedicated chest-pain clinic to further improve cardiology services within the hospital.

CARDIOLOGIST TEAM: • Dr Angie Brown • Dr Brendan Doyle • Dr Thomas Gumbrielle • Dr Robert Kelly • Prof Brendan McAdam • Dr Jonathan Lyne • Dr Richard Sheahan CONTACT DETAILS Cardiology Department: 01-8065368 Outpatient appointments: 01-8082300

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DERMATOLOGY DEPARTMENT

Dermatology at Bon Secours The Dermatology Department at Bon Secours treats a myriad of different conditions writes Consultant Dermatologist, Dr Nicholas Walsh.

THE TEAM Presently, the dermatology department at Bon Secours Hospital consists of six dermatologists offering the very best in inpatient and outpatient care. It specialises in providing both medical and surgical support for its patients, striving to deliver a swift diagnosis and implement a treatment plan which will alleviate the patient of their dermatological condition. COMMON SKIN ABNORMALITIES While many patients present with suspected skin cancer, not all of our treatments are focused on cancer

patients. Common conditions we deal with on a regular basis include: • psoriasis • eczema • acne vulgaris • warts • acne rosacea All but the most severe of these are dealt with via medicinal treatment. SKIN CANCER Skin cancer occurs in two forms; melanoma and non-melanoma. Melanoma occurs primarily in the melanocytes – the pigment cells present in the skin.

It is normally darkly pigmented, and can spread to other parts of the body if not treated in time. Consequently, early diagnosis is paramount. Patients themselves are often the first to become aware of potentially problematic issues as the disease visually manifests on the surface of the skin in the form of spots or moles. Fortunately, most spots or moles that appear are harmless; they are not cancerous and lack the capacity to become so. However, if a suspicious looking mole does arise it is always better to exercise caution and have it checked by a doctor who can, if necessary, refer the patient to us for treatment. Typically,

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suspicious moles are larger than their more benign counterparts, have irregular shapes with uneven borders and are different in colour to other spots on the body. Although less frequent than non-melanoma, melanoma is a very aggressive strain of cancer, and therefore early recognition and intervention are vital for successful treatment. DIAGNOSIS AND TREATMENT Dermatologists are the main point of referral for suspected skin cancer. Skin cancer diagnosis typically transpires via a skin biopsy, which is available as a day case in the hospital. A diagnostic biopsy is not always needed to determine if treatment is necessary. Often the necessary course of treatment will be immediately evident to the dermatologist. If there is any uncertainty then a diagnostic biopsy will be performed. Non-melanoma skin cancer is the more common of the two, increasing at a steady annual rate for much of the last two decades. It occurs in two distinct forms; basal-cell carcinoma and squamous-cell carcinoma. Basal-cell carcinoma (BCC) is the single most common form of cancer, occuring most frequently in people over the age of 40 and those with freckled skin. BCC manifests in the epidermis of

the skin, including the scalp and areas most regularly exposed to sunlight and other forms of UV radiation. It is normally painless and less obvious than melanoma skin cancer, consisting of subtle bumps that may be pearly or waxy, ranging from flesh-coloured to brown in colour, and even pink or white. Squamous-cell carcinoma also occurs in skin that is regularly exposed to sun rays and often developing in skin that has been injured or inflamed. Old age and exposure to sunlight put one at a greater risk from this cancer, and reveals itself in the form of scaly, crusted, reddish patches on the skin. Once a biopsy has been performed, the results will determine the subsequent

DERMATOLOGY TEAM • Dr Callaghan Condon • Dr Tony Egan • Dr Fiona Keane • Dr Sandra Kirke • Dr Brigid O'Connell • Dr Nicholas Walsh CONTACT DETAILS Tel: (01) 808 2340

management of the condition. For instance, treatment of melanoma is contingent upon the depth of the tumour in the skin. After the biopsy results are available, a wider excision of the tumor may be carried out which may involve surgical removal and other post surgery treatments. Outpatient surgery of this kind is performed on a near daily basis in our minor operating theatre with only some instances being referred to plastic surgeons. EQUIPMENT The hospital is well equipped with the latest in dermatological care. We use a number of specialised instruments, including an Intense Pulse Light (IPL) used in the treatment of vascular lesions (broken veins on the face), leg veins, liver spots and for hair removal and a YAG Laser for vascular abnormalities in the skin. WORKING TOGETHER Although all six dermatologists working here at Bon Secours are adept in both surgical and medicinal care, we augment our surgical prowess with strong working relationships with the plastic surgeons at the hospital that help us amend skin disfigurements.

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DIAGNOSTIC IMAGING DEPARTMENT

Diagnostic Imaging at Bon Secours Significant investment in Diagnostic Imaging services ensures fast and effective diagnosis for patients and clinicians.

urrently the Diagnostic Imaging Centre is collaboratively led by Denise Conroy and Professor Michael Lee. Professor Michael Lee directs eight dedicated and experienced Consultant Radiologists. Their expertise incorporates a great expanse within Radiology including Vascular Imaging, MusculoSkeletal Imaging, Neuro-Radiological Imaging, Gastro-Intestinal Imaging, Genito-Urinary Imaging, Cardiac Imaging, Breast MR Imaging, Bone Densitometry, and General Imaging. Our Consultant Radiologists have close linkage with Beaumont Hospital allowing for joint care of patients, where required, in a multi-disciplinary setting. This skilled Radiology team is supported by 14 enthusiastic, dynamic

and experienced Radiographers and a compassionate administration team. The department provides a complete range of state-of-the-art diagnostic equipment to support our many Diagnostic Specialties to include Magnetic Resonance Imaging (MRI), Multi-Slice Computed Tomography (CT), Ultrasound (including vascular studies), Fluoroscopy, Dual Energy X-Ray Absorptiometry (DEXA), Digital Radiography (DR) and Ankle Brachial Indices (ABI). COMPUTED TOMOGRAPHY (CT) Computed Tomography (CT) provides an extensive service to the hospital, particularly to the endoscopy, cardiology and oncology units. The Siemens Definition 64 slice scanner provides dynamic image detail and resolution that

allows for a more accurate diagnosis. The scanner also includes a dose management technology - Iterative Reconstruction (IR) with second generation SAFIRE. This SAFIRE shield ensures patients only receive the minimum clinically relevant dose of radiation. The syngo.via application helps to improve productivity by giving radiologists the flexibility to analyse and report on CT scans at any suitable work station within the hospital, removing the dependency on single review points. Specialised CT software and hardware enable dedicated subspeciality CT services including: â&#x20AC;˘ Virtual CT Colonoscopy â&#x20AC;&#x201C; an increasingly useful diagnostic tool that can in some cases replace colonoscopy. If colonoscopy fails to

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get a clear image of the bowel then CT colonoscopy is used to produce a 3D image to visualise the bowel. • Dedicated oncological imaging • Cardiac/coronary vessel imaging • Vascular imaging The department is actively involved in extensive post-graduate CT training and education, ensuring the highest standards of quality and care are consistently maintained. MAGNETIC RESONANCE IMAGING (MRI) Magnetic Resonance Imaging (MRI) is one of the most important diagnostic tools at the department’s disposal and provides an invaluable service to the hospital. The 1.5 Tesla Siemens Avanto MRI unit is a scanner with a wide range of capabilities. The department performs cardiac, neurological, breast, musculoskeletal, whole body, vascular and gastro intestinal MRI with subspecialty reporting in all areas. MR Enterography has become an integral part of the gastrointestinal MRI service. This examination provides state of the art visualisation of small bowel pathologies. The MR Enterography service, together with our CT Colonography Service, plays a vital role in the management of GP patients due to the service excellence delivered by our vastly experienced and expert radiological and technical teams. The images produced are of the highest resolution and contrast, enabling fast and accurate diagnosis. The scanner facilitates feet first scanning, which greatly improves patient comfort alleviating anxieties and stressors relating to claustrophobia which can present difficulty for certain patients. The department has hosted numerous MRI training courses and is an integral element of post-graduate MRI education and training in Ireland, affiliated to both Trinity College Dublin and University College Dublin. DEXA Bone densitometry is the assessment of the density of a person’s bones which is crucial in detecting the early stages of osteoporosis. The DEXA scanner quantifies bone mineral density by measuring the patients bone density and then comparing it to the mean bone

density for their age and demographic. The test is safe, accurate and painless and takes less than 15 minutes to complete. It is essential when assessing those at risk for osteoporosis. A consultant rheumatologist is at hand to report on the DEXA scans and offer lifestyle advice with regard to treatment. ULTRASOUND Ultrasound is a non invasive modality used to investigate a wide variety of conditions including disease of the thyroid, kidneys, liver, gall bladder, pancreas and pelvis. Ultrasound is also used for musculoskeletal imaging and trans-rectal and trans-vaginal imaging of the prostate and the uterus. Biopsies are performed in the department. There are regular doppler ultrasound clinics providing vascular services including duplex scanning and screening for suspected DVTs. ANKLE BRACHIAL INDEX (ABI) ABI is a non invasive test used to investigate a patient's risk of peripheral artery disease. Blood pressures of the upper and lower limbs are measured in conjunction with a Doppler Ultrasound probe to measure the sound waves within the arteries. This is becoming an increasingly valuable test for vascular surgeons. DIRECT PAYMENT SCHEMES Direct payment schemes are in place with most of the major health insurers.

This means that patients need only fill in their insurance information and we bill their insurance company directly. Such schemes are in situ with VHI (MRI Consultant referral) excluding Cardiac MRI, CT Colonography, ABI, Duplex scans (veins, carotids, aorta), Irish Life Health (MRI, CT [all], ABI/Duplex, etc [Prof fee only]), Laya (ABI, Duplex scans [veins, carotids, aorta]), Garda, ESB, Prison Officers (all radiology) AVIVA (all MRI/CT scanning), ESB (all diagnostic imaging), GMA (all diagnostic imaging), GLO Health (all MRI/CT scanning). WALK IN SERVICE The Radiology Department provides a walk-in x-ray and ultrasound service between 8am and 5pm Monday to Friday. Patients with a referral letter from their GP can come in without an appointment and will be seen straight away for all plain radiographic and ultrasound examinations which do not require specific patient preparation. This is an excellent facility which saves valuable time and expense for those who may be travelling to Bon Secours from outside the greater Dublin area.

CONTACT DETAILS General Enquiries : (01) 8065406 Mon - Fri 9am - 5pm Appointments: (01) 8082300 Mon - Fri 8am - 6pm

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ENDOCRINOLOGY DEPARTMENT

Endocrinology at Bon Secours The Endocrinology Department is dedicated to the timely treatment of its patients. Professor Chris Thompson, Consultant Endocrinologist discusses the role which the department plays in the day to day life of the hospital.

ENDOCRINOLOGY Endocrinology is the study of glands and the hormonal control of the body, the regulation of which can be upset by particular conditions including diabetes and pituary malfunction. It is one of the many disciplines pursued at Bon Secours Hospital by a dedicated team determined to deliver the highest quality of treatment to sufferers of endocrine disorders including hormonal imbalances. Endocrinology at Bon Secours is divided into two tenets; diabetes and pituitary.

DIABETES Our diabetes related services have been facilitated by our dedicated diabetes nurse Brenda Wade, who has been on staff for a number of years now. She provides inpatient education for people who are admitted to the hospital for diabetes care, as well as newlydiagnosed patients who have become aware of their diabetes during their stay within the hospital. This is a vital role as education is the first step needed when learning to live with diabetes.

According to the Diabetes Federation of Ireland, diabetes afflicts around one in every 20 people living here (including approximately one in every eight old people) and that figure is set to grow substantially over the coming years. By 2020, it is estimated that over 200,000 people in Ireland will suffer from the condition. This highlights the real need for access to top-quality treatment for sufferers. Awareness about the symptoms, implications and management of diabetes are also of critical importance, and

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administration of pituitary function tests for patients with pituitary tumors. Over the last number of years we have seen a great increase in the number of pituitary patients seeking to have their treatment at Bon Secours as opposed to through the more traditional means of public hospitals. This serves as a terrific testament to the quality of the treatment we offer our patients and we look forward to further expanding and improving this service over the years ahead.

Bon Secours Hospital continues to work towards delivering this crucial service to inpatients and out patients. THE DIABETES CARE CENTRE The Diabetes Care Centre at the Bon Secours Hospital is a specialist coordinated care and education service for recently diagnosed patients who are experiencing current and / or ongoing problems managing their diabetes. The centre focuses on patient empowerment through educational programmes delivered by a dynamic multidisciplinary team including a diabetes clinical nurse specialist, dieticians, endocrinologists and podiatrists backed up by ophthalmologists, vascular surgeons, cardiologists and renal physicians as required. The Bon Secours Diabetic Care Centre has developed three different care options to support GPs in the management of their diabetic patients. 1. GP Managed Care - The care is solely managed by the GP with referral into the centre for consults with one of the specialist team as required. 2. Diabetes Centre Managed Care - The patients ongoing diabetic care is managed by the Bon Secours Diabetic Care Team with regular updates provided to the referring GP. 3. Shared Care - The patients care plan is devised by the endocrinologist and the plan is delivered by the GP.

BENEFITS TO THE PATIENT OF ATTENDING THE CENTRE • Immediate and timely appointments • Quick and early intervention reducing and / or preventing the risk of complications developing • Team based approach to care • Access to a range of specialists as required • Convenient same day scheduling of appointments with the care team and laboratory tests if required • 'One stop shop' - minimising the time off work and disruption to personal time PITUITARY - THE 'MASTER GLAND' Increasingly, we are seeing a growing number of patients suffering from issues with their pituitary gland. Situated at the base of the skull, the ‘master gland', as it is aptly named, is the dominant gland within the body – stimulating other glands to release hormones in accordance with the body’s requirements. It is responsible for regulating – among other things – hunger, growth and metabolic activity and as such, pituitary malfunction can be the cause of a catalogue of bodily difficulties which can seriously affect the health of a patient. The management of patients with pituitary tumours is a particular focus and area of interest for our endocrine team. The hospital has a specialised ward geared towards the

DIAGNOSTICS Endocrinology as a discipline requires very little in the way of specialised equipment, but its practice does demand access to blood testing and the most upto-date MRI scanning, both of which are available at Bon Secours. MRI scanning is central to endocrinology as it is the only definitive way by which images of suspected abnormal pituitary glands can be acquired, enabling diagnosis. Collaboration with our Diagnostic Imaging Department is fundamental to the delivery of appropriate treatment and ensuring the best possible outcome for our patients. WHAT THE FUTURE HOLDS With continued advances in MRI technology there will be far greater accuracy when imaging tumours which will engender superior precision in the deliverance of surgery, radiotherapy, etc. This being the case, technological change – particularly within the realm of radiology – will be crucial to ensure the continued and improved treatment of patients suffering from pituitary problems and Bon Secours fully intends to be at the forefront of this shifting paradigm to make sure our patients receive only the best care.

ENDOCRINOLOGY CONSULTANT TEAM • Dr Margaret Griffin • Dr Diarmuid Smith • Prof Chris Thompson • Dr Matilde Zamuner (Joining summer 2017) DIABETES CARE CENTRE Tel: (01) 806 5488 Fax:(01) 808 2343

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DIETETICS DEPARTMENT

Dietetics at Bon Secours The Dietetics Department at Bon Secours provides a comprehensive service to its patients on the importance of nutrition for a healthy lifestyle.

WHAT IS A DIETITIAN? Dietitians are experts in food and nutrition and advise people on what to eat in order to lead a healthy lifestyle or achieve a specific health-related goal. They use their knowledge of food, nutrition and other related disciplines such as biochemistry, physiology and social science to promote health, and aid in the management of illness. The professional body for clinical nutritionists/dietitians in Ireland is the Irish Nutrition and Dietetic Institute (INDI). DEPARTMENT INFORMATION The nutrition and dietetic service is available to all inpatients during their stay in Bon Secours hospital, and is also available to outpatients by appointment. It is supported by a wide range of services and multidisciplinary teams within the hospital, including consultants, doctors, nurses, physiotherapists, diabetic nurse specialist, speech and language therapists, pharmacists, podiatrist, tissue viability nurse, and discharge planner. The department's dedicated team of dietitians are trained to degree or masters level and are members of the INDI. SEEING A DIETITIAN Referrals are accepted from consultants as inpatients. Both self referrals and GP and consultant referrals are accepted to our outpatient department. SPECIALIST AREAS Nutrition plays a vital role in health and well being, and our dietitians can offer support and advice for a wide range of conditions/diet plans to include; • Malnutrition, enteral and parental nutrition • Weight management/obesity including bariatric patients • Diabetes, IGT and reactive hypoglycaemia • PCOS (Polycystic Ovary Syndrome) • IBS as treated by the new FODMAP diet plan • Sports performance and enhancement • Cancer • Coeliac disease • Lactose Intolerance • Constipation and diverticulitis • IBD (Crohn's disease and colitis), • High cholesterol, triglycerides and blood pressure • Gout and gallstones • Nutritional deficiencies e.g. anaemia

DIABETES CARE CENTRE The dietitian team is an integral part of the services delivered by the Diabetes Care Centre. Together with the diabetes nurse specialist, the team provides a two hour educational consultation session for newly diagnosed diabetes patients and existing diabetes patients who are experiencing current and/or ongoing problems managing their diabetes. Patients can self refer but a GP referral is preferable to ensure continuity of care and the best possible outcome for the patient.

DIETETICS DEPARTMENT For appointments and additional information please call 01 806 5488 or email ioreilly@bonsecours.ie and jcahill@ bonsecours.ie DIABETES CARE CENTRE Tel: (01) 806 5488 / Fax: (01) 808 2343

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ENT SURGERY DEPARTMENT

ENT at Bon Secours Mr Peter Walshe, Consultant Otolaryngologist discusses the range of ENT services at Bon Secours Hospital.

THE SERVICE Mr Walshe is one of a team of six consultant surgeons in this department, providing comprehensive evaluation and medical or surgical intervention to both adult and paediatric patients. “Along with my colleagues I operate on both paediatric and adult cases,” explains Mr Walshe. “I have particular sub-specialty interests in thyroids and salivary disease and fellowships in rhinology, head and neck cancer surgery and I practice in otology, in which I also hold a research fellowship.” Mr Walshe’s colleagues, Mr Tadhg O’Dwyer, Mr Munish Shandilya, Prof Michael Walsh, Mr Rory McConnWalsh, Mr Kieran O'Driscoll and Mr Fergus Glynn have complimentary interests in a wide range of subspecialty ENT areas.

ACCESSIBILITY Mr Walshe believes that one of the best things about Bon Secours is its accessibility and affordability to those with different levels of private health cover which is not the same in many other private hospitals. “I would say that the overwhelming majority of patients at the hospital can be treated here without surcharges, significantly differentiating it from other private hospitals. The hospitals location adjacent to the M50 and the M1 also means that we receive referrals from all around the country.” TEAMWORK The otolaryngology team are enthused by the ethos and teamwork at Bon Secours. “It’s a fantastic working environment,” adds Peter. “We have access to state-ofthe-art technology and the theatre staff

at Bon Secours are superb. Staff at the hospital have a fantastic ‘can-do’ attitude. If it needs to be facilitated and it can be facilitated, we will do it. That ethos, working towards the solution instead of the problem is one of the biggest plus factors of working at Bon Secours.” Patients reap the benefits of this ethos with excellent quality care and medical and surgical support, providing a much more positive hospital experience.

CONSULTANT LIST • Mr Feargal Glynn • Mr Rory McConn-Walsh • Mr Tadgh O'Dwyer • Mr Munish Shandilya • Prof Michael Walsh • Mr Peter Walshe

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GYNAECOLOGY DEPARTMENT

Gynaecology at Bon Secours The Gynaecology Department at Bon Secours offers a full range of gynaecological services to its patients. Dr Paul Byrne, Consultant Gynaecologist explains.

t the forefront of modern gynaecological treatment, Bon Secours Hospital offers the best of gynaecological care to its patients. There are five consultant gynaecologists in attendance with an excellent support staff in place, ensuring that the very highest standards of patient care are maintained at all times. Each consultant gynaecologist has their own sub-specialty, including special interests in infertility and urinary incontinence. LAPAROSCOPY Laparoscopy is one of the more common procedures used in gynaecology. Its

onset has transformed the field allowing surgeons to access the abdomen and pelvis through a key hole incision. This minimally invasive procedure has greatly reduced post-operative pain, hospital stay duration and post-operative recovery time. It can be used to treat a number of gynaecological complaints including endometriosis which is commonly associated with infertility. ENDOMETRIOSIS Endometriosis occurs when there is an abnormal growth of endometrial cells outside of the uterus. Endometrial cells are cells shed each month during

menstruation. Endometriosis is when these cells attach themselves to tissue outside the uterus forming endometriosis implants â&#x20AC;&#x201C; commonly formed on the ovaries, fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. Pelvic pain and infertility are common symptoms of endometriosis, however many women present with non-symptomatic endometriosis. Laparoscopy is a great diagnostic tool for patients presenting with a suspected diagnosis of endometriosis. A laparoscope will be inserted to examine the abdomen and pelvis for endometriotic

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GYNAECOLOGY DEPARTMENT

implants. Biopsies may also be taken during this procedure. It is performed as an inpatient procedure and is usually carried out under general anaesthesia. OVARIAN CYSTS The team here at the Bons also diagnose and remove ovarian cysts which are one of the more common gynaecological problems amongst women. Ovarian cysts are fluid-filled sacs that form on the ovaries. Most are benign, but some can cause rupture or pain. Laparoscopy is used to remove smaller non-malignant cysts. If there is a risk that the cyst is malignant then a more invasive procedure called a laparotomy may be necessary. PROLAPSE A complication sometimes arising after childbirth is a prolapsed uterus. Various muscles, tissue and ligaments ordinarily hold the uterus in place within the pelvis. However, the weakening of these muscles during the stages of childbirth or the decrease of oestrogen with the aging process can cause the uterus to prolapse into the vaginal canal. Surgery for prolapse is usually done through the vagina. The prolapse of the bladder and rectum is repaired. If the uterus is also prolapsing, a vaginal hysterectomy will be done as part of the procedure. URINARY INCONTINENCE Urinary incontinence or leakage is likely to be suffered by women due to the effects of childbirth, pregnancy, and menopause. This can lead to involuntary leakage when laughing, sneezing, coughing or performing strenuous activities. We have a fully integrated urodynamic service at Bon Secours Hospital. This allows us to investigate the cause of urinary incontinence before deciding on the best form of treatment. My own special interest is surgery for stress incontinence. There have been significant developments in this type of surgery over the last 15 years. Until recently, surgery for stress incontinence required major abdominal surgery with a hospital stay of 7 to 10 days. Using modern techniques, the surgery is done through the vagina and requires very small incisions. Women are usually fit to go home within a few days of having the surgery. The surgery involves the

placement of a prolene or nylon mesh into the vagina to support the bladder. The operation is called a Trans-Obturator Tape (TOT) procedure. Bon Secours is one of the busiest hospitals in this field. In 2015-2016, the hospital organised a number of public information seminars on a variety of subjects including Urinary Incontinence and Prolapse. Over 100 people attended the event to learn more about these common conditions, which are said to affect about 30% of adult women. The focus of the evening was to help demystify these conditions which many suffer in silence with, what causes them, and also the different treatment options available from a physiotherapy (for urinary incontinence), medical and surgical perspective. The presentations were followed by interactive question and answer sessions. As one of the attendees said following the event: "Now I understand and know that I am not alone and there are treatment options available for me." COLPOSCOPY I run the colposcopy clinic in the Bons. Colposcopy examinations are carried out when a Pap smear test is abnormal. It enables the gynaecologist to take a closer look at the cervix and examine the reasons for such results. The procedure is a short, simple one, lasting around 5 minutes. If an abnormality is seen, a biopsy is taken for a more detailed analysis. If abnormal (pre-cancerous) cells are found, a LLETZ procedure is done. This involves removing a

small part of the cervix containing the abnormal cells. This is done in the colposcopy clinic under local anaesthesia and takes no more than 10 minutes. As a doctor, the Bon Secours Hospital is a wonderful place to work. There is a great team spirit here. This is seen at every level in the hospital – medical, nursing, paramedical, laboratory, household, administration and clerical. Based on feedback from my own patients, there is an extremely high satisfaction rate. I am delighted to be associated with this hospital.

CONSULTANT GYNAECOLOGISTS • Dr Paul Byrne • Dr Yahya Kamal • Dr Edgar Mocanu • Dr Hassan Rajab

Dr Paul Byrne presenting at the Urinary Incontinence Public Information Seminar

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GASTROENTEROLOGY DEPARTMENT

Gastroenterology at Bon Secours The Gastroenterology Department at Bon Secours offers a full range of endoscopy procedures and is fully equipped to diagnose and treat all disorders affecting the gastrointestinal tract.

THE TEAM The Bon Secours Hospital Dublin has one of the largest Gastroenterologist teams in the country, with currently 15 consultants with a variety of interests and expertise. Gastroenterology is the branch of medicine which focuses on the digestive system and its disorders. These are diseases affecting the gastrointestinal tract which includes the organs from mouth to anus along the alimentary canal. Endoscopy is a minimally invasive diagnostic medical procedure used to assess the interior surfaces of an organ by inserting a tube into the body. This is done using a rigid or flexible tube which has a built in fibre optic camera which will provide an image for visual inspection and photography. Endoscopy is also capable of taking biopsies and retrieving foreign objects. The consultant team provide a direct access service whereby their GP will refer

directly in for the procedure. They also provide a consultant-led service whereby the consultant will meet with and evaluate the patient prior to the procedure. The team provides both inpatient and outpatient care. The majority of procedures are carried out on an outpatient basis. The service is quick and easy, with patients being admitted to have their procedure and are discharged the same day. CLINICAL GOVERNANCE The Gastroenterology service is governed by the GI Endoscopy User group who have responsibility to oversee and manage all components of the service provision and clinical governance to include the best quality service for patients through the use of: • Operational Planning, Service Planning and Development

• • • •

Clinical Audit Clinical Efficiency Clinical Risk Management Patient Feedback

The user group is chaired by Dr Conor O'Brien, who is also clinical lead for the GI Endoscopy Service. DIRECT ACCESS ENDOSCOPY One of the fastest growing areas in the Endoscopy Unit is the Direct Access Endoscopy Service, whereby a GP or consultant can refer directly to the department for a colonoscopy, upper GP endoscopy and Left/Sigmoidoscopy. The referral may be made out to a named consultant or to the next available consultant. The named consultant referral forms are forwarded directly to the consultant. The unspecified consultant referral forms are immediately triaged on

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GASTROENTEROLOGY DEPARTMENT

it is then guided into the oesophagus. A camera attached to the scope allows for examination of the oesophagus as the scope is guided through the stomach and passed through the pylorus to examine the first and second parts of the duodenum. Photographs are taken of the pathway during the procedure for examination. Biopsy can also be performed during a gastroscopy, this is done using a biopsy forceps which is passed through the scope and allows sampling of one to three millimetres of tissue which can

standard colonoscopy would still need to be performed. Colonoscopy can remove polyps smaller than one millimetre. Once

polyps are removed, they can be studied to determine whether they are precancerous. Larger polyps which cannot be removed during a colonoscopy can be surgically removed. In most cases a partial colectomy is performed. This is when the cancerous tissue is removed along with a small amount of the surrounding normal tissue. If the cancer has not spread, the colectomy will usually provide a complete cure.

then be examined by a pathologist to

arrival in the department and the patient is contacted to arrange an appointment. Where an urgent referral is received, patients will have their procedure within the shortest time frame possible. Where a referral is marked as routine, patients are seen within 28 days or sooner. The number of consultants within the unit and the variety of expertise and their interests ensure that the waiting time for a procedure is minimal and a referral will be directed to the consultant with a particular area of expertise according to the details included on the referral form. Occasionally patients may not be suitable for the Direct Access Endoscopy Service due to a number of risk factors and in this case, they may be seen by the consultant in advance of their procedure in the consultant's room.

render an opinion as to whether there are abnormalities in the cells. COLONOSCOPY There has been an increasing demand for colonoscopies in recent years. This is due, in part, to the proposed National Colon Cancer Screening Programme. This screening programme is in response to the growing numbers of people being affected by colon cancer, which is now one of the leading forms of cancer in Ireland. This government initiative is increasing awareness amongst the public and GPs, prompting more and more people to get screened. This is a welcome development as early detection is key to tackling and curing this form of cancer. Colon cancer begins as small polyps in the bowel, which are small benign growths which form on the lining of the

GASTROSCOPY Gastroscopy is the most commonly performed type of endoscopy. Gastroscopy is a diagnostic endoscopic procedure used to visualise the upper part of the gastrointestinal tract up to the duodenum. It is a minimally invasive procedure that takes only four to five minutes and does not require any significant recovery time. This procedure is carried out on patients who have stomach ulcers, acid reflux disease or cancer of the stomach or oesophagus. The patient must fast for 4 hours prior to the procedure taking place. Most patients undergo the procedure with no more than a topical anaesthesia which numbs the throat. However some patients opt for sedation if they are particularly anxious or nervous. The patient is asked to lie on their side resting their head on a pillow. The endoscope is then placed over the tongue and into the oropharynx,

SIGMOIDOSCOPY Sigmoidoscopy is similar but not the same as colonoscopy. The difference being the parts of the colon each can examine. Sigmoidoscopy allows doctors to view only the final two feet of the colon, while colonoscopy allows an examination of the entire colon, which measures four to five feet in length. Often a sigmoidoscopy is used as a screening procedure for a full colonoscopy.

bowel. If undetected they will increase in size and can become cancerous. Colonoscopy is a minimally invasive endoscopic procedure which is used to screen for colon cancer. It lasts 20 to 30 minutes and the patient is usually sedated. It is an examination of the large colon using a fibre optic camera on a flexible tube which is passed through the anus. It may provide a visual diagnosis of these polyps granting the opportunity for biopsy or removal of suspected lesions. Virtual colonoscopy, which uses 2D and 3D imagery reconstructed from computed tomography (CT) scans or nuclear magnetic resonance (MRI) scans, is also possible, as a totally non invasive medical test. However, virtual colonoscopy does not allow for therapeutic manoeuvres such as polyp/tumour removal or biopsy, nor visualisation of lesions smaller than five millimetres. If a growth or a polyp

CONSULTANT GASTROENTEROLOGISTS • Dr Danny Cheriyan (Joining autumn 2017) • Dr Richard Farrell • Prof Fergus Gleeson • Dr Gavin Harewood • Dr Jack Hollingsworth • Prof Padraic MacMathuna • Prof Frank Murray • Dr Cathal O’Keefe • Dr Aoibhlinn O'Toole • Prof Stephen Patchett • Dr Barbara Ryan • Dr Subhasish Sengupta • Dr Claire Smyth • Dr Shiobhan Weston CLINICAL LEAD • Dr Conor O’Brien DIRECT ACCESS ENDOSCOPY Tel: (01) 806 5491 Fax:(01) 806 5490 Direct Access Referral forms are available to download from www. bonsecours.ie/direct-accessendoscopy-dublin

is detected using a CT colonography, a

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ENDOSCOPY DEPARTMENT

Endoscopy at Bon Secours The first Private Endoscopy Unit in Ireland to be JAG accredited.

ABOUT In 2016, the Endoscopy Unit at the Bon Secours Hospital Dublin completed a 2.5 million investment programme culminating in the unit being the first private endoscopy unit to be awarded JAG accreditation. JAG accreditation is widely recognised as the gold standard for endoscopy units and is a formal independent assessment of and recognition that the unit has demonstrated its competence to deliver the highest standard of endoscopy care. As part of the accreditation process, the teams were assessed against 313 standards including staffing, quality of care, privacy and dignity for patients and training for staff. In particular, the assessors praised the units for their strong clinical, nursing and administration leadership and dedication patient care. The completion of the redevelopment programme and the achievement of JAG accreditation was officially marked by Minister Simon Harris. The Endoscopy Unit is Ireland’s second busiest endoscopy unit and is second only to St James Hospital in terms of the number of endoscopy procedures which are carried out within the unit annually. The completion of the redevelopment has significantly enhanced the patient experience and journey through the unit and has also increased capacity within the unit to meet the growing demands for endoscopy procedures. During 2016, over 15,000 procedures were carried out in the unit by 31 endoscopists, 12 of whom specialise in the area of Gastroenterology, Respiratory, Urology and also General Surgery. The Endoscopy Unit provides

GASTROENTEROLOGY Dr Richard Farrell Prof Fergus Gleeson Dr Gavin Harewood Dr Jack Hollingsworth Prof Padraic Mac Mathuna Prof Frank Murray Dr Conor O’Brien Dr Cathal O’Keefe Prof Colm O'Morain Prof Steve Patchett Dr Barbara Ryan Dr Shiobhan Weston

RESPIRATORY Prof Conor Burke Prof Richard Costello Dr Ross Morgan GENERAL SURGERY Mr Joe Deasy Ms Deborah Mc Namara Mr Eadbhard Mulligan Mr Colm Power Mr Will Robb Prof Tom Walsh Mr John Burke

UROLOGY Mr Tom Creagh Mr Hubert Gallagher Mr Ponnusamy Mohan Mr Denis O'Sullivan Mr Richard Power Mr James Forde Mr Gordon Smyth

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a Direct Access Endoscopy service where a GP will refer directly in for a procedure and also provide a consultant led service whereby the patient is evaluated prior to the procedure. The Unit's focus is ensuring that patient care and best practice is at the centre of everything that we do. This drives us to continually review our systems and look for ways to develop and improve the work we do. The following projects have been rolled out to ensure that we are at the forefront of endoscopy care in Ireland. ELECTRONIC REPORTING SYSTEM (ERS) The unit uses an electronic reporting system, which allows the endoscopist to electronically record the results from each procedure. The recording of information in this way allows for previous reports to be quickly and easily retrieved electronically for comparison purposes. The system allows for the electronic storage of images and videos captured during each procedure and the high quality imagery is extremely useful when formulating management plans for patients.

The use of this system also enables the endoscopy unit to participate in the National Quality Improvement Programme for Endoscopy, and it is planned that the unit will be the first private facility to fully engage with the programme. Engagement in this programme is a vital part of our steps toward achieving the area specific accreditation. TRAINING At the forefront of care in the unit is the dedicated nursing and allied health professional team whose focus is on delivering the best possible care for patients. Support and development of the nursing team within the unit and throughout the hospital is ongoing through education and training programmes. PATIENT CARE The department is focused on patient care and has a very effective strategy in place to ensure that the patients needs are always prioritised. Keeping waiting times down and ensuring the patient is kept informed at all times

"During 2016, over 15,000 procedures were carried out in the unit by 31 endoscopists, 12 of whom specialise in the area of Gastroenterology, Respiratory, Urology and also General Surgery." is central to this. The department's aim is to minimise the waiting time in the unit, to improve the overall patient experience and minimise any potential anxieties that the patient may experience. THE FUTURE Endoscopy is very much an evolving sector with amazing technology being consistently pioneered. Ireland has an ageing population and in future years there will be a very significant cohort of the population who will fall into the screening range. The Endoscopy Department has recognised that the ability of the entire sector to cope with this demand is going to be challenged and that only the units which are achieving the highest standards are going to be able to rise to this challenge. With recent and planned developments in the department, the endoscopy department will be in an excellent position to meet these challenges.

ENDOSCOPY DEPARTMENT OPENING TIMES Monday to Friday 8.30am â&#x20AC;&#x201C; 8pm Occasional Saturday Clinics CONTACT NUMBERS Tel: (01) 806 5491 (01) 806 5492 (01) 806 5348 Fax: (01) 806 5346

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LABORATORY DEPARTMENT

Laboratory Bon Secours has a comprehensive laboratory service on site providing a 24 hour service to the hospital. Pauric Reilly, Laboratory Manager explains.

THE TEAM The laboratory team at the Bon Secours Hospital is consultant led and consists of 31 scientific, assistant, clerical and phlebotomy staff, servicing 18 clinical units in the hospital, including cardiology, endoscopy, surgery, medicine and oncology. The laboratory receives a significant number of samples for processing on a daily basis, both from inpatients and outpatients. Outpatient specimen numbers continue to increase since the launch of a free walk-in phlebotomy service in the hospital. The service is available from 8.30am to 3.30pm Monday to Friday with many patients dropping in on their way to work or over their lunchtime and throughout the day. Pathology results are available to GPs via Healthlink, a much appreciated development. The laboratory service on offer is across five major disciplines: 1. Chemical chemistry 2. Haematology 3. Blood transfusion 4. Histology 5. Microbiology The laboratory offers a full range of diagnostic services to in-house consultants and also external parties who wish to use the service including the Eccles Clinic, the Clonmel Healthcare Group and the Whitfield Clinic. There is a rapid turn around time for blood tests, generally taking less than three hours from the time the specimen is received to the issuing of the final full profile report. EQUIPMENT The laboratory has state of the art equipment. The biochemistry suite has been recently upgraded with Abbott architect analysers; blood transfusion

has been automated, histopathology had significant replacement of equipment and is a top performing service using national metrics for quality and turnaround time. Microbiology has also seen recent investment. WARFARIN CLINIC The hospital operates a very busy Warfarin Clinic which is provided as a point of care test. The Clinic operates on a walk-in basis whereby the test is completed and the prescription is issued with the minimum of delay to the patients. Patients of the Warfarin Clinic include those suffering from certain health conditions, those at risk of stroke or those who have developed clots post-operatively. As they tend to visit the clinic once every three to four weeks, the efficiency

and smooth running of the service is of paramount importance, and patient feedback about the service is excellent. In 2015, significant changes to the way the Warfarin Clinic in the Bon Secours Hospital operates have significantly enhanced the quality of the service and the experience of the patient.

LABORATORY DEPARTMENT CONTACT DETAILS For appointments and additional information please call (01) 806 5308 Warfarin Clinic (01) 806 5494 Phlebotomy: Walk-in service daily from 8am - 3.30pm

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MEDICAL ASSESSMENT UNIT

Medical Assessment Unit The Medical Assessment Unit gives patients and GPs same day access to consultant review, diagnostic tests and treatment.

he Medical Assessment Unit (MAU) provides patients with same day access to a General Medical Consultant following referral by their GP. It is suitable for stable, medically-unwell patients requiring immediate assessment, investigation and treatment for a broad spectrum of medical conditions. Patients requiring emergency care can only be referred to the unit by their GP and no walk-in patients are accepted. The MAU at Bon Secours is one of the finest in the country, functioning as it does under its Medical Director, Dr Geraldine Hosny. Dr Hosny has worked widely throughout the medical sector over the years, gaining experience throughout Ireland, as well as in countries from Australia to Saudi Arabia. She joined the Bon Secours Hospital in Dublin in the

“Everything is actually done on admission. It's much safer really, and it's a much better use of resources, because the length of stay of the patients tends to be lower as well.” summer of 2016, acting as the clinical lead of a team of registrars, nurses and allied health professionals in the hospital's expanding Medical Assessment Unit. The Medical Assessment Unit replaces the Rapid Access Service which was previously provided by the hospital. The principal difference is that the patients are seen by Dr Hosny on entry to the hospital, their management plan is assessed, tailored and delivered very quickly, and any investigations that are required will most likely be completed on the same day. “Everything is actually done on

admission. It's much safer really, and it's a much better use of resources, because the length of stay of the patients tends to be lower as well.” In essence, patients entering the MAU are seen very quickly, and any urgent tests are performed on the day. Patients will be discharged on the same day with a treatment plan or alternatively they may be admitted to the hospital for further investigation and treatment. “If you go into an MAU in a public hospital, you'll be seen by a junior doctor, and you'll have a lot of what they call

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MEDICAL ASSESSMENT UNIT

The staff in the unit have been focusing on getting it fully off the ground in the time since it has opened, but plans to evolve will begin to take a more definite shape over the coming years. Ideas on the table at the moment include a purposebuilt unit for the MAU, the introduction of a chest pain pathway, and the ongoing improvements of the facilities themselves. routine standard investigations done - we don't do that,” continues Dr Hosny. “We get all of our investigations done on site at the time. The other thing is, because our resources are so much better, we can actually get an awful lot of work done on a patient in one day. That wouldn't generally happen in a public hospital.” TOP FACILITIES The Bon Secours is well positioned to provide the essential services demanded of any MAU. It has excellent laboratory, radiology and non-invasive cardiology diagnostic services. “From what I understand, the facilities at Bon Secours are comparable, if not at a higher standard, than what's available in other private hospitals, where paying patients don't actually have a full pathway finished before they leave,” says Dr Hosny. After years of working within the HSE, the speedy turnaround of patients and the quality of care that the MAU at Bon Secours affords are hugely satisfying for Dr Hosny. “I must say, one of the things I still feel a novelty for is when I say to patients, 'We're just going to give you a shot of IV antibiotics, and then you'll be able to get a bed,'” says Dr Hosny. “After spending so long in

the HSE, that's actually a huge thing for me, because that's a huge part of the patient experience, to be able to get their care in a timely manner. Basically we're trying to get our patient to the right place at the right time and to get their treatment in very quickly.” The unit is still in its infancy, having only opened in the summer of 2016. There remains great potential to grow and expand – an idea that Dr Hosny is fully behind. “There are always plans to expand the unit!” she laughs. “I think my general manager has a flea in his ear at this stage. He sees me and he goes 'Agh, what do you want now?'” The staff in the unit have been focusing on getting it fully off the ground in the time since it has opened, but plans to evolve will begin to take a more definite shape over the coming years. Ideas on the table at the moment include a purposebuilt unit for the MAU, the introduction of a chest pain pathway, and the ongoing improvements of the facilities themselves. “We are in an existing ward at the moment, which has been accommodated for us, but we still need some structural changes to be made,” explains Dr Hosny. “A lot of building work is being done.” The continued evolution and

improvement of the Bon Secours' Medical Assessment Unit will benefit patients and GPs alike, given the speed with which the patient is seen and the necessary tests that are performed. The alternative to this would be a series of multiple hospital attendances or potential referral to a local emergency department, which would stretch resources and possibly heighten a patient's level of anxiety. “The main thing to say is that we are a sleeping giant at the moment. I'm hoping there will be a lot of extra activity generated,” says Dr Hosny. “I think there's going to be a huge change in the manner in which the hospital is run in the next couple of years, there'll be a huge mindset change, and it's going to become quite big business here.”

ADMITTING HOURS Monday to Friday 8am to 4pm CONTACT DETAILS: Call: (01) 806 5498 / 086 209 8380 Fax: (01) 806 5405 Web: www.bonsecours.ie

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MEDICAL ASSESSMENT UNIT

PATIENT SUITABILITY The MAU is suitable for stable, ambulatory patients requiring immediate assessment, investigation and treatment for a broad spectrum of medical conditions. These include patients presenting with the following conditions: Weight loss • PUO • Fatigue • Malignancy work-up • Cellulitis • Flu like illness Gastroenterology • Stable GI bleed • Inflammatory bowel disease • Malignancy • Jaundice • Gastroenteritis Haematology • Anaemia • DVT • Thrombophlebitis Respiratory • Respiratory tract infection • Asthma / COPD • Shortness of breath • Pleuritic chest pain • Interstitial Lung Disease • PE Cardiology • Stable acute coronary syndrome exclusive of STEMI • Stable angina, Stable arrhythmias • Palpitations for assessment • CCF • Pericarditis and Myocarditis Endocrine • Uncontrolled Diabetes • DKA • Thyroid Disease • Pituitary Dysfunction Rheumatology • Rheumatology Disorders

MAU ADMISSION PROCESS The GP will contact the MAU with their patient’s details and the admitting consultant will indicate whether the patient's condition is suitable for referral to the MAU. On referral from their GP, the patient is admitted to the dedicated eight bedded unit and has an initial consult with Dr Ger Hosny or one of the other members of the consultant team on duty, who will arrange the appropriate investigations and treatment. The aim is to complete all tests and investigations on the same day with a view to the patient being discharged with a treatment plan or alternatively being admitted to an inpatient hospital bed for further investigations and treatment. Admitting hours are Monday to Friday, 8am to 4pm, meaning that the last patient is admitted to the unit at 4pm and worked up until they are either admitted to the hospital or discharged home from the unit. FEE STRUCTURE The cost of the service is dependant upon the level of investigations required. The initial attendance fee at the MAU is 150 and the maximum fee charged is 495. If a patient is admitted, all payments in addition to the attendance fee will be refunded. The service is currently offered on a self-pay basis and is not covered by medical health insurance. It is however possible for patients to claim some of the costs back against their personal taxes at the end of the financial year.

CONTINUED CARE PATH Following the diagnostic and assessment process in the MAU the patient will be discharged back to the care of their GP or, if required, patients will be admitted to the hospital via the Rapid Access Service. The early success of the MAU and the positive feedback from patients and the GP community are very encouraging. The Bons is exploring how it may expand the service further to meet the increasing demands from its referring GPs.

ADMITTING HOURS Monday to Friday 8am to 4pm CONTACT DETAILS Call: (01) 806 5498 / 086 209 8380 Fax: (01) 806 5405 Email: dmau@bonsecours.ie Web: www.bonsecours.ie KEY STAFF • Dr Geraldine Hosny MAU Clinical Lead • Suzanne Donlon - CNM11 MAU • Dr Colette Barry • Dr Ross Morgan • Dr Matilde Zamuner

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ONCOLOGY DEPARTMENT

Oncology at Bon Secours The Oncology Department at Bon Secours offers both inpatient and outpatient care. Dr Oscar S. Breathnach, Consultant Oncologist explains.

THE SERVICE The Medical Oncology Service at Bon Secours Hospital provides care through both the inpatient and dedicated outpatient units. Patients receive care under the direction of Prof Liam Grogan, Dr Oscar S. Breathnach or Dr Patrick Morris, all of whom are affiliated with the Cancer Centre in Beaumont Hospital. Bon Secours benefits greatly from this integration as Beaumont Hospital is one of the country's eight designated Cancer Centres of Excellence. TREATMENT Generally, when a patient is referred to the Medical Oncology Service they would have a pre-existing diagnosis of cancer and their clinical situation would have been assessed by the various other physicians and surgeons involved in their care. Once the patient has been assessed and educated regarding their condition by the consultant medical oncologist and the medical oncology nurses, a plan is developed for their care. This may include one or more of the following treatments: • Systemic chemotherapy • Radiation therapy • Future surgical intervention • Supportive medications, such as blood transfusions, bone strengthening agents • Palliative medicine, for pain control, breathlessness, low energy, etc. Before commencement of each therapy, patients are re-assessed and necessary adjustments to care are made. The care is predominantly outpatient based, via the dedicated oncology day unit. However, inpatient care is provided for those patients who

become unwell either from their cancer or from side-effects of their therapies and require more intensive care. Inpatient care is provided for by the Medical Oncology Service, with daily ward rounds, seven days a week. QUALITY CARE A quote from a Bon Secours patient sums up the care and compassion of the team: "The team in the Bons are brilliant - kind, efficient, great listeners. They treat the person first, then the symptoms. This is so refreshing. The oncology ward is bright, small and cheerful, and all the staff are wonderful."

TEAMWORK As with all services at Bon Secours Hospital we are supported by the allied health professionals in the hospital, such as the dietetic service, physiotherapists and pastoral care.

DEPARTMENT OF ONCOLOGY • Dr Oscar Breathnach • Prof Liam Grogan • Dr Patrick Morris CONTACT DETAILS Tel: (01) 806 5409

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OPHTHALMOLOGY DEPARTMENT

Vision Science at Bon Secours The Ophthalmology Department at Bon Secours provides the best and latest treatments for its patients. Dr Susan Fitszimons, Consultant Ophthalmologist outlines the importance of ophthalmic health.

THE TEAM Ophthalmology and vision science has seen rapid technological advances in recent years. These new technologies and treatment modalities have revolutionised the field, making treatment less invasive and much more accurate. Specialist patient care is provided by the consultant ophthalmologists here at the Bon Secours Hospital. The ophthalmologists are dedicated to providing the very best and most up-to-date patient care. There are nine ophthalmologists

working and seeing patients in the hospital - seven ophthalmic surgeons and two medical ophthalmologists. Each of them covers general ophthalmology but also have subspecialty interests. These specialty areas include cataract and refractive surgery, anterior segment, glaucoma, strabismus, paediatrics and medical retina. Three consultants have clinics on site and regular outpatient clinics. The medical ophthalmologists focus on the medical assessment, investigation, diagnosis and management of disorders affecting vision.

RANGE OF SERVICES Conditions covered by the ophthalmology specialists at Bon Secours are not limited to â&#x20AC;&#x2DC;eye diseasesâ&#x20AC;&#x2122; but include broader conditions affecting ophthalmic health. Many of the patients seen by the ophthalmologists are referred by other specialists in the hospital, which greatly improves the service to each individual inpatient. Conditions such as multiple sclerosis, diabetes, rheumatologic disorders and general medical problems are among the most common referrals. Consequently the service to the hospital is quite extensive, with the

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ophthalmologists on staff providing up to a dozen various and different medical consultations each week. From a surgical perspective, each ophthalmologist admits their own patients for different surgical procedures. In addition to cataract operations, many other procedures are also offered to patients including: • Assessment and treatment of cornea and ocular surface disease • Eye lid and anterior segment surgery • Glaucoma medical and surgical treatment • Assessment and management of age related macular degeneration • Assessment and management of uveitis, vitreous and medical retinal disorders • Strabismus assessment and surgery • Diabetic Retinopathy screening and management. CATARACTS The most common procedure performed here is cataract surgery. This is the most common procedure in ophthalmology worldwide. It is the removal of the natural lens of the eye which has lost transparency due to the development of an opacification known as a cataract. Following the removal of the natural lens, an artificial intraocular lens is implanted. This is known as phacoemulsification or small incision surgery whereby the lens implant is folded up into a scroll and inserted through a keyhole incision. Due to advances in technology this incision can be less than 2mm in length and self seals without the need for sutures. Computer controlled fluidics in a modern phacoemulsification machine causes less trauma to the eye. This results in safer surgery, rapid patient rehabilitation, fewer post-operative complications and a superior refractive outcome. The eye theatre and clinical eye room are well equipped with all the instrumentation and nursing expertise to facilitate the very best of modern eye care. DIABETIC EYE DISEASE According to the Association of Optometrists Ireland ‘diabetes related eye disease is the leading cause of vision loss in adults of working age (20-65) in industrialised countries’. Both type I and type II diabetes can cause severe,

vision threatening damage to occur inside the eye. Currently, one in 20 people in Ireland suffer from diabetes and one in 8 of those over 60 have the disease. Unfortunately 74 per cent of those who have diabetes for 10 years or more will develop diabetic eye disease. These figures are quite staggering and really highlight the importance of ophthalmic health. If diabetes goes undiagnosed for a number of years, changes in the retina or diabetic retinopathy may occur. As the disease develops, blood vessels at the back of the eye leak causing macular oedema and slow deterioration of vision, or may proliferate causing intraocular haemorrhage and sudden loss of vision. Damage to the eye can be seen directly by the ophthalmologist long before symptoms begin to emerge. If left untreated, both leakage and proliferation will cause permanent vision loss. As always, prevention in the form of regular eye check-ups for diabetics is better than remedial treatment in the form of an operation. Here at the Bon Secours, diabetic retinopathy screening and treatment is available to both outpatients and inpatients. When treatment is performed in good time, vision can be preserved or restored and visual results can be excellent.

CO-OPERATION IN THE FIELD Each ophthalmologist at Bon Secours also attends at least one other eye department or hospital. This fosters strong links with teaching hospitals and develops excellent relationships. Good communication between other hospitals and departments results in good standards of practice and the best use of resources. On-going teaching by the ophthalmologists of junior hospital staff, in association with the RCSI, maintains an academic environment which is so important to ensure that the education of our next generation of doctors is top notch.

OPHTHALMIC SURGEONS • Ms Yvonne Delaney • Mr Edward Dervan • Ms Aoife Doyle • Ms Susan Fitzsimons • Ms Patricia Logan • Prof Paul Connell • Mr Weng Lee OPHTHALMOLOGIST • Dr Aisling Foley Nolan • Dr Louise O'Toole

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ORTHOPAEDIC DEPARTMENT

Orthopaedic Surgery at Bon Secours The Orthopaedic Department at Bon Secours is at the forefront of modern orthopaedic care. Mr Philip O’Connor, Consultant Orthopaedic and Spinal Surgeon explains.

THE ORTHOPAEDIC TEAM The Orthopaedic Department at Bon Secours includes ten orthopaedic surgeons, four of whom have consulting rooms on-site. All eight perform inpatient orthopaedic surgery. There is one laminar flow operating theatre for performing joint replacement surgery.

All orthopaedic subspecialties are represented including: • hand • knee • spine • upper limb and shoulder • lower limb • arthroplasty

• foot and ankle surgery The hospital is fully equipped to provide the best orthopaedic care for our patients. There is a dedicated Orthopaedic Theatre with laminar flow for performing joint replacement surgery. In July/August 2017, it will undergo a significant investment programme to remodel the

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theatre. The hospital has a dedicated Orthopaedic Ward called Sacred Heart, which is staffed by a team of experienced orthopaedic nurses to optimise the post operative care and rehabilitation of the patients in conjunction with the physiotherapy team whilst the patients are in the hospital There is also a dedicated orthopaedic ward that has been recently refurbished and which is staffed by a very experienced and compassionate team of nurses. The Department also benefits from extensive medical backup from the large number of experienced medical consultants on hand here at the Bons. We pride ourselves on our diligence and our patient centred approach. We believe that a caring and supportive environment goes a long way to ensure patient satisfaction and peace of mind. RECENT DEVELOPMENTS The Orthopaedic Department at Bon Secours is at the forefront of modern orthopaedic medicine. Continuous advancements in technology and continued education amongst our consultants are what set us apart from the rest and ensures that we are leaders in our field. Recent technological advancements include the installation of a digital templating system (TraumaCad®) in the operating suite and the kingmark™ calibration of all orthopaedic x-rays performed which virtually eliminates all errors in positioning calibration markers on patients. Calibrating x-rays eliminates the effect of magnification and allows for accurate measurements to be made. The kingmark™ system easily allows the placement of markers behind and

in front of the pelvis, from which magnification calculation can be made. In conjunction with the TraumaCad® software, surgeons can precisely plan joint replacement surgery, measure expected bone cuts, and view a digital image of the joint replacement components superimposed on the x-ray. Pre-operative digital templating also allows the orthopaedic surgeon to plan osteotomies and complex joint reconstruction. In addition to accurate pre-operative planning, orthopaedic patients at Bon Secours are now availing of new technology aimed at improving the accuracy of total knee replacements. In conjunction with Smith and Nephew™, MRI images of the patient’s knee are used to create a customised cutting block that is then used in the subsequent surgery. The “Vissionaire” system reduces the inventory requirements in the operating room, facilitates more accurate placement of joint replacement components and can reduce operating time. Pre-operative planning is a key step in successful joint replacement surgery and the high degree of accuracy of the kingmark™ and TraumaCad® systems together with the ‘Vissionaire” system used at Bon Secours hospital continue to place it at the leading edge of orthopaedic surgery. The hospital's dedicated orthopaedic ward has recently been refurbished. SPINAL SURGERY Spinal surgery is reputed as being quite an invasive and risky procedure. Often the implants used in spine surgery are small but traditionally they involved long incisions, which resulted in lots of muscle destruction and bleeding, just to get to the area of the spine involved. However, new Minimal Access Surgical Techniques (MAST) allows for access to the spine through much smaller incisions, resulting in much less muscle damage and consequently less bleeding. Some of the general orthopaedic services and surgery provided include: SPINE • All aspects of adult degenerative spine conditions

• Anterior cervical decompression and fusion (ACDF) • Posterior spinal decompression and instrumentation • Lumbar discectomy • Lumbar decompression and instrumented fusion • Lumbar fusion (PLIF/TLIF/DLIF) • Lumbar dynamic stabilisation • Minimal access spinal fusion • Epidural and selective nerve root injections • Discography • Facet joint injections HIP • Total hip arthroplasty – all types • Revision total hip arthroplasty • Soft tissue surgery KNEE • Total knee arthroplasty • Patient matched instrumentation for total knee arthroplasty • Revision total knee arthroplasty • Uni-compartmental knee arthroplasty • Patello-Femoral knee arthroplasty • Arthroscopy and meniscal repair FOOT AND ANKLE • Total ankle replacement surgery • Authrodesis surgery • Bunion forefoot corrective surgery • Treatment of paralytic disorders affecting the ankle and foot. SHOULDER AND UPPER LIMB • Total shoulder replacement • Rotator cuff repair • Shoulder Acromioplasty • Elbow and wrist scopes • Carpal tunnel

ORTHOPAEDIC CONSULTANTS • Ms Olivia Flannery • Mr Darragh Hynes • Mr Patrick Kenny • Mr Peter Keogh • Mr Aaron Glynn (joining summer 2017) • Mr Philip O'Connor • Mr James (Shea) O'Flanagan • Prof Michael Stephens • Mr James Walsh • Mr Philip Brady

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PODIATRY DEPARTMENT

Podiatry Foot and Ankle Clinic Podiatry is an up and coming specialty and Bon Secours is getting in on the ground of this exciting new field of practice. Niall Donohue, Podiatrist explains.

UP AND COMING Podiatry specialises in the management of diseases and disorders associated with the foot and lower limb. It is very much an up and coming specialty here in Ireland with NUI Galway launching the first degree course in podiatry four years ago. The need for a course here was evident and its establishment reflects the growing demand for the specialty in Ireland. The foot is a highly complex structure; problems with which can greatly affect the overall health of patients. Podiatry promotes and maintains mobility which can significantly improve patients quality of life. With this in mind, it is very much a branch of medicine which is going to continue to grow over the coming years. The Bon Secours is dedicating considerable time and resources into establishing a top class podiatry service for its patients. Podiatry is a far reaching specialty as clients vary widely, as do treatment modalities. It is also a specialty where preventative care is key. Many issues which arise with the foot and lower limb can be prevented with continuous upkeep and care.

closely with diabetic patients at risk from foot disease, implementing management plans to prevent problems occurring. Education plays a pivotal role in diabetic foot care as often patients are unaware of the risks and consequently neglect to take the proper steps to ensure problems do not arise. For patients presenting with established foot complications such as infections or

necrotic tissue, podiatrists will provide wound care and dressings, offer advice on footwear or prescribe orthotics to reduce pressure on the foot which will greatly improve the patients' quality of life. The use of orthotics is critical to combat the risk of ischemia, ulcers and neuropathy in diabetic patients. However, such measures could often have been prevented with a timely visit to our podiatry service.

DIABETES The importance of podiatry as a preventative measure is none the more evident than in diabetic care. Unfortunately, foot care of patients is often one of the most overlooked aspects of diabetes management. Diabetes causes nerve damage known as peripheral neuropathy, it also causes poor circulation and stiff joints. These are complex foot problems which can lead to episodes of infection, foot ulceration and in some cases amputation. Podiatry is vital for the prevention of such problems. Patients suffering from diabetes need close monitoring and ongoing podiatric care. The podiatrists at Bon Secours work

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ORTHOTICS One of the more advanced podiatric services which we offer our patients is podiatric biomechanics. This is the study of the way the lower limb and foot moves, inclusive of the muscles and soft tissue as well as the anatomical structure and movement of the bones and joints. Podiatrists will perform gait analysis on the individual patients to get an understanding of why particular injuries are occurring within the musculoskeletal system. Once the podiatrist identifies what is causing the problem then they can prescribe the necessary care. This can range from stretching exercises, specialist footwear advice or functional foot orthoses. Here at the Bons, we have advanced equipment that has revolutionised the manufacture of our orthotics. Our Computer-Aided Design/ComputerAided Manufacturing (CAD/CAM) machine renders traditional Plaster-of-Paris methods of orthotic manufacture obsolete.

We use a laser scanner to visualise the foot enabling the creation of a 3D design of the finished orthotic on our computer. We use this design in conjunction with each patient’s bio-mechanical assessment to manufacture orthotics. Each finished product is a one hundred per cent unique custom design for an individual patient and will enable the rehabilitation of the patient's symptoms. ELDERLY PATIENT CARE We also offer services in the area of routine palliative foot care. This is particularly important when it comes to elderly patients. Palliative care encompasses nail debridements, corn and callous removal – plantar and inter-digital – and also onycochryptosis procedures, veruca treatments and the removal of plantar warts through the use of a caustic or cryotherapy. The importance of good foot-care becomes all the more evident in elderly

patients. Feet carry us throughout the day and throughout our lives. If the feet aren’t comfortable, nothing is comfortable. This is why the service we provide here at the Bon Secours is so important. The simplest tasks begin to get more and more difficult as we age and often elderly patients find that foot care and maintenance becomes increasingly unmanageable. If foot care is neglected, problems are sure to arise. Poorly lookedafter nails can cause pain and discomfort and make it difficult to move. Good nail care and nail management is essential for older patients and can have very positive effects on mobility. Mobility is one of the key factors when maintaining health and strength in the older patient.

PODIATRY DEPARTMENT For appointments call: (01) 5545699

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PLASTIC SURGERY DEPARTMENT

Plastic Surgery at Bon Secours The Plastic & Reconstructive Surgery Department at Bon Secours provides a wide range of services to its patients, explains Mr Barry O'Sullivan, Consultant Plastic Surgeon.

lastic surgery is concerned with the correction or restoration of form and function of the human body. It is a diverse surgical specialty, looking after a wide variety of problems for patients. The plastic surgery department at Bon Secours recognises and caters to this diversity, dealing with skin cancers and their sequelae, as well as performing hand surgery,

and aesthetic and reconconstructive breast and facial surgery. A BROAD FIELD Mr Barry O'Sullivan, Consultant Plastic Surgeon at the Bon Secours Dublin, explains that plastic surgery extends much further than most people's perception of it. “It's much broader than that,” he asserts. “The techniques I learned during my training provided me with a wide

range of reconstructive skills... not just to sort out patients' appearance or form, but also to optimise their functional outcome. There are many disciplines within plastic surgery. Cosmetic practice certainly represents a section, but not the dominant section, of my practice. I would see myself more as a reconstructive surgeon.” Mr O'Sullivan undertook his plastic surgery specialist training in Ireland, qualifying with his fellowship in

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“Cosmetic practice certainly represents a section, but not the dominant section, of my practice. I would see myself more as a reconstructive surgeon.” plastic and reconstructive surgery in 2011. Following this, he undertook a fellowship in trauma and micro-vascular reconstruction in the Royal Perth Hospital in Australia, as well as an aesthetic fellowship in the Mount Hospital in Western Australia. He remained in the country, working as a consultant, before returning to Ireland in 2014. He then took up a post in Beaumont and Connolly Hospitals as a plastic surgeon, with a special interest in head and neck cancer and breast cancer reconstruction. He then joined the team at the Bons - the sixth plastic surgeon to join the department. Mr O'Sullivan's personal speciality area is in head and neck reconstructive surgery – in facial surgery and breast reconstructions. “There are two types of breast reconstruction,” he explains. “There's either implant reconstruction or autogulous reconstruction, which means, basically, your own tissue. Autogulous breast reconstruction is where we move tissue from one part of your body to another.” O'Sullivan performs what is known as a DIEP flap, which is a form of breast reconstruction in which microsurgical techniques are used to transfer abdominal skin and fat to reconstruct the breast. It is an advanced technique which utilises blood vessels, fat and skin from the abdomen, allowing for the preservation of abdominal strength and integrity. VARIED EXPERTISE As plastic surgery is so broad, the team that works within it needs to be varied, in terms of its specialities. “We all bring our own set of skills at the Bons, because plastic surgery... doesn't focus on one specific area of the body,” says Mr O'Sullivan. “We all bring our own set of skills or techniques to the department.”

Aiding the diverse team at the Bons are the top-class facilities found there. “We're able to manage small, day-case, local anaesthetic procedures – and we have a purpose-built facility for that – right through to people who have major surgery and need duel anaesthetic with all the supports that go with that,” says Mr O'Sullivan. “Then, along with that, we have the supports of an x-ray department, a physiotherapy department, nutritional and dietitian departments, which all contribute to the optimising outcome for our patients.” The key to the future of the plastic surgery department at the Bon Secours, according to Mr O'Sullivan, is expansion. He suggests that the hospital should continue, as it has been doing, to

bring in international experience and to continuously develop upon existing systems and facilities. “Previously a lot of things about reconstructive surgery were about just achieving closure,” he concludes. “We now try to get people as close back to their pre-operative function as they possibly can.”

PLASTIC SURGEONS • Mr Nadeem Ajmal • Mr Brian Kneafsey • Ms Margaret O'Donnell • Mr Barry O'Sullivan • Mr Anthony Ryan • Mr James Small

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DEPARTMENT OF RESPIRATORY AND SLEEP MEDICINE

Respiratory and Sleep Medicine at Bon Secours The Department of Respiratory and Sleep Medicine at Bon Secours strives to deliver the highest standard of care to its patients. Prof Pat Manning, discusses the importance of respiratory care.

he respiratory department at Bon Secours Hospital Dublin was one of the first to be established in Ireland. The laboratory possesses state-of-theart equipment with procedures being continually updated to reflect the latest in testing standards. This service is available to consultants for inpatients and outpatients, and for referrals from general practitioners. It has been providing an efficient respiratory testing service for inpatients and outpatients, referrals from consultant and general practitioners since the early 1990s. The department is one of the biggest in the country and a number of prominent

consultant Dublin respiratory physicians refer patients for testing including, Prof Shane O’Neill, Prof Conor Burke, Prof Gerry McElvaney, Prof Richard Costello, Dr Ross Morgan, Dr John Faul, and Dr Liam Cormican. The department is comprised of two labs: 1. Sleep Diagnostic Testing 2. Respiratory Diagnostic Testing SLEEP DIAGNOSTIC TESTING The Departments Sleep Lab provides the following investigations and treatments: • Nocturnal Polysomnogram (PSG) • Cardio Respiratory studies • CPAP/BiPAP titration studies • CPAP/BiPAP compliance studies

• Multiple Sleep Latency Tests (MSLTs) • Maintenance of Wakefulness Tests (MWTs) • Actigraphy • Overnight Oximetry Studies • Insomnia Services iCBT Patient education is provided on an individual basis and includes troubleshooting and an advisory service through helpline from patients on a range of CPAP problems. See feature on Sleep & Apnoea in the following section. PULMONARY FUNCTION LAB The pulmonary department is responsible for testing the performance

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of the lungs. It compares the function of the lungs against what would be expected from the normal lungs of a person of similar age, weight, sex and height. Pulmonary Function Tests are essential in diagnosis, initiation and monitoring of respiratory drug therapy and in continuous clinical assessment of chest symptoms such as cough, dyspnoea, lung conditions such as chronic obstructive pulmonary disease (COPD), asthma, sarcoidosis, pulmonary fibrosis, lung cancer and pneumonia. It allows the assessment of the potential effects or response to environmental or occupational exposure and evaluation of sleep disordered breathing such as obstructive sleep apnoea (OSA), with a flexible sleep diagnostic service available to suit the patients’ needs. PULMONARY FUNCTION TESTING SERVICE The department provides a comprehensive range of lung investigations: 1. General Respiratory Tests Referrals are accepted from GPs and Consultants. Most tests are covered by the majority of insurance companies. 2. Full Pulmonary Function Testing includes: • Spirometry with Bronchodilator Response Testing • Static Lung Volumes • Diffusing Capacity • Body Plethysmography (including Thoracic Gas Volume, Airways Resistance) • Maximum Respiratory Pressures (MIPs and MEPs) 3. Skin Prick Allergy Testing for Atopy • Histamine and Mannitol Inhalation Tests for Asthma • Cardiopulmonary Exercise Testing • Exercise Provocation Test for Exercise-Induced Asthma • Assessment for Long-Term Oxygen (ABGs, 6 minute walk tests and overnight oximetry)

4. Bronchial Challenge Testing includes • Histamine • Methacholine • Mannitol • Exercise Challenge • Cardiopulmoary Exercise Testing (CPET) • 6 Minute Walk Testing REPORTING & TURN AROUND A prompt reporting service is available for all outpatient/general practice referrals. Preliminary results are available on the day of testing. An interpreted report by a Consultant Respiratory Physician usually follows in 48 hours. RAPID ACCESS INPATIENT RESPIRATORY SERVICE This successful consultant led service has been in operation now for several years and accepts patients who have respiratory difficulties such as exacerbation of COPD, pneumonia/ chest infections or suspected pulmonary embolus directly from GPs or consultants. This service provides a direct admission under a respiratory consultant. Conditions that are not accepted through Rapid Access include: • Acute chest pain/MI • Collapse • Lacerations/burns • Stroke patients

OTHER RESPIRATORY SERVICES 1. Fiberoptic bronchoscopy service including transbronchial needle aspiration. 2. Radiology including chest x-rays, high resolution CT scan and CT pulmonary angiogram. 3. Access to multidisciplinary diagnostic and therapy oncology services for lung cancer patients. INSURANCE COVERAGE Most tests carried out in the department are covered by the main private health insurance companies.

DEPARTMENT OF RESPIRATORY AND SLEEP MEDICINE Telephone: (01) 8065479 Fax: (01) 8065480 Email: respiratory@bonsecours.ie CONSULTANT LIST • Dr Conor Burke • Dr Liam Cormican • Prof Richard Costello • Dr John Faul • Dr Patrick Manning • Prof Gerry McElvaney • Dr Ross Morgan • Dr Shane O'Neill

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RESPIRATORY AND SLEEP MEDICINE

Sleep Medicine and Sleep Apnoea at Bon Secours Sleep medicine has evolved over the last fifty years based on major developments in the science of sleep and circadian rhythms.

dvances in both clinical testing and research have identified how prevalent sleep disorders are and also the significant negative impact they can have on health and public safety. Sleep disorders are conditions that prevent a person from obtaining restful sleep and as a result, can cause daytime sleepiness and dysfunction. They have also been associated with a range of adverse health conditions including increased risk of hypertension, diabetes, obesity, depression, heart attack and stroke. WHAT IS OBSTRUCTIVE SLEEP APNOEA SYNDROME ? Obstructive sleep apnoea syndrome (OSAS) is a very common sleep disorder that is characterised by recurrent episodes of partial or complete upper airway collapse during sleep. This collapse results in pauses in breathing which cause oxygen levels to drop leading to frequent brief awakening and interruptions from sleep. With time and left untreated, obstructive sleep apnoea (OSA), can cause many serious health and social problems including excessive daytime sleepiness resulting potentially in accidents in the home, at work or whilst driving. There are two main types of sleep apnoea: 1. Obstructive Sleep Apnoea - this is the most common form and occurs when the throat muscles relax. 2. Central Sleep Apnoea - this occurs when the brain does not send proper signals to the muscles that control breathing. Risk factors for the condition: • Obesity • Increased collar size • Small upper airway • Large tongue

• Snoring • Age • Gender OSA – THE FACTS • It is estimated that almost 100,000 people suffer with OSA in Ireland and up to 60% of these are undiagnosed. • About 70% of those with OSA are obese. • Up to 60% of patients with OSA may have hypertension (high blood pressure). • People with OSA are 15 times more likely to have a road traffic accident due to excessive daytime sleepiness. • Cardiovascular complications include hypertension, coronary artery disease and OSA has also been identified as an independent risk factor for stroke. • There is an increased risk of metabolic disturbances, such as insulin resistance (Diabetes) in patients with OSA. HOW TO GET TESTED STEP 1: SPEAK TO YOUR GP The first step is to discuss your symptoms with your GP who will refer

you to a consultant who specialises in sleep disorder medicine. STEP 2: CONSULTATION AND TESTING The consultant will assess you and decide whether you will require an over night sleep study to confirm the diagnosis of OSA. The sleep study is carried out on an overnight inpatient basis. Nocturnal Polysomnogram (PSG) is the gold standard test for overnight sleep assessment. This involves measuring EEG (electroencephalography), EOG (electrooculography), EMG (electromyography), respiratory effort, abdominal effort, airflow, oxygen saturation levels, snore vibrations, body position and leg movements. These signals are then analysed in order to assess sleep patterns. STEP 3: RESULTS AND TREATMENT. The results of the over night sleep study are reported on in a timely manner by the consultant who will then decide what treatment options you may need.

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SYMPTOMS OF OBSTRUCTIVE SLEEP APNOEA SYNDROME MAJOR DAYTIME SYMPTOMS • Excessive daytime sleepiness (EDS) • Fatigue • Unrefreshed sleep • Difficulty concentrating and • Reduction in short term memory • Morning headache • Morning dry mouth • Depression, irritability, mood changes

MAJOR NIGHT TIME SYMPTOMS • Snoring • Witnessed apnoea • Restless/fragmented sleep • Nocturia – excessive urination at night and/or enuresis (Bed-time wetting) • Night time sweats • Nightmares/unpleasant dreams • Nocturnal choking/gasping (often identified by bed partners) • Thirst during the night • Impotence

TREATMENT OPTIONS CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) CPAP is a well established treatment most suitable for patients with moderate to severe OSA. This involves wearing a mask on the face which is attached to the CPAP device via a tube. The device blows air at an increased pressure in order to keep the airway open while sleeping, allowing normal breathing and preventing dips in oxygen levels. This in turn allows the individual to have a normal and refreshed sleep. CPAP is the recommended treatment for OSA.

SURGERY This involves major surgery with the removal of a large portion of the soft tissue at the back of the throat. Success rate is generally poor.

WEIGHT LOSS Loss of excessive weight can improve the severity of OSA and in some cases even to the point where treatment may no longer be needed.

DEPARTMENT OF RESPIRATORY AND SLEEP MEDICINE AT THE BON SECOURS HOSPITAL The department's sleep lab is one of the busiest in Ireland with a highly qualified team. Since 2008, it has performed over 4,500 diagnostic sleep procedures. It consists of multidisciplinary staff with access to dieticians, cardiologists, respiratory consultants, ENTs, neurologists, orthodontists and endocrinologists. Over 600 patients have commenced CPAP titrations within the hospital in the last 5 years.

MANDIBULAR ADVANCEMENT DEVICES AND SIMILAR MOUTH APPLIANCES These are devices that fix inside the mouth at night and holds the lower jaw in a forward position. This option is only suitable for certain people, mostly with mild OSA.

As well as diagnosis and treatment of OSA, the department also carries out a full range of diagnostic and treatment procedures for an extensive range of sleep disorders including: • Narcolepsy • Sleep walking • Night terrors

• • • •

Body clock issues Restless leg syndrome Insomnia Central Sleep Apnoea

Procedures carried out include: • Nocturnal Polysomnogram (PSG) • Cardio Respiratory studies • CPAP/BiPAP titration studies • CPAP/BiPAP compliance studies • Multiple Sleep Latency Tests (MSLTs) • Maintenance of Wakefulness Tests (MWTs) • Actigraphy • Insomnia Services ICBT

DEPARTMENT OF RESPIRATORY AND SLEEP MEDICINE CONTACT DETAILS Phone: (01) 8065479 Fax: (01) 8065480 E mail: respiratory@bonsecours.ie

BON SECOURS HOSPITAL

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RHEUMATOLOGY DEPARTMENT

Rheumatology at Bon Secours The Rheumatology Department at Bon Secours offers a broad spectrum of treatment to its patients. Dr Maurice Barry, Consultant Rheumatologist discusses.

THE TEAM Four rheumatologists provide a consultant service - Dr Susan Sant, Dr Paul O'Connell, Dr Maurice Barry and Dr Ruth Lee. Drs Sant and Barry hold on-site outpatient clinics twice weekly and all provide inpatient care and see consults. THE SERVICE The spectrum of conditions seen includes inflammatory arthritis, osteoarthritis, osteoporosis and soft tissue rheumatic conditions such as tendinitis and fibromyalgia. The vast majority of imaging investigations required can be carried out on site including MRI, CT, DEXA and ultrasound and a full array of laboratory investigations can be ordered with a very rapid 'turn around' time for results. A broad range of specialties are represented at the hospital which is reassuring when complex or multi-system cases require input from other disciplines. The broad range of specialties also results

in the rheumatology department being consulted on a large variety of rheumatic conditions arising e.g. in oncology, orthopaedic and geriatric patients. THE TREATMENT The treatment options available to rheumatologists have changed dramatically in the last decade. This is especially true of inflammatory arthritis. There are now at least ten biologic agents which are highly effective, well tolerated and have revolutionised the quality of life for those with conditions such as rheumatoid arthritis and ankylosing spondylitis. Some of these agents are infused in the recently opened infusion clinic in the hospital by an increasingly knowledgeable and experienced staff. Experience also counts in physiotherapy and the therapists are extremely efficient at assessing, treating and rehabilitating a range of rheumatic conditions within an increasingly short time-frame.

QUALITY NURSING CARE For some rheumatic patients the key to the success of their hospital stay is the quality of the nursing care. This is often multi-faceted and includes understanding the patient and their condition; controlling their symptoms and caring for them in a holistic way; and organising investigations and treatment to minimise their time in hospital. The nursing staff at Bon Secours work very hard and are very effective at all of the above.

CONSULTANT RHEUMATOLOGISTS • Dr Maurice Barry • Dr Ruth Lee • Dr Paul O'Connell • Dr Susan Sant

BON SECOURS HOSPITAL

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SURGERY DEPARTMENT

Surgery at Bon Secours The Surgical Department at Bon Secours Hospital provides a full range of services for its patients. Ms Deborah McNamara, Consultant General and Colorectal Surgeon discusses.

for a much shorter period of time. With our four bed High Dependence Unit and its specialist highly trained nursing team, we provide a full range of surgical services to all patients including those with multiple co-morbidities and in more high risk patients. INFECTION CONTROL We have an extremely well developed infection control programme with a state-of-the-art decontamination facility for sterility of equipment. Bon Secours has invested in both staff and processes to ensure that every patient is thoroughly screened at admissions, thereby greatly reducing the risk of hospital acquired infection.

THE TEAM Bon Secours Hospital provides excellent surgical care to its patients. We offer a full range of general surgical services and have specialist colorectal, vascular and gastro intestinal surgeons on staff. This highly experienced team performs both open and laproscopic procedures as well as providing a surgical endoscopy service. Other specialties include orthopaedics, gynaecology, ENT, plastic surgery and spinal neurosurgery. As a longstanding institution, the Bons has developed an excellent skill mix in both consultant staff and nursing. This allows patients to benefit from the latest techniques but also to receive the personalised care that only experienced doctors and nurses can provide.

FACILITIES The surgical department consists of four major operating theatres and two minor operating theatres. Bon Secours has invested in modern laparoscopic equipment that allows more patients to receive minimally invasive treatment. This greatly reduces recovery time and increases post-operative comfort. The state-of-the-art new theatres allow us to provide ambulatory day case surgery with minimum wait time allowing a patient to be home within an hour of their procedure. We have a very active day surgery programme whereby we deliver as much surgery as possible using short stays and enhanced recovery programmes. This means that patients recover faster and are in hospital

PATIENT NUMBERS The variety of procedures and the expertise, skills and reputation of our surgical team means that despite the downturn in private health insurance members, patient numbers are continuing to increase in the Bon Secours Hospital Dublin.

SURGICAL DEPARTMENT • Mr Mayilone Arumugasamy • Ms Ann Branigan • Mr John Burke • Mr Joe Deasy • Prof Arnie Hill • Ms Deborah McNamara • Mr Martin O’Donohoe • Mr Kevin O’Malley • Mr Colm Power • Mr Will Robb • Prof Tom Walsh

BON SECOURS HOSPITAL

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UROLOGY DEPARTMENT

Urology at Bon Secours The Urology Department at Bon Secours continuously strives to provide top class treatment to its patients. Mr Richard Power, Consultant Urologist explains.

rology is the medical and surgical speciality that focuses on the urinary tracts of both males and females. Common problems associated with the field include prostate and bladder cancer, infection, incontinence and prolapse. The Urology Department at Bon Secours has a long tradition of providing state-of-the-art services in urology. The Department has dedicated

theatres with highly experienced staff for both inpatient and day care procedures. There is also an excellent urodynamics department, supporting both the hospital's urologist and gynaecologist teams. The urology team includes seven consultant urologists who collectively provide a complete and comprehensive urology service. Each of the urologists has a specific and complimentary

The Urology Clinic at Bon Secours has a long tradition of providing state-of-the-art services in urology.

area of interest. Mr Richard Power, Consultant Urologist, whose own specific areas of interest and expertise include prostate cancer, robotic and laparoscopic surgery, urological oncology, benign prostate disease, renal transplantation, and stone disease, believes that the department is in a constant state of growth and expansion. “There seems to be a new person every week,” he laughs. “I think it's an expanding department.” URODYNAMIC SERVICE Urodynamic testing is any procedure that looks at how well the bladder, sphincters, and urethra are storing and releasing urine. Most urodynamic tests focus on the bladder’s ability to hold

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UROLOGY DEPARTMENT

“It offers a fantastic service as regards evaluating men and females with lower urinary tract symptoms by way of a uroflowmetry, and by way of full urodynamic studies.” urine and empty steadily and completely. Urodynamic tests can also show whether the bladder is having involuntary contractions that cause urine leakage. The aim of the urodynamic service at Bon Secours is to reproduce symptoms while making precise measurements to identify the underlying causes of the symptoms and to quantify the related pathophysiological processes. By doing so, it is possible to establish the presence of dysfunction, understand its clinical implications and either confirm a diagnosis or a new specifically urodynamic diagnosis. Richard Power believes the urodynamic service at Bon Secours is absolutely pivotal. “It offers a fantastic service as regards evaluating men and females with lower urinary tract symptoms by way of a uroflowmetry, and by way of full urodynamic studies, and to evaluate them for incontinence or for benign prostatic obstruction, etc.” he explains. “It also provides a service of bladder installations, post bladder cancer surgery – so you may have chemotherapeutic agents instilled into the bladder. This service is provided by the urodynamic's nursing staff. They also provide catheter changes for longtime catheter patients, and catheter education. It really is an invaluable service within the Bon Secours Dublin.” Referrals are made to the urodynamic service through the consultant specialists, who receive a copy of the test results which are reported on and

feedback given to the referring GP. The urodynamics team is led by Clinical Nurse Manger Adele Ross. TREATMENTS All aspects of general urology are catered for at Bon Secours. The urology department is continuously developing new facilities, equipment and treatments, as Richard Power outlines. “The stone service is in the process of being further developed, with the introduction of flexible uretero renoscopy,” he says. “We've also had a laser machine commissioned for a theatre at the Bons in Dublin, so that will increase the spectrum of stones cases that we can deal with on site.” There is also an excellent Medical Assessment Unit available where

“I think the outlook of the urology department is bright, and it is expanding.”

GPs can refer patients with urological conditions for investigation and treatment, which Richard Power praises. “The Medical Assement Unit, which is run by Dr Ger Hosny, with the support of Dr Colette Barry and colleagues, has facilitated access for patients to the hospital, and we provide urological back up for those patients if required,” he says. “I think the outlook of the urology department is bright, and it is expanding.”

UROLOGY DEPARTMENT • Mr Tom Creagh • Mr James Forde • Mr Ijaz Cheema • Mr Hubert Gallagher • Mr Ponnusamy Mohan • Mr Denis O’Sullivan • Mr Richard Power • Mr Kashif Siddiqui • Mr Gordon Smyth

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VASCULAR SURGERY

Vascular Surgery at Bon Secours Significant developments in facilities and treatment options has seen the area of vascular surgery come into its own in the Bon Secours, making it a very attractive option for patients who want to be seen and treated swiftly in a professional yet personal setting.

r Peter Naughton, Consultant Vascular Surgeon joined the Bon Secours last year having held a consultant post in Beaumont for four years. Prior to that Peter completed his higher surgical training in a number of academic hospitals in Ireland and pursued an enhanced speciality fellowship in St Mary’s in London and a two year fellowship in Chicago focusing on intravenous, open and endovascular techniques. His role in the Bon Secours brings him into contact with patients experiencing a range of vascular issues that require ongoing management or intervention. Peter treats patients with medical requirements that include stroke prevention surgery, carotid artery disease, peripheral arterial disease and the treatment of varicose veins using both open surgery and, where appropriate, newer forms of endovenous surgery. The latter is an area that Mr Naughton feels is often not regarded as particularly serious, however untreated they can lead to secondary complications that can have a more profound impact, as he explains. “Many people, including some physicians, are under the misapprehension that the treatment of varicose veins is purely for cosmetic purposes, and it’s important to stress that varicose veins are known to lead to chronic irreversible skin damage which can be severely lifestyle limiting. We are working on creating awareness to address this. The new form of surgery we use means that the majority of patients can be treated with minimally invasive

techniques resulting in small, centimeter long scars. The procedure can be carried out with sedation, averting the need for general anesthetic, and it can be done on a day-case basis. The patient is home the same day, back at work three days later and back to full activity within a week. Previously it required open surgery

resulting in significant scarring and substantially longer recovery time.” The majority of patients seen by Mr Naughton at Bon Secours are elective - this is in line with the shift towards minimally invasive treatment of conditions that would previously have required open surgery such as bypasses

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VASCULAR SURGERY

in the legs, angioplasty and stenting. The Bon Secours have made significant investment in infrastructure that benefits patients - in particular the new catheterisation lab brings the highest level of diagnostics and treatment capabilities to the hospital. Providing the facilities of a major hospital in a more intimate and personal setting is very attractive to patients. “Patients have an overwhelmingly positive experience at the Bon Secours and their feedback tells us that the key reasons they choose this hospital are that it is a good personal environment where they feel comfortable, the accessibility of the campus, the high tech facilities which allow the hospital to provide the very best modern treatments. It’s the best available. They can have all their follow-up consultations, continuing treatment or post-op review here too. “It’s also a very warm and happy environment with mutual respect between colleagues and between staff and patients. There’s a strong

sense of camaraderie. It’s a fully multi-disciplinary approach to the patient, so different departments and specialities engage regularly in the treatment of the patient. I have regular contact with my colleagues in cardio, diagnostics and other departments,” Mr Naughton explains. Both the Bon Secours and its consultants are very committed to maintaining a leading edge in the area of treating vascular conditions and in ensuring lasting results for patients, as Mr Naughton attests: “We also work towards improving outcomes and strengthening the benefits of our treatments by engaging with medically supervised exercise programmes such as the Smart Steps programme run by DCU. This allows patients to maximise the benefits of their treatment and it can increase the longevity of the treatment benefits over time. Keeping abreast of the latest treatments is vitally important for the

Bon Secours. Vascular surgery is a fast moving area and demand for services is growing. The Bon Secours will continue to expand the range of therapies it offers beyond endovascular and endovenous treatments. Improved diagnositcs will have a role in this too, with developments in the area of aortic disease screening and screening for peripheral vascular disease anticipated in the near future. Mr Peter Naughton has a website with more information of vascular conditions & treatments: www.veinclinicdublin.com

VASACULAR SURGEONS • Prof Austin Leahy • Mr Ciaran McDonnell • Mr Daragh Moneley • Mr Peter Naughton • Mr Martin O'Donohoe • Mr Kevin O’Malley • Mr Seamus McHugh (joining summer 2017)

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HEALTH INSURANCE

Private Health Insurance and Self-Payer Packages The Bon Secours treats patients with private health insurance and those who opt to be self-payers. We are at hand to discuss your cover or payment options in relation to inpatient and outpatient treatment and tests.

he Bon Secours Hospital Dublin has negotiated excellent health insurance coverage for patients with all of the health insurance companies. We have direct settlement with all health insurance companies and almost every plan covers the Bon Secours Hospital Dublin. Any potential shortfalls that may be associated with a plan are at a minimum. With new health insurance packages coming on-line almost on a weekly basis, our general recommendation is that you should check your plan on an annual basis to ensure that you are getting the best value for your fee, that it is the right plan for you and your medical needs, and also to ensure that you are covered for the Bon Secours Hospital Dublin. Changing an insurance provider and/ or cover is simple and easy to do. Sites such as the Health Insurance Authority (www. hia.ie) have a simple comparison section and sites such as www.totalhealthcover. ie provide additional useful information. The following steps will help your cover in relation to a procedure or outpatient tests: • Check the name / type of your plan • Check your policy number • Confirm the procedure name and code with your consultant's secretary • Contact your insurance provider to make sure there are no exclusions under the terms and conditions of your policy • Call us to confirm the details: • Outpatient tests – 01 8082300 • Inpatient and day case procedures – 01 8065305 SELF-PAYER OPTIONS FOR PATIENTS WITHOUT HEALTH INSURANCE For patients who may not have health insurance, there is also a self-pay option available. For quotations on individual procedures, please contact our Credit Control Department on (01) 8065305. The amount quoted will be an estimate of the cost of the treatment being proposed based on the normal

length of stay and tests for your treatment. In order to check the price please; • Confirm the name and procedure code with your consultants secretary • Call our credit control Department on 01 8065305 USEFUL HEALTH INSURANCE TERMS: Co-payment - this is a payment paid by a patient each time a specified medical service which is liable to a co-payment is used. It is a percentage or value payment up to an agreed certain limit as specified in the terms and conditions of a patient's contract with the insurer. It is paid directly by the patient to the hospital and is not repayable under the patient’s plan of insurance. Day-patient - Treatment received during a hospital stay in a day care bed which does not include an overnight stay. Excess - This is the first part of any insurance claim that you have to pay yourself. In-patient - Treatment received during an overnight stay in hospital. Out-patient - Treatment which does not involve in-patient treatment or day care procedures. Pre-existing condition - Any disease, illness or injury which started before you took out health insurance contract. You need not have presented with any symptoms been diagnosed or have been aware of the presence of this condition for the condition to be pre-existing. Private room - A private room will contain a single bed. Schedule of benefits - This schedule details the amount an insurer will pay under the policy. Semi-private room - A semi-private room will contain more than 1 and up to 5 beds. Waiting periods - A waiting period is the amount of time that must pass from the start date of a health insurance policy before full cover is available.

Period of cover - The Minimum Benefit Regulations set out the minimum payments that all health insurers must make. You are guaranteed to receive cover to the level of the minimum payments that are set out in the Minimum Benefit Regulations - 180 days. Participating and Non Participating Consultants - Consultants with whom the insurer has an agreement are referred to as “participating consultants”. Participating consultants accept the insurer payment in full settlement of their charges for performing the procedures and treatments listed in the Schedule of Benefits.

KEY INSURER DETAILS Aviva Health 1890 714 444, www.avivahealth.ie ESB MPF 061 430581, www.esbelectricmail.com Garda Medical Aid (01) 8991604, www.medicalaid.ie Glo Health 1890 781 781, www.glohealth.ie Laya Healthcare 1890 904 067, www.layahealthcare.ie POMAS (01) 830 8963, www.pomas.ie VHI Healthcare 1890 444 444, www.vhi.ie KEY REGULATORS Health Insurance Authority 01 4060080, www.hia.ie Central Bank of Ireland 01 2246000, www.centralbank.ie National Consumer Agency 1890 432432, www.nca.ie COMPARISON AND GENERAL INFORMATION WEBSITES Health Insurance Authority 01 4060080, www.hia.ie Totalhealthinsurancecover.ie www.totalhealthcover.ie

BON SECOURS HOSPITAL

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HEALTH INSURANCE GP DIRECT REFERRAL SERVICES (CORRECT JULY 2017) CARDIOLOGY Appointments: Tel: 01 808 2300 / Fax: 01 808 2309

DIAGNOSTIC IMAGING Appointments: Tel: 01 808 2300 / Fax: 01 8082309

• Ambulatory Event Monitoring • Ambulatory Blood Pressure Monitor • ECG • Echocardiography • Exercise Stress ECG • Holter Monitor - 24 hour - 48 Hour - 3 day - 5 day • Pacemaker / ICD Follow-Up

• CT Scans

€190 €125 €40 €267* €190 €155 €195 €235 €290 €30

€350* €487* €350 • Dexa €96 • MRI €250 - Cardiac MRI €483 • Ultrasound €190 • Duplex/Doppler - Veins, Carotid, Aorta, ABI €202* • X-Ray €90 - CT Colonography - CT Calcium Score

- Complete Spine

€211

• Syncope Clinic – TILT Test €366* INSURANCE COVERAGE: Echocardiography – covered by all Private Health Insurance plans except Laya. Tilt Testing – Covered by all Private Hospital Plans All cardiology tests covered by POMAS, Garda, ESB

INSURANCE COVERAGE: CT – Covered by Irish Life Health CT Colon - Covered by Laya and Vhi MRI – Covered by Irish Life Health ABI / Duplex – Covered by all Private Hospital Plans excl. Irish Life Health covers Prof fees only

ENDOSCOPY (INCL. DIRECT ACCESS) Appointments: 01 806 5491/5490 / Fax: 01 8065346

RESPIRATORY & SLEEP MEDICINE Appointments: 01 808 2300 / Fax: 01 808 2309

• Bronchoscopy • Colonoscopy • Cystoscopy • Gastroscopy • Sigmoidoscopy

• Pulmonary Function Test + / - Skin Prick Allergy testing for common aeroallergens €160*

INSURANCE COVERAGE - DIRECT PAY: Service covered by all Insurance Companies and Private Hospital Plans. Please advise patients to contact the hospital directly to check individual plans for excesses / shortfalls.

INSURANCE COVERAGE - DIRECT PAY: Service covered by all Insurance Companies and Private Hospital Plans – Please advise patients to contact the hospital directly to check individual plans for excesses / shortfalls.

PHYSIOTHERAPY Appointments: Tel: 01 8065339 / Fax: 01 8375896

PHLEBOTOMY

• Initial Consultation • Review Consultation

€60 €45

Walk-in Phlebotomy Service 8am – 3pm Monday - Friday Lab Tel: 01 8065320 Phlebotomy Tel: 01 8065347 • Phlebotomy • Blood tests

No Charge Individually and competitively priced

DIABETIC CARE CLINIC Appointments: Tel: 01 8375111 Fax: 01 8082343

CLINICAL NUTRITION & DIETETIC Appointments: Tel: 01 806 5488 / Fax: 01 8375896

The Diabetic Care Clinic provides a specialist care and education service for recently diagnosed diabetic patients & existing diabetic patients who are experiencing problems managing their diabetes.

Specialist Clinics • IBS management via FODMAP dietary plan • Diabetes in conjunction with diabetic nurse and podiatrist • Weight management and obesity

Specialist Areas • Education of newly diagnosed type 2 diabetics • Management of hypoglycemia and hyperglycemia • Home blood glucose monitoring

• Endocrinologist • Ophthalmologist • Podiatrist INSURANCE COVERAGE: Echocardiography – covered by all Private Health Insurance plans except Laya. Tilt Testing – Covered by all Private Hospital Plans All cardiology tests covered by POMAS, Garda, ESB

PODIATRY Appointments: Tel 01 554 5699 • Podiatry Consult and Assessment

€65

Specialist Areas • Malnutrition, enteral and parenteral nutrition • Coeliac disease • Lactose Intolerance • Nutritional deficiencies • Constipation and diverticulitis • Gout and Gallstones • IBD (Crohns disease & Colitis) • Cancer pre & post treatment COSTS: • Initial consultation (35 – 45 minutes) • Review consultation (15 minutes) • IBS FODMAP (1st visit) • Follow up review • Or initial Consult €86 plus follow up €43

Suitable Medical Conditions for referral include: • General • Weight loss • PUO • Fatigue • Malignancy work-up • Cellulitis • Flu like illness Gastroenterology • Stable GI bleed • Inflammatory bowel disease • Malignancy • Jaundice • Gastroenteritis Haematology • Anemia • DVT • Thrombophlebitis Respiratory • Respiratory tract infection • Asthma / COPD • Shortness of breath • Pleuritic chest pain • Interstitial lung disease • PE Nephrology • UTI / Pyelonephitis • Nephrotic/ Nephritic Syndrome • Acute and chronic kidney injury Cardiology • Stable acute coronary syndrome exclusive of STEMI • Stable angina • Stable arrhythmias • Palpitations • CCF • Pericarditis and Myocarditis Endocrine • Uncontrolled Diabetes • DKA • Thyroid Disease • Pituitary Dysfunction

• Sports performance and enhancement

Referrals are accepted to the following specialists: • Educational referral - Dietician and Diabetic Nurse - €110

MEDICAL ASSESSMENT UNIT (MAU) Appointments: Tel: 01 806 5498 or 086 2098380 Fax: 01 806 5405 Admitting Hours Monday – Friday 8am – 4pm

Neurology • Headaches • TIAs • Collapse / Syncope Rheumatology Disorders Initial attendance fee €150 up to a max of €495. If admitted all but the attendance fee will be refunded to the patient. €75 €36 €75 €26 €150

Important contact numbers Insurance Enquiry Line: 1890 50 40 30 Local number: 01 808 2300 Self Pay Enquiries: 01 806 5305

BON SECOURS HOSPITAL

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CONSULTANT DIRECTORY

Consultant Directory Consultant Name

Phone

Fax

087 900 4766 087 432 3688 (01) 836 0332 087 622 1793 (01) 857 3721 (01) 857 4744 (01) 292 0510

(01) 890 1945 (01) 684 8930 (01) 837 6357 (01) 902 3932 (01) 857 1130 (01) 837 2503 (01) 292 0512

(01) 288 0053 (041) 984 4489 087 670 9533 (01) 645 9444 (01) 644 9696 (01) 206 4223

(01) 283 5626 (041) 984 4490 (01) 885 8888 (01) 645 9568 (01) 644 9699 (01) 206 4230

(01) 857 2979 (01) 837 6532

(01) 857 2979 (01) 837 6501

(01) 206 4528 (01) 837 3868 (01) 885 8603 (051) 319 859 (01) 288 4073 (01) 899 7010

(01) 206 4695 (01) 206 4229 (01) 885 8838 (051) 319 861 (01) 206 4518 (01) 899 7017

NOTES

CARDIOLOGY Dr Angela Brown Dr Brendan Doyle Dr Thomas Gumbrielle Dr Jonathan Lyne Dr Brendan McAdam Dr Richard Sheahan Dr Robert Kelly

DERMATOLOGY Dr Callaghan Condon Dr Tony Egan Dr Fiona Keane Dr Sandra Kirke Dr Brigid O’Connell Dr Nicholas Walsh

ENDOCRINOLOGY Dr Diarmuid Smith Prof ChrisTompson

ENT SURGERY Mr Feargal Glynn Mr Rory McConn-Walsh Mr Tadhg O’Dwyer Mr Munish Shandilya Prof Michael Walsh Mr Peter Walshe

GASTROENTEROLOGY/ DIRECT ACCESS ENDOSCOPY Dr Richard Farrell Prof Fergus Gleeson Dr Gavin Harewood Dr Jack Hollingsworth Prof Padraic MacMathuna Mr Eadhbhard Mulligan Prof Frank Murray Dr Conor O’Brien Dr Cathal O’Keefe Dr Aoibhlinn O'Toole Prof Stephen Patchett Dr Barbara Ryan Dr Subhasish Sengupta Dr Claire Smyth Dr Shiobhan Weston

(01) 884 4840 (01) 646 5415 (01) 837 2721 (01) 857 1520 (01) 837 5007 (01) 837 5008 (01) 278 4363 (01) 283 1471 (01) 830 0840 (01) 830 0840 (01) 645 9650 (01) 836 9482 (01) 837 5155 (01) 678 8025 (01) 676 3489 (01) 678 8025 083 1036 3330 (01) 271 5210 087 244 2116 (01) 837 7550 (01) 837 7538 (01) 837 7550 (01) 645 9605 (01) 645 9606 086 898 5434 (042) 933 5692 086 784 8442 (01) 544 1414 (01) 292 0552 (01) 293 9301

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CONSULTANT DIRECTORY

Consultant Name

Phone

Fax

NOTES

GENERAL MEDICINE Dr Colette Barry (01) 808 2335 Dr Geraldine Hosny (MAU) (01) 806 5498

(01) 806 5405 (01) 806 5405

GERONTOLOGY Dr Joseph Duggan

(01) 884 1222

(01) 857 3041

(01) 836 7616 087 362 5010 (01) 878 2699 (01) 836 7610

(01) 857 6835 (01) 684 8913

(01) 221 3125

(01) 221 3968

(01) 837 5111

(01) 837 5896

(01) 837 9311

(01) 837 9411

GYNAECOLOGY Dr Paul Byrne Dr Yahya Kamal Dr Edgar Mocanu Dr Hassan Rajab

(01) 857 6835

HAEMATOLOGY Dr Donald McCarthy

MINOR SURGERY Dr Joe McKeever

NEPHROLOGY Prof Peter Conlon

NEUROLOGY Dr David Moorehouse

(01) 836 9043

(01) 836 9045

ONCOLOGY Dr Oscar Breathnach Prof Liam Grogan Dr Patrick Morris

(01) 809 3338 (01) 837 7547 (01) 837 9299

(01) 809 2603 (01) 837 7550

OPHTHALMIC SURGERY Ms Yvonne Delaney Mr Edward Dervan Ms Aoife Doyle Ms Susan Fitzsimon Mr Weng Lee Ms Patricia Logan Ms Brid Morris Prof Paul Connell

(01) 838 6732 085 208 2834 (01) 491 5722 (01) 832 0248 (01) 6267212 (01) 885 8622 085 858 6822 (01) 803 2878

(01) 868 4642 (01) 556 3396 (01) 491 4789 (01) 857 2721 (01) 6459591 (01) 885 8224 (01) 295 1241 (01) 830 5693

(01) 832 0248 (01) 885 8656

(01) 885 8658

OPHTHALMOLOGY Dr Aisling Foley-Nolan Dr Louise Oâ&#x20AC;&#x2122; Toole

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CONSULTANT DIRECTORY

Consultant Name

Phone

Fax

ORAL SURGERY Mr PJ Byrne Mr Gary Leonard

Mr Philip Brady (01) 902 3040 Ms Oliva Flannery (01) 645 9526 Mr Darragh Hynes (01) 830 0797 Mr Patrick Kenny (01) 645 9585 Mr Peter Keogh (01) 645 9586 Mr Philip O’Connor (01) 837 2721 Mr James (Shea) O’Flanagan (01) 837 3007 Prof Michael Stephens (01) 885 8643 Mr James Walsh 087 436 8920

(01) 668 8478

(01) 902 3041 (01) 645 9589 (01) 860 0076 (01) 645 9589 (01) 645 9589 (01) 857 1520 (01) 837 7781 (01) 838 6795 (01) 885 8549

PAIN MANAGEMENT (01) 857 1203 (01) 857 6939

(01) 857 1203 (01) 857 4637

PALLIATIVE CARE Dr Liam O’Siorain

(01) 885 8888

(01) 885 8541

(01) 645 9621 (01) 857 1384 (01) 206 4419 087 930 2973 087 277 3116 (01) 219 6050

(01) 837 6130 (01) 837 6357 (01) 212 2633 (01) 837 6357 (01) 278 0354 (01) 219 6055

(01) 836 0100 (01) 836 0100

(01) 837 6616 (01) 837 6616

PLASTIC SURGERY Mr Nadeem Ajmal Mr Brian Kneafsey Ms Margaret O'Donnell Mr Barry O'Sullivan Mr Anthony Ryan Mr James Small

PSYCHIATRY Dr Michelle Cahill Dr Ann Leader

Phone

Fax

(01) 837 3372 087 900 5451 (01) 837 6381 (01) 213 5632

(01) 857 3041 (01) 696 1071 (01) 884 4016 (01) 213 5613

Mr Mayilone Arumugasamy (01) 206 4539 Ms Ann Branigan (01) 885 8673 Mr John Burke (01) 685 4121 Mr Joe Deasy (01) 836 9167 Prof Arnie Hill (01) 809 3760 Ms Deborah McNamara (01) 857 4885 Mr Colm Power 087 233 8235 Mr William Robb (01) 837 3646 Prof Tom Walsh (01) 822 8954

(01) 210 9396 (01) 850 0071 (01) 684 0009 (01) 837 6447 (01) 809 3758 (01) 857 4885

RHEUMATOLOGY (01) 269 2442 (01) 668 8441

ORTHOPAEDIC SURGERY

Dr Josh Keaveny Dr Valerie Pollard

Consultant Name

Dr Maurice Barry Dr Ruth Lee Dr Paul O’Connell Dr Susan Sant

SURGERY

(01) 837 6719 (01) 820 2284

UROLOGY Mr Ijaz A Cheema Mr Tom Creagh Mr James Forde Mr Hubert Gallagher Mr Ponnusamy Mohan Mr Denis O’Sullivan Mr Richard Power Mr Gordon Smyth

(01) 645 9459 (01) 837 9350 (01) 806 5621 (01) 289 8834 (01) 835 0651 (01) 645 9690 (01) 806 5621 (01) 806 5622

(01) 645 9529 (01) 837 9355 (01) 699 1690 (01) 289 8831 (01) 836 9312 (01) 645 9692 (01) 806 5609 (01) 806 5475

VASCULAR SURGERY Prof Austin Leahy Mr Ciaran McDonnell Mr Daragh Moneley Mr Peter Naughton Prof Martin O’Donohoe Mr Kevin O’Malley

(01) 809 3754 (01) 830 8241 087 615 3372 (01) 809 3816 (01) 806 0190 (01) 830 1077

(01) 809 3755 (01) 809 3090 (01) 857 1983 (01) 809 3755 (01) 838 0851 (01) 830 1077

RESPIRATORY AND SLEEP MEDICINE Prof Conor Burke Dr Liam Cormican Prof Richard Costello Dr John Faul Prof Patrick Manning Prof Gerry McElvaney Dr Ross Morgan Prof Shane O’Neill

(01) 837 1440 (01) 645 9540 (01) 809 3762 (056) 777 5280 (01) 837 2721 (01) 809 3764 (01) 851 1938 (01) 837 3430

(01) 837 0296 (01) 645 9543 (01) 809 3765 (01) 645 9543 (01) 857 1520 (01) 809 3765 (01) 837 6104

BON SECOURS HOSPITAL

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PATIENT INFO / ACCESS TO SERVICES

Patient Information As a patient or visitor to the Bon Secours Hospital, we would like to ensure that your visit or stay is as welcoming and comfortable as possible. The following information may help you before you attend the hospital. If you would like any additional information, please do not hesitate to contact us on (01) 806 5300. LOCATION & CONTACT DETAILS You can contact the hospital at: Bon Secours Hospital Glasnevin, D09 YN97 Tel: (01) 806 5300 Web: www.bonsecours.ie Email: info@bonsecours.ie GPS Co-ordinates: N 053° 22.528 W 006° 16.019 The number 83 bus from Dublin city centre passes just in front of the hospital. The number 9 and number 4 buses go via St Mobhi Road which is a short walk away. DRIVING DIRECTIONS FROM M50: • Exit M50 after Finglas (Junction 5). • Take city centre direction. • Go through 6 sets of traffic lights. • At the next set of traffic lights turn left onto the old Finglas Road. • Continue up the hill and through 5 sets of traffic lights. • Bon Secours Hospital is signposted on the left shortly after the triangular Met office. ADMISSIONS Please inform admission staff before registration if you have attended the hospital previously as an inpatient, day care, outpatient, or for any tests such as blood tests, x-ray, cardiac, breathing or physiotherapy. This will avoid duplication of records and ensure efficient registration. INPATIENT Generally, admission time to the hospital for inpatients is before 11am. If you are a surgical patient, you will be advised of your exact admission time by your consultant's secretary.

ACCOMMODATION The type of accommodation is as booked by your consultant’s secretary. If you have cover for a single room, please highlight this to the secretary.

3. If you have a Drug Payment Scheme card, please bring this with you. You will have to pay for any medication you take home. 4. Acceptable methods of payment include Mastercard, Visa, Debit Cards, cash or a cheque with a valid banker’s card.

MEDICINES 1. Please bring all your medicines with you and do not put different medicines together in the same container. 2. Ask your pharmacist for a printout of all your medicines or bring in all of the prescriptions your doctor has written for you.

INSURANCE Bon Secours has direct payment insurance plans with the following insurers: • ESB/GMA and POMAS • Irish Life Health • Laya • Vhi

DAY CASE/ENDOSCOPY Admission time for Day Case/Endoscopy will be given to you by your consultant’s secretary.

BON SECOURS HOSPITAL

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PATIENT INFO / ACCESS TO SERVICES

soft drinks, confectionery and toiletries are available. FLOWERS Flowers or potted plants are no longer allowed at the hospital for health and safety and infection control purposes.

To check if your health insurance policy covers you in the Bon Secours Hospital Dublin, please call 1890 50 40 30 or 01 808 2300. Before admission we would encourage you to check directly with your insurance company that your policy covers you for the accommodation and / or treatments that you require and if a policy excess is payable. Patients are liable at the time of admission for any charges not covered by their insurance company. You will also be required to bring details of your insurance cover on the day of your admittance. NON-INSURED PATIENTS Non-insured patients are required to pay for treatment in full on the day of their admission. Please contact patient accounts (01) 806 5351 for an estimate of your treatment cost prior to admission. HIGH DEPENDENCY UNIT Visiting times in the High Dependency Unit are: 10:00 – 12:00 14:00 – 16:30 18:30 – 20:00 The maximum number of visitors per patient at any one time in this unit is two. CAR PARKING Pay and Display car parking is available throughout the grounds for patients and visitors. For security purposes, the hospital gates close each evening at 22:30. A change machine is located just inside the main door should you require change. SHOP The hospital shop is located on the ground floor, opposite the lift. A range of newspapers, magazines,

THE RESTAURANT The hospital restaurant is located on the first floor of the hospital and is open to patients, visitors and staff. Restaurant opening hours are: Monday to Friday: 7.45 – 18.30 Saturday: 9.30 – 15.30 Sunday/ Public Holidays: 9.30 – 18.30 In addition, vending machines are located on the ground floor of the hospital. Due to health and safety regulations, there are restrictions on certain foodstuffs that can be taken from the restaurant. SMOKING For a healthier environment, smoking is not permitted in or at the entrance to the hospital. There is a designated smoking area in the car park. SECURITY & SAFE KEEPING Valuables, jewellery, large sums of money or items of sentimental value should not be brought into the hospital and must be either returned to your home or immediately deposited in the hospital's safe for safekeeping. The hospital is not responsible for items kept in patients’ rooms. Please bring any personal items you may require for your hospital stay with you. The hospital discourages the use of mobile phones as they can interfere with medical devices. Each patient is provided with a telephone for incoming and outgoing calls. RELIGIOUS/PASTORAL CARE The hospital chapel is located on the ground floor at the end of St Laurences ward. The pastoral care team can be contacted on (01) 806 5327 or through the wards or main reception. Arrangements can be made for patients of all denominations to receive visits by their respective clergy.

USEFUL NUMBERS Main Reception: (01) 806 5300 Accounts - Patients: (01) 806 5351 Admissions - Day Case: (01) 806 5439 Admissions - Inpatients: (01) 806 5355 Cardiology: (01) 806 5368 Diabetic Care Centre: (01) 808 2343 Diagnostic Imaging (X-ray, MRI, CT etc.) (01) 806 5470 Dietetics: (01) 806 5488 Endoscopy- Direct Access:(01) 806 5490 Laboratory: (01) 806 5320 Medical Assessment Unit: (01) 806 5498 Mobile: 086 209 8380 Oncology: (01) 806 5409 GP Liaison & Outpatient Booking Department: (01) 808 2300 Fax: (01) 808 2309 Phlebotomy: Physiotherapy: Podiatry: Respiratory & Sleep Medicine: Urodynamics:

(01) 806 5347 (01) 806 5339 (01) 554 5699 (01) 806 5479 (01) 806 5484

VISITING GUIDELINES Visitors are welcome between 10.00 and 21.00 but are encouraged to avoid mealtimes: Mid-day meal: 12:00 – 13:00 Evening meal: 17:00 – 17:30 Children under 12 years old are advised not to visit as the hospital can be a source of infection to small children. Visitors under 16 years are not allowed to visit patient care areas. There may be occasions when visiting is restricted for reasons such as doctors consultations, routine daily procedures or to facilitate periods of rest deemed necessary by nursing or medical staff. When receiving visitors in shared accommodation, please show consideration for patients who may be resting. Please ask relatives not to visit should they have a cold, stomach bug or other contagious disease.

BON SECOURS HOSPITAL

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Caring for Life since 1829 With a heritage dating back to 1829, Fannin has evolved into one of the leading suppliers of a wide range of pharmaceuticals and medical devices to the primary and acute care sectors in Ireland. Our range of products include Wound Care, Urology, Critical Care, Scientific and Pharmaceutical. Our longevity has been achieved through a passion for service excellence and innovation. We deliver confidence and trust to our customers, underpinned by our dedicated workforce representing the best products in their class. We look forward to our continued partnership with the Bons Secours Group of hospitals today and in the future.

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