Bon Secours 2019

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CONTENTS

Contents

3 The Hospital Manager's View

6 Standards, Quality and Accreditation

9 Infection Control

12 Information Technology

15 Cavan Outreach Clinic

17 Cardiology

20 Dermatology

22 Diagnostic Imaging 25 Dietetics

27 Endocrinology

30 ENT Surgery 32 Gynaecology 35 Gastroenterology

38 Endoscopy

41 Laboratory

42 Medical Assessment Unit

47 Oncology Editor: Adam Hyland Designer: Anna Wesolowska Advert Design: James Moore Production Executive: Nicole Ennis Chairman: Diarmaid Lennon Creative Director: Jane Matthews Published by: Ashville Media Group, Unit 55, Park West Road, Park West, Dublin 12 Tel: (01) 432 2200 Email: info@ashville.com Web: www.ashville.com All articles Š 2018/2019. 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.

48 Ophthalmology 50 Orthopaedic Surgery 52 Plastic Surgery

54 Respiratory and Sleep Medicine & Sleep Apnoea

57 Rheumatology

59 Surgery

60 Urology

62 Vascular Surgery 64 Health Insurance and Self-Payer Packages 67 Consultant Directory

71 Patient Information

BON SECOURS HOSPITAL

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WELCOME

The Hospital Manager's View Hospital Manager Mike Tonery sets out some of the recent developments within the Bon Secours Dublin, as well as looking to the future.

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he Bon Secours Health System is the largest independent hospital group in Ireland. With more than 3,000 staff and 450 consultants, Bon Secours treats in excess of 280,000 patients annually in its five modern acute hospitals in Cork, Galway, Limerick, Tralee and, of course, Glasnevin. It also has a care village in Cork and a consultant clinic in Cavan.

The hospitals are internationally accredited by the Joint Commission International Accreditation Standards for Hospitals (JCI), the leading organisation in the international accreditation of hospitals for quality and patient safety, and are renowned for the quality of their service provision.

GROWTH “Year on year, we have seen significant growth in the number of consultants and other staff who have joined Bon Secours Dublin,” says Mike Tonery, who has served as the Bon Secours Dublin’s hospital manager since September 2015.

“That is set to continue in the next few years, particularly supported by National Treatment Purchase Fund waiting list Initiative who’s budget has increased this year to €75 million “We pride ourselves on having a cohort of experienced staff, many of whom have worked here for many years, and who are hugely experienced both clinically, and in the delivery of a high-quality, compassionate care" he says. “The increase in the number of new consultants who have joined us in the last couple of years together with a further cohort who will be joining us in 2020 has enabled us to broaden the

range of services we provide, and also introduce a number of new technologies and treatment techniques for our patients resulting in shorter lengths of stay.”

Before joining the Bons, Mike was Senior Financial Controller for the Mater Private Hospital, subsequently being appointed to the Higher Executive Team. He moved to the Mater Private Cork in 2015 as CFO, before joining the Bon Secours Hospital in September 2015. Prior to working in the healthcare sector, Mike spent almost three years as CFO in Aryzta Plc/Wendy’s Inc., Joint Venture, reporting directly to the JV board. He had also previously spent five

“The quality of consultant we have here is of a very high calibre, and that is across the board” years as an Audit and Risk Senior with Deloitte Ireland. Mike is a Fellow of the Institute of Chartered Accountants Ireland and holds a Bachelor’s degree in Accounting and Business Management, and has completed programmes in Clinic Leadership, Pensions for Finance

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WELCOME

“The increase in consultancy expertise in the last few years and into next year enables us to deal with a much broader range of issues, and gives us new technology and new ways of treating patients, facilitating shorter lengths of stay, and constantly improving consultancy services” Directors, Debt Financing Training and Negotiation Skills Training.

Now, as Hospital Manager at the Bons Dublin, Mike’s tenure has seen many developments, including the introduction of the very successful Medical Assessment Unit, and the achievement of JCI and JAG accreditation and reaccreditation.

DEVELOPMENTS The hospital’s 2020 Plan, which was launched in October 2016 and set out six strategic goals and 20 initiatives, reaches fruition in 2020, and has been extremely successful. “The growth of our endoscopy service, and the opening of our new Medical Assessment Unit were great successes,” Mike says, “and we are also in the process of developing an out-patient respiratory clinic. The general shift has been towards the introduction of more outpatient services. A lot of work has been done to enhance our services in this area through the employing of new minimally invasive procedures and treatments, which helps us to provide an efficient service with much shorter hospital stays.

"In recent years we have completed a number of significant investment projects particularly in the area

of endoscopy, medical services and we have also created a new minor theatre and upgraded our orthopaedic theatre. The next stage in the investment programme will include a new entrance to the hospital, a new surgical day ward and also a new day oncology ward which will be independent of the rest of the hospital.

The new surgical day ward will be located on the same floor as the theatres, significantly improving patient flow and access."

MERGER On July 1 2019, Bon Secours Health System in Ireland merged with Bon Secours Mercy Health in the US. Bon Secours Mercy Health is amongst the top 20 Health System in the US employing more than 57,000 staff in 43 hospitals and 1,000 sites of care across seven states.

“The merger hugely expands our growth capability, from the expertise that is provided by our US colleagues to improved access to new technologies and increased capital investment,” Mike says. “We can avail of the benefits in the areas where we align in advanced medicine, particularly in the area of medical record management, where the merger is bringing together the best in class from both medical systems. The merger allows for a lot of exchange of expertise and knowledge sharing. It will also streamline how we provide the services we do, and make is more ready to respond to the changing needs of our patients.”

INCREASED SERVICES The increase in demand on services provided by Bon Secours, and the changing nature of high-quality healthcare, are factors that Mike, as hospital manager, keeps a close eye on, in order to proactively plan for what the future holds. “The ever-increasing reliance on health insurance is becoming more and more relevant,” he says, “and we maintain a very competitive approach regarding our insurance cover - we have good coverage and minimal excessesfor patients.

“We also have to keep an eye on social care and what is happening there, and the impact that has on private hospitals.

We need to make sure we continueto grow across all fields where there is an increased demand, hence the increased investment in oncology, where we are seeing an increase in cancer cases, as the population is getting older, increasing the chances of cancer diagnosis.

“Also, a lot more surgery is moving from in-patient to out-patient or day surgery, where previously patients could expect to be in for three or four days, they can now in many cases be treated and discharged on the same day.

We are also using more minimally invasive and laparoscopic surgery, resulting in better outcomes. On top of that 2020 is also our JCI reaccreditation year which comes around every 3 years. Whilst JCI is part of the day to day operation of the hospital and is lived daily by all staff in the provision of the very highest standards of care to our patients, an accreditation year always tends to focus our mind set on what we could be doing a little better to further improve the high standards we set ourselves.

“Referrals have also become much more streamlined, and we are receiving them directly from GPs patient management systems via our link to the national e-referral portal Healthlink In the coming months, we will also be able to send out diagnostic results, starting with radiology results, directly to GPs, which gives better, more timely results for patients.”

The expertise and patient-centred focus at Bon Secours is what makes it so successful, and Mike says this is down to the whole team.

“The quality of consultant we have here is of a very high calibre, and that is across the board,” he says. “We have continued to recruit a number of new consultants into Bon Secours Dublin across a number of specialties, giving us increased expertise, as well as having a wonderful support staff of administrators across all functions.

In total, we have a great team here.

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QUALITY & RISK AT BON SECOURS

Quality & Risk at Bon Secours The Quality and Risk Department at Bon Secours Dublin maintains the highest level of clinical care with a patient-centred approach to quality, safety and patient satisfaction

ACCREDITATION Bon Secours Hospital Dublin was the first hospital in Ireland to achieve international healthcare accreditation for its excellence in patient-centred medical care, and the work of the Quality & Risk department ensures that the hospital maintains this high standard in every service it provides through the structures and processes in place that permeate throughout the organisation. This is validated through Hospital Accreditation by

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“Bon Secours means giving good health help to those in need, and part of this ethos in the past was providing a level of holistic, compassionate care�

Joint Commission International (JCI) and the achievement of Joint Advisory Group (JAG) accreditatio of the Endoscopy Unit, the first private hospital in Ireland to achieve this standard and accreditation of the laboratory. Receiving its first JCI accreditation in 2002, the hospital is re-surveyed every three years against a revised set of standards, and we are proud to have maintained our accreditation through each of the tri-annual surveys. The most recent

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QUALITY & RISK AT BON SECOURS

survey took place in May 2017, and we are hard at work in preparation for the next round of accreditation in 2020.

A sense of true quality flows from our maxim of “Advanced Medicine, Exceptional Care”. Creating a culture of compassion, respect, innovation, and accountability are all part of any quality agenda, and the aim of Quality & Risk Manager Dr Carmel Sheridan and the department is to drive medical quality forward and place patient safety at the forefront of the services provided across Bon Secours’ facilities.

“We have a very broad remit, to govern patient safety, clinical risk and quality improvement,” explains Dr Sheridan.

“We oversee and manage all clinical risk within the hospital. We also have a whole body of work built around the accreditation programme – there are more than 1,200 things that we measure as part of this.”

PATIENT SATISFACTION With patient satisfaction central to the medical care provided at Bon Secours, feedback from patients plays an important role. Bon Secours was the first healthcare provider to introduce a system to measure quality of care, and use a Net Promoter Score (NPS) to assess how satisfied patients are.

“We run a continuous online patient experience survey, which provides us with feedback regarding the values of Bon Secours – how compassionate we are, the quality of care, whether they see justice, dignity and respect in how we are delivering care. That gives is very valuable feedback that we can then act upon,” Dr Sheridan explains.

SHARING VALUES Best practice information is disseminated through multiple avenues. “Every morning the hospital management team meets with the heads of departments, and we share information from a patient safety perspective,” Dr Sheridan says.

“There is also a monthly head of department meeting where quality is very high up on the agenda, which is a very progressive step.”

Dr Sheridan also runs a monthly lunchtime education programme, delivering educational talks

to staff, focusing on learning from lessons, while refresher training is carried out on an ongoing basis with Quality feeding into that.

REPORTING While quality and safety are a mainstay at Bon Secours, incidents are inevitable in any hospital, and Bon Secours Dublin has a hospital-wide reporting system in place that ensures any event is reported in a timely and accurate fashion in order to act upon it immediately and seek improvement.

“It is everybody’s responsibility in the hospital to get involved with quality,” Dr Sheridan explains, “and we have a system that is open to anybody, which allows them to make a notification of an incident. We have a clear classification system for such incidents - a transfusion reaction, fall or unexpected return to theatre - from low risk to higher risk. These are referred to a new forum that has just been established, the membership of which includes myself, a senior nursing rep and the clinical director, and we conduct an in-depth analysis or clinical review to decide what level of investigation is required. From that we form our recommendations and actions.”

QUALITY PLAN A Quality Plan is developed every year, with priorities identified this year based on feedback received from patients.

“We focus on making sure patients leave the hospital with the correct information that assists them in their recovery, and their ability to re-access the service should they need to,” Dr Sheridan says.

“We also focus on recognising and escalating the care of a patient if they run into difficulties while in hospital, and on our international patient safety goals, which are part of our accreditation programme. These are: Ensuring patients are correctly identified, ensuring that critical results are relayed in a timely and comprehensive way, high-risk medications, safe surgery practices, hand hygiene, and patient falls. This year we have introduced fall risk screening for out-patients as well as in-patients.”

Other priorities include compliance

“It is everybody’s responsibility in the hospital to get involved with quality” with GDPR, and looking at our safe use profile in relation to medication and making modifications to our existing education programme.

TRANSPARENCY Bon Secours recently published a report on Quality and Patient Safety across all of its hospitals, including Glasnevin, and chose to detail adverse event rates.

“That was a new step for us, but it was done in the spirit of being open and transparent. We want to break down the barriers that people perceive about not being able to access information, or distrusting the health service, in the hope that people would acknowledge that sometimes events are unavoidable,” Dr Sheridan explains. “But when they do happen, as the report shows, we have a very reliable and robust system to look into these things in a comprehensive way, and of putting recommendations and priorities in place.

THE QUALITY ETHOS “Quality is one of our key values and always has been,” Dr Sheridan explains. “Bon Secours means giving good health help to those in need, and part of this ethos in the past was providing a level of holistic, compassionate care. Even though patient-centred care is a relatively new term, the sisters at Bon Secours were doing it back in the 1800s.

“When you look at our survey results in terms of how we measure against quality, compassion and respect, these are areas in which we are in the 90% mark, so clearly in the eyes of our patients, we are delivering a quality service in a compassionate way. This means we are at the forefront in terms of the quality and safety of care provided in the hospital.”

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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.

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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 two consultant microbiologists and includes two full-time 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 one of the hospital's team of consultant microbiologists SUREWASH SYSTEM The SureWash system has been in place in the hospital since 2014 as part of the hospital’s infection and control programme. Cleaning hands properly, whether with soap or alcohol

rub, is the single most important action to prevent infections in a hospital.

Accordingto the WHO (2009), Health Care Associated Infections (HCAIs) in Europe are acquired annually by 5 million patients, resulting in 50,000 deaths each year and 25 million extra bed days costing 13 – 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

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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

gaming technology to train and assess 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 Organisation 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 compliance rate in May / June 2019 was 93.8% - well exceeding

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the HSE national target rate of greater than 90% for the same period.

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 SureWash 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 compliance rate in May / June 2019 was 93.8% - well exceeding the HSE national target rate of greater than 90% for the same period.

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Oxivir Plus from Diversey Care Offers Safe, Simple & Sustainable Infection Prevention Effective against bacteria, viruses, fungi and yeasts Oxivir Plus from Diversey Care is a unique and fast-acting cleanerdisinfectant that offers powerful broad-spectrum performance against a wide range of infections and micro-organisms including bacteria, viruses, fungi and yeasts in a single product.

The unique formulation of Oxivir Plus contains patented Accelerated Hydrogen Peroxide (AHP) and is fully compliant with the European Biocidal Product Directive. It has passed numerous standard microbiological tests including EN14476, EN1276, EN13697 and EN13727 with five minutes contact time or less.

It also passes EN1650, EN13624 and EN14348. AHP kills viruses including Norovirus in two minutes.

There is no risk of creating resistance in pathogens because of the way AHP destroys viruses and bacteria. It provides a simple

and effective way to remove body spillages and to contain and remove the source of infection during outbreaks. The formulation is suitable for a wider range of applications than comparable products with quaternary ammonium or chlorine compounds as the active ingredient. The AHP breaks down to water and oxygen alone shortly after use.

Oxivir Plus is safe to use on most washable surfaces. It is Woolsafe approved. It does not leave residues or stains or produce any potential respiratory irritants. This means it can be used safely with reduced risk to cleaning staff, bystanders, surfaces being cleaned or the environment.

Oxivir Plus is available in 750ml ready-to-use spray bottles and as an ultra-concentrate in the J-Flex and SmartDose platforms.

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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.

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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.

E-REFERRALS Since April 2018, the Bon Secours has been able to receive referrals

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to outpatient departments, the consultant team, Direct Access Endoscopy, the Medical Assessment Unit and Diabetes Clinic directly from a GP's patient management system via the Healthlink portal. In the first 20 months of the project to the end of September 2019, almost 20,000 referrals have been received into the hospital via Healthlink. Healthlink was originally set up 20 years ago to enable GPs to refer electronically into public hospitals and has since expanded from a single hospital proof-of-concept to a national broker for country-wide

messaging with over 10 million exchanges of information annually.

The Bon Secours Hospital Dublin was one of the first private hospitals in Ireland to be on the system, enabling GPs to send e-referrals directly into the hospital. Message files are specified in HL7, an internationally recognised standard for healthcare information exchange and formatted in XML. The system interfaces with hospitals, clinical centres, healthcare agencies and GP practice management systems and transfers data via a secure

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INFORMATION TECHNOLOGY DEPARTMENT

network to its messaging servers.

The HealthlinkOnline portal is secured with SSL and Client Certificates. Web Services are also made available as an alternative access to our system and for best interoperability.

GPs can also continue to send referrals via Zeus, another e-referral platform for GPs using Socrates patient management systems. As with Healthlink, referrals are received securely within seconds and the processing and appointment confirmation times are greatly reduced.

In early 2020, radiology, direct access endoscopy results and MAU discharge letters will also be sent back to the GP via the Healthlink portal. This will be further expanded to include all discharge summaries in late 2020.

HEALTHMAIL In addition to sending e-referrals via Healthlink or Zeus, GPs can also send referrals securely to all bonsecours. ie email addresses using a Healthmail address. Healthmail is a secure clinical email that is issued by the HSE, which allows health care providers to send and receive clinical patient information in a secure manner. GP users are issued with @healthmail.ie email accounts, allowing them to communicate patient identifiable clinical information with clinicians in primary and secondary care. Results, discharge summaries and post consult letters from consultants can also be sent to GPs via their healthmail email address for the benefit of patients and clinicians.

PATIENT ADMINISTRATION SYSTEM The backbone of the hospital’s IT infrastructure is our Patient

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.

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.

ORDER COMMUNICATION SYSTEM The Bon Secours Hospital Dublin will be introducing an Order Communication System (OCS) in the next six months across the hospital and all departments. An OCS allows diagnostic tests and treatment services to be ordered instantly, eliminating delays, bottlenecks and potential errors of paper-based systems. The system will harmonise all clinical ordering processes into a single order system for all disciplines and likewise provide a one-stop-shop for viewing and acknowledging results. The project will also see the introduction of the Workstation on Wheels to allclinical areas. This will be the principal device for placing orders but hospital computers and tablets can also be utilised for this purpose. OCS improves safety and efficiency by helping ensure that all the necessary patient and clinical information is included Clinicians can be confident that the order has gone to the right place and no transcription errors have occurred.

The order can be tracked and results are fed back immediately and accurately. OCS also reduces the number of unnecessary or inappropriate tests and other services.

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CAVAN OUTREACH CLINIC

Medical Consultant Clinic in Cavan Town The Cavan Outreach Clinic is in its 3rd year of operation in Cavan Town and has become an integral part of the medical service in the town. It sees 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.

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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 (all GP referred) to the clinic are co-ordinated by our dedicated Clinic Administrator and GP Liaison – Sarah Mc Glade The Clinic has expanded in the last 12 months to provide access to seven specialties; Cardiology, Dermatology, Gastroenterology, Orthopaedics, Plastic Surgery, Urology and Vascular Surgery.

On-site Cardiac Diagnostic Testing is also provided including Echo, Holter, ECG and BP Monitoring. The Vascular team is supported by two vascular technicians who provide ultrasound and ABIs. Both of these services are provided to patients in advance of their consultation with the relevant consultants adding significant value to their consultation.

GPs can also refer directly in for these cardiology tests and vascular studies and the results will be sent directly back to the GP in their practice.

In the past 18 months, the Cavan Clinic has organised 3 very well attended public information on cardiac health and varicose veins in Cavan and Monaghan.

Similar events are planned for other specialties in the future. In addition, the Clinic also organises GP educational events with the participation of the attending consultants to discuss recent developments in the various specialties.

Since 2018, the Bon Secours Cavan Clinic have been proud sponsors of the Castlerahan GAA Club who are back to back league and Championship winners in 2018 and 2019. The Bon Secours Cavan Clinic is also the proud sponsors of Castlerahan GAA Club Cavan. The club is one of the largest in Cavan, located in Ballyjamesduff in south Cavan, bordering Meath and the hinterlands of Westmeath and Longford.

CONSULTANTS ATTENDING THE CAVAN CONSULTANTS CLINIC • Cardiology Dr Susan Connolly • Dermatology Dr Sinead Collins • Gastroenterology Dr Aoibhlinn O’Toole • Orthopaedics, Mr James Walsh (Foot and Ankle) • Plastic Surgery Mr Barry O’Sullivan • Urology Mr Denis O'Sullivan 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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CARDIOLOGY DEPARTMENT

Cardiology at the Bon Secours Hospital Dublin Cardiology at Bon Secours has undergone extensive development over the last number of years and the department is now at the forefront of cardiology services in Ireland.

THE TEAM Over the last few years, the Cardiology Department within the Bon Secours hospital has undergone huge developments.

An expanded team of five permanent consultant cardiologists and investment in the most modern technology and facilities improves the range of services the department provides.

Cardiology services are managed

by Sean Hendley, Cardiology Manager, and Clinical Nurse Manager Helen Broderick in St Brigid’s Ward,

the hospital’s dedicated cardiac ward, while Chrissie Barbero is Clinical Nurse Manager in the Cath Lab. The focus over the last number of years has been on the development, expansion and consolidation of our cardiology services, bringing the department to the forefront of cardiac services nationally.

The wide range of expertise provided by the team of consultant cardiologists is supported by a dedicated administration team led by Jennifer Ledwith, an admissions team managed by Gillian

Grant and Suzanne Donlon, a team of nine cardiac physiologists and an ECG technician. This enables a streamlined and timely service, with minimum waiting lists for an expanded number of cardiology tests, and allows for the provision of onthe-day cardiology testing for outpatients attending on-site consultant clinics.

The Cardiology team works closely with the Medical Assessment Unit (MAU), which is led by Dr Ger Hosny and Clinical Nurse Manager, Leah Duggan.

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“The admin team is excellent, as is the Medical Assessment Unit (MAU),” says Consultant Cardiologist Dr Paul Keelan, who specialises in interventional cardiology, primarily managing patients who require stents, pacemakers or defibrillators. “Cardiac physiology is a very busy department, and is one of the mainstays of our department, providing a service to the wider hospital, whether that is for pre-op assessment or following up with patients who have had cardiac setbacks or perturbations.

“The MAU invites patients who are perhaps not critically ill but are presenting with an accelerated phase of their illness, and when you provide that service it has to be underwritten by early access to the various specialty tests. Certainly, chest pain is one of the most frequent reasons for patients to attend the MAU, and

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a proportion of those patients are going to be judged in need of coronary angiography, so it is important that if that is the assessment of the MAU, that they can pick up the phone and order an angiogram, which is often done on the same day.”

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 for which GPs can refer their patients directly into the department.

The diagnostics imaging department consists of ten cardiac physiologists and two care assistants.

With the recent addition of another echo room, new services such as a carotid doppler scanning service and dobutamine stress echocardiography service led by

Dr Angie Brown, as well as additional echo machines with 3D technology, new ECG machines and an upgraded echo reporting system, timely appointments for patients are ensured.

“We have also added more consultant clinics, enabling us to see more patients, ” Dr Keelan says. “Year on year, we are seeing a 10-15% increase in activity.”

An echo service, along with ECG, Holter Monitor and BP monitoring is also provided in the hospital’s Cavan Consultant Clinic to meet the needs of the Cavan, Monaghan and surrounding areas for Cardiology Services. This is led by Dr Susan Connolly, Consultant Cardiologist, who runs regular clinics in Cavan alongside one of the Dublin Cardiac Physiologist team. GPs can refer their patients directly to Dr Connolly and / or directly for specific tests.

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SERVICES 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 range of cardiology procedures at the Cath Lab, which provides a service for invasive vascular cases on a weekly basis, include: • Coronary angiography • Right-heart catheterisation • Percutaneous coronary intervention • Loop recorder, pacemaker and ICD implantation.

• EP studies.

PACING SERVICE The pacing service at Bon Secours, headed

by Dr Gumbrielle, means all patients are 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 comfort of their own home. This is another step in guaranteeing patient safety.

COLLABORATION Collaboration is very good between all consultants in the department, as well as all departments across the hospital and beyond, according to Dr Keelan (pictured left), who describes it as a close and very collegial set-up that results in an excellent service for patients.

“The patient will always come first,” he says, “and the system we have in place means we can accommodate patients whenever they are in need.”

This extends to the excellent support services provided by the nurses, physiology team and MAU, he adds, all provided with a compassion and caring atmosphere that places the Bon Secours at the forefront of cardiac care.

“What marks the Bon Secours hospital out is that it is a very friendly atmosphere, with very efficient, very personable staff, and that results in a very high patient satisfaction,” says Dr Keelan. “The general sense from patients is that they appreciate the overall service, the excellent access,

and while we have the most up-to-date technology and expertise, we retain that traditional ethos of the patient coming first, and that is very apparent.

“We have leading technology and intensive medication to care for our patients, but it all takes place in an atmosphere that is calm and peaceful, and that is something our patients really do appreciate.”

CARDIOLOGIST TEAM: • Dr Angie Brown • Dr Susan Connolly (Cavan Clinic only) • D Brendan Doyle • Dr Thomas Gumbrielle • Dr Paul Keelan • Prof Brendan McAdam • Dr Richard Sheahan (Cath Lab) • Dr Ivan Casserly (Cath Lab) CONTACT DETAILS General enquiries: (01) 806 5368 Outpatient appointments: (01) 808 2300 Email: dublincardiologybookings@ bonsecours.ie Fax: 01 8065398 Opening hours: Monday – Friday, 8am – 6pm

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DERMATOLOGY DEPARTMENT

Dermatology at Bon Secours The Dermatology Department at Bon Secours Dublin treats a myriad of different skin conditions, Consultant Dermatologist Dr SĂ­ona NĂ­ Raghallaigh tells Adam Hyland

THE TEAM Having recently joined the team alongside my colleague Dr Lorraine Jennings, the Dermatology Department at Bon Secours Hospital Dublin now consists of eight consultants. My own areas of expertise are rosacea, acne and skin cancer diagnosis and surgery, but within our department we have a wide range of specialties and areas of interest which cover most dermatological conditions.

The department specialises in providing both medical and surgical support for its patients, delivering a swift diagnosis and implementation of a treatment plan for disorders of the skin, hair, nails and mucous membrane.

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COMMON SKIN ABNORMALITIES While there are more than 3,000 different skin diseases, the main ones treated at Bon Secours, apart from skin cancer, include inflammatory disorders such as eczema, psoriasis and acne, autoimmune disorders such as lupus, genetic disorders, and blistering disorders such as bullous pemphigoid (particularly in elderly patients). We also treat contact allergies and urticaria, which produces chronic hive-like reactions.

Many less severe conditions can be treated with topical treatments, which can be applied at home once the patient has been assessed and diagnosed.

Medications for inflammatory diseases,

if topical treatments fail, include systemic treatment such as methotrexate, or biologic injections. We also have a referral pathway for phototherapy, an ultraviolet treatment which can be very useful, particularly in younger patients. For allergies or contact dermatitis, patch testing or skin prick testing is provided.

SKIN CANCER Skin cancer occurs in two main forms: melanoma and non-melanoma. Melanoma occurs primarily in the pigment cells present in the skin. It can spread to other parts of the body if not treated in time.

While most moles are harmless, it is very

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important to have any new or changing moles checked by your GP, who can refer on to us if they are concerned. Early recognition and intervention are vital where melanoma is suspected.

Non-melanoma skin cancer occurs in two distinct forms: basal-cell carcinoma and squamous-cell carcinoma. Basal-cell carcinoma (BCC) is the most common form of cancer, and manifests in the epidermis of the skin, including the scalp and areas exposed to sunlight and other UV radiation.

Squamous-cell carcinoma also occurs in skin that is regularly exposed to sun rays.

Once a biopsy has been performed, the results will determine the subsequent management of the condition. A wider excision of the tumour 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 three minor theatres, with only some instances being referred to one of our plastic surgeon colleagues.

For undifferentiated lesions of the skin, moles, lumps or bumps, the first port of call should be a dermatologist.

We use dermoscopy to assess the lesion before deciding on the next course of action.

It is important to know that not every referral leads to a surgical excision. For chronic sun-damaged skin, preventative treatments, including cryotherapy, and topical chemotherapy creams, are used when there is a lot of pre-cancerous change on the skin. Photodynamic therapy is another useful field treatment we provide to prevent further skin cancers in the future for patients.

Rapid access is very important and is something we in Bon Secours are able to provide. If a GP contacts us regarding an urgent referral, we will ensure this is prioritised.

EQUIPMENT The hospital is well equipped with the latest in dermatological care, using specialised instruments. Techniques and treatments include cryotherapy, phototherapy, photodynamic therapy, laser, intralesional steroid injections, etc. The opening of an additional minor theatre in the summer of 2019 means that there are now three minor theatre rooms running simultaneously, giving increased access to surgery resulting in minimal waiting times for minor procedures and treatment.

WORKING TOGETHER All eight dermatologists at Bon Secours are adept in both surgical and medical care. We have a strong working relationship with the plastic surgeons at the hospital. We have well-established referral pathways for photodynamic therapy, patch and skin prick testing, phototherapy, plastic surgery, immunology and radiotherapy, and rely on our pathologists for their accurate and timely reports.

Bon Secours also has an excellent aftercare nursing service for patients with post-biopsy or surgical wounds.

All in all, with our collaboration with other departments and our rapid access system, the Dermatology Department at Bon Secours is able to provide a swift and extensive diagnosis and treatment plan for our patients.

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

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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.

C

urrently the Diagnostic Imaging Centre is collaboratively led by Paul Hudson (Interim Manager) 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, Musculo-Skeletal Imaging, Neuro-Radiological Imaging, Gastro-Intestinal Imaging, GenitoUrinary 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 10 enthusiastic, dynamic

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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: • Virtual CT Colonoscopy – an increasingly useful diagnostic tool that can in some cases replace colonoscopy. If colonoscopy fails to get a clear image of the bowel then CT colonoscopy is used to produce

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DIAGNOSTIC IMAGING DEPARTMENT

a 3D image to visualise the bowel.

• Dedicated oncological imaging • Cardiac/coronary vessel imaging • Vascular imagin The department is actively involved in extensive post-graduate CT training and education, ensuring the highest standards of quality and care are consistently maintained.

MRI (MAGNETIC RESONANCE IMAGING) In 2019, the department installed a new MRI machine with high density coils, significantly improving the quality of the imaging. It is a wide bore magnet to scan patients who might be overweight and enable shorter scan times to improve the experience for claustrophobic patients.

MRI is one of the most important diagnostic tools at the department’s disposal and provides an invaluable service to the hospital. 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 patient's 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 egard 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.

VASCULAR LAB The lab provides a full range of noninvasive arterial and venous testing using the latest ultrasound scanners and can help work up patients with suspected venous or arterial disease. These include patients with varicose veins, TIA/ stroke, abdominal aortic aneurysm or peripheral arterial disease. All scans are reported on by one of our Consultant Vascular Surgeon team.

DIRECT PAYMENT SCHEMES Direct payment schemes are in place with most of the private health insurance companies. This means that patients need only fill in their insurance information and we bill their insurance company directly.

Not all of the diagnostic tests are covered with all the insurance companies (details

that are covered by the individual companies. For Garda Medical Aid (GMA), POMAS and ESB the cost of the all scans are covered, however patients must pay on the day of the scan and seek reimbursement directly from their respective insurance companies. We have recently developed an insurance tracker that is available on our website www.bonsecours.ie/dublin that can be used to check whether you are covered.

As insurance coverage can change during the course of the year, please call your insurance company directly or phone 01 8082300 to confirm your coverage.

WALK IN SERVICE The Radiology Department provides a walk-in x-ray and ultrasound service between 9am 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

are available on page 65 of the examinations

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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, tissue viability nurse, and discharge planner. The department's dedicated team of three dietitians are trained to degree or masters level and are members of the INDI. SEEING A DIETITIAN Referrals to the outpatient dietician service are welcome from the general public directly or via referral from their GP and / or consultant. Inpatients are referred to the service by their consultant team.

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; • IBS as treated by the new FODMAP diet plan • IBD (Crohn's disease and colitis) • Diabetes, IGT and reactive hypoglycaemia • PCOS (Polycystic Ovary Syndrome) • Malnutrition, enteral and parental nutrition • Weight management/obesity including bariatric patients • Sports performance and enhancement • Cancer • Coeliac disease • Lactose Intolerance • Constipation and diverticulitis • 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 Referrals to the service can be made via Healthlink or by secure email DIABETES CLINIC Tel: (01) 806 5488 / Fax: (01) 808 2343 DIABETES CARE CENTRE Tel: (01) 806 5488 / Fax: (01) 808 2343

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ENDOCRINOLOGY

Endocrinology at Bon Secours The endocrinology department is dedicated to the timely treatment of its patients.

Dr Matilde Mijares Zamuner, Consultant Endocrinologist and Diabetologist, discusses the work of her department.

E

ndocrinology is the study of glands and the hormonal control of the body. Certain conditions, such as diabetes and pituitary malfunction, can upset the regulation of hormonal control, and so it is down to the team in the endocrinology department to help these patients. The department includes a team of four endocrinologists, a diabetic nurse specialist, dietitians and a podiatrist, and it has access to other specialities across the hospital including, ophthalmologists, vascular surgeons and cardiologists.

“We work very well as a team to deliver a unique, comprehensive and patient tailored endocrine service in the hospital,” says Dr Matilde Mijares

Zamuner, Consultant Endocrinologist and Diabetologist at the Bons Secours, Glasnevin. “Our team are very experienced and we are getting very positive results and feedback from our patients.”

Dr Zamuner joined the Bon Secours Hospital Dublin in the summer of 2017, and is also part of the consultant team in the hospital's Medical Assessment Unit. Before her time at the Bons, Dr Zamuner completed her specialist training in endocrinology, diabetes, nutrition and general internal medicine in Alicante’s University Hospital, Spain.

She gained a master's degree in clinical research in Spain in 2011, before moving to Ireland in 2014 and completing a research fellowship in diabetes,

specifically in monogenic forms of diabetes in the Mater Misericordiae University Hospital. Her specific areas of interest are diabetes mellitus, maturity onset diabetes of the young (MODY), thyroid disease and obesity, but she is experienced in all aspects of general endocrinology.

DIABETES Dr Zamuner and her endocrine colleagues deal with all manner of endocrine disorders, but diabetes is particularly prevalent. According to the Diabetes Federation of Ireland, diabetes afflicts around one in twenty people in Ireland, though this figure is projected to rise in the coming years.

By 2020, it is estimated that over 200,000

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for the hospital's endocrine team. The hospital has a specialised ward geared towards the administration of pituitary function tests for patients with pituitary tumours.

“The team works together and we have good experience. We are getting a good response from our patients.” people in Ireland will suffer from the condition. Clearly, there is an increasing need for high-quality treatment.

The diabetes-related services offered at Bons Secours have been facilitated by the hospital's dedicated nurse, Brenda Wade. Dr Zamuner explains that Brenda has been at the hospital for many years, offering expertise in both Type I and Type II diabetes. She provides inpatient education for people who are admitted to the hospital for diabetes care, as well as for newly-diagnosed patients who have become aware of their diabetes during their stay within the hospital. This is a particularly vital role that Brenda delivers, as education is the first step to learning to live with the condition.

The hospital is home to a Diabetes Clinic, which offers a specialist coordinated care and education service for recently diagnosed patients experiencing problems with managing their condition. It focuses on patient empowerment through educational programmes, and is delivered by a multi-disciplinary team. The clinic has developed three different care options to support GPs in the management of their diabetic patients. The first, entitled 'GP Managed Care', is managed by the GP

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with referral into the clinic for a consultation with one of the specialist team as required. The second, 'Diabetes Centre Managed Care', sees the patients' diabetic care being managed by the Bons' diabetic care team, with regular updates provided to the referring GP. The third is known as 'Shared Care', wherein the patient's care plan is devised by the endocrinologist and is delivered by the GP. There are many benefits to the patient attending the clinic, as it provides immediate and timely appointments, which, in turn, allows for quick and early intervention to reduce or prevent the risks of complications developing.

PITUITARY The endocrinology team at the Bons is increasingly faced with patients suffering from issues with their pituitary gland.

Situated at the base of the skull, the 'master gland', as the pituitary gland is aptly known, 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 the patient.

Over the last number of years, there has been a great increase in the number of pituitary patients seeking to have their treatment at the Bon Secours, as opposed to through the more traditional means of public hospitals. The management of patients with pituitary tumours is a particular focus and area of interest

DIAGNOSTICS Endocrinology as a discipline requires little in the way of specialised equipment, but its practice does demand access to blood testing and up-to-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 the Radiology Department at the hospital is fundamental to the delivery of appropriate treatment and ensuring the best possible outcome for patients.

With continued advances in MRI technology, there will be greater accuracy when imaging tumours, which will engender superior precision in the deliverance of surgery and radiotherapy.

This being the case, technological change – particularly within the realm of radiology – will be crucial to ensuring the continued and improved treatment of patients suffering from pituitary problems. Bon Secours fully intends to be at the forefront of this shifting paradigm to ensure that the department continues to grow and develop, and thus provide its patients with the best possible care.

“We are increasing our numbers, especially of diabetes patients,” concludes Dr Zamuner. “We're getting more referrals, more diabetic patients, and essentially there are patients coming through MAU with endocrine pathologies. We are getting excellent results and our patients are very happy with the service we provide.”

ENDOCRINOLOGY CONSULTANT TEAM • Dr Margaret Griffin • Dr Matilde Mijares Zamuner • Dr. Diarmuid Smith • Prof. Chris Thompson 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 ten consultant ENT surgeons in the department providing comprehensive evaluation and medical or surgical intervention to both adults and young adults over the age of 16. “I have a particular sub-speciality interest in thyroids and salivary disease,” explains Mr Walshe, “and fellowships in rhinology, head and neck cancer surgery, and I also practice in otology in which I also hold a research fellowship.”

Mr Walshe’s colleagues Prof Tadhg O Dwyer, Prof Michael Walsh, Prof Rory Mc Conn-Walsh, Prof James Paul O Neil, Mr Fergal Glynn, Mr Munish Shandilya, Mr Michael Harney, Mr Stephen Kieran and Mr Mohmed Amin have complementary 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

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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 hospital's 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-of-theart 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 Mohamed Amin • Mr Fergal Glynn • Mr Michael Harney • Mr Stephen Kieran • Prof Rory McConn-Walsh • Prof Tadgh O'Dwyer • Prof James Paul O Neill • 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.

THE TEAM Bon Secours Hospital is at the forefront of modern gynaecological treatment.

An excellent support staff works with four consultant gynaecologists to ensure the very highest standards of patient care are maintained at all times, with each consultant providing their own skill set in benign gynaecology.

Dr Kushal Chummun, Dr Yahya Kamal, Dr Edgar Mocanu and Dr Hassan Rajab provide medical and surgical management

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"An excellent support staff works with four consultant gynaecologists to ensure the very highest standards of patient care are maintained at all times".

of a spectrum of benign conditions, including but not limited to abnormal uterine bleeding, fibroid, endometriosis, ovarian cysts, prolapse, incontinence and subfertility, to mention a few. Most surgeries are minimally invasive, which provides less pain, a shorter hospital stay and quicker recovery for the patient.

LAPAROSCOPY Laparoscopy is a popular and preferred approach for a number of gynaecological

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GYNAECOLOGY DEPARTMENT

surgeries. It has transformed the field and allowed surgeons to access the abdomen and pelvis through a keyhole incision.

Hysterectomy and treatment of endometriosis, ovarian cysts, fibroids and fertility issues can all be surgically managed with a laparoscopic approach.

This minimally invasive procedure allows less pain, quicker recovery and shorter hospital stay.

ENDOMETRIOSIS Endometriosis occurs when there is presence of endometrial tissue outside of the uterus. This results in cyclical inflammation that can cause painful period, chronic pelvic pain, painful intercourse, ovarian cysts and infertility.

Endometriosis are commonly found in different parts of the pelvis including the ovaries, uterosacral ligaments, surface lining the pelvic cavity.

Laparoscopy is a great diagnostic and operative tool for patients with a suspected endometriosis. A laparoscope will be inserted to examine the abdomen and pelvis for endometriotic implants.

If present they can be burnt or excised.

This procedure is performed under general anaesthesia and usually as a day case.

OVARIAN CYSTS The team at the Bons also diagnose and remove ovarian cysts which are one of the commonest gynaecological problems in women. Ovarian cysts are fluid-filled sacs that form on the ovaries. Most are benign. While cysts can be asymptomatic, some can cause pain.

Laparoscopy is used to remove most cysts. However, big cysts or cysts with suspicious features may require an open procedure.

PROLAPSE A complication sometimes arising after childbirth or in advancing years is a prolapsed uterus. Various muscles, tissue and ligaments ordinarily hold the uterus in place within the pelvis.

However, the weakening of these muscles and ligaments or loss of oestrogen in advancing years, can cause the uterus to prolapse into the vaginal canal. The bladder and rectum can also prolapse into the vagina. Typically, patients complain

of a pressure or lump sensation in the vagina, or a dragging sensation, and depending on the degree of prolapse, treatment involves either using a pessary ring, which can be inserted in our private rooms, or surgery. If the womb is prolapsing, vaginal hysterectom is an option.

URINARY INCONTINENCE Urinary incontinence or leakage is likely to be suffered by women due to the effects of childbirth, pregnancy, and menopause.

There are three types of incontinence – urge incontinence (difficulty controlling the bladder), stress incontinence (accidental urination when coughing, sneezing, exercising, etc), and mixed (a combination of both). There is a fully integrated Urodynamic Service at the Bon Secours Hospital Dublin, which allows the consultant team to investigate the causes of urinary incontinence before deciding on the best form of treatment.

COLPOSCOPY 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.

DAY SURGERY There are plans to further extend the gynaecology department at Bon Secours to provide for a day surgery where certain procedures can be done under local anaesthetic, providing an effective and efficient treatment that will enable patients to return to their normal lives as quickly and as safely as possible.

CONSULTANT GYNAECOLOGISTS • Dr Kushal Chummun • Dr Yahya Kamal • Dr Edgar Mocanu • Dr Hassan Rajab

BON SECOURS HOSPITAL

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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, explains Dr Aoibhlinn O’Toole

THE TEAM The Bon Secours Hospital Dublin has one of the largest Gastroenterologist teams in the country, with 13 consultants with a variety of interests and expertise, and more than 30 endoscopists working on site. A further two consultants are expected to join the team in 2020.

ENDOSCOPY Gastroenterology focuses on the digestive system and all diseases affecting the gastrointestinal tract and all organs along the alimentary canal. Investigation and detection of these conditions is done through endoscopy, a minimally invasive procedure used to assess the interior surfaces of an organ by inserting a tube with a built-in fibre optic camera into

the body to provide an image for visual inspection and photography.

The consultant team provide a direct access service whereby a patient’s GP will refer directly in for the procedure, as well as a consultant-led service whereby the consultant will meet with and evaluate the patient prior to the procedure if required.

The team provides both in-patient and out-patient care. The service is quick and easy, with the majority of patients being admitted to have their procedure and discharged the same day.

DIRECT ACCESS ENDOSCOPY The Direct Access Endoscopy Service allows a GP or consultant to refer directly to the department for a colonoscopy, upper

GI endoscopy and Left Sigmoidoscopy.

Referrals to the Direct Access Endoscopy Service can be made via Healthlink or by secure email using healthmail.

The unspecified consultant referral forms are triaged on arrival in the department and the patient is contacted to arrange an appointment.

Where an urgent referral is received, patients will be offered an appointments asap and possibly within 72hrs, while a referral marked as routine means patients are seen within 28 days or sooner.

GASTROSCOPY Gastroscopy, a diagnostic endoscopic procedure used to visualise the upper part of the gastrointestinal tract up to the duodenum, is the most

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GASTROENTEROLOGY DEPARTMENT

commonly performed type of endoscopy.

It is a minimally invasive procedure that takes just 5 minutes and does not require any significant recovery time. This procedure is carried out on patients who have stomach ulcers, acid reflux disease or potential or diagnosed cancer of the stomach or oesophagus. A biopsy can also be performed during a gastroscopy, using a biopsy forceps which is passed through the scope and allows sampling of one to three millimetres of tissue which can then be examined by a pathologist to render an opinion as to whether there are abnormalities in the cells.

COLONOSCOPY 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 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.

SIGMOIDOSCOPY Sigmoidoscopy is similar to a colonoscopy, allowing doctors to view only the final two feet of the colon. Often a sigmoidoscopy is used as a screening procedure for a full colonoscopy.

OTHER TREATMENTS "The main reason why an endoscopy is performed is to rule out tumours, but there are lots of other reasons.

Our department sees many patients with inflammatory bowel disease, Crohn’s disease or colitis who might have precancerous conditions such as polyps.

We are seeing a marked increase every year in cases of inflammatory bowel disease, which is my own particular areas of interest," says Dr Aoibhlinn O'Toole.

The Gastroenterology Department also detects and removes a lot of precancerous conditions, such as polyps, which can grow and turn into cancers.

We also carry out dilatation procedures, if a patient has a narrowing of the colon.

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.

We work very closely with the Medical Assessment Unit so that if somebody needs rapid access to diagnostic endoscopy, we can perform it on the same day or the next day. The in-patient service gets great access to endoscopy in terms of quick turnover from request to procedure, with in-patient services maintaining a high level of excellence.

ADVANCEMENTS

The Gastroenterology Department continues to broaden the breadth of its services to introduce advanced technologies and remain at the forefront of modern medical practices. Recently, Bon Secours took part in an Endoscopic Ultrasound (EUS) trial, an advanced endoscopy procedure that has not yet been done at any other private hospital in the country.

FULL SERVICE

New technologies and medical expertise at Bon Secours are supplemented by a comprehensive care service. Patients can avail of endoscopy in modern, comfortable surroundings, but they can also attend the infusion centre to avail of new and modern biologic therapies, administered at our clinic.

The team works very closely with the Nutrition and Dietician team, the

Diagnostic Imaging Department and the Upper GI and Colorectal Surgical Team within the hospital to provide a complete and comprehensive service for patients with gastrointestinal complaints.

CONSULTANT GASTROENTEROLOGISTS • Dr Danny Cheriyan • Dr Richard Farrell • Prof Fergus Gleeson • Prof Gavin Harewood • Dr Jack Hollingsworth • Prof Padraic MacMathuna • Prof Frank Murray • Dr Aoibhlinn O'Toole • Prof Stephen Patchett • Prof Barbara Ryan • Dr Subhasish Sengupta • Dr Claire Smyth CLINICAL LEAD • Dr Conor O’Brien DIRECT ACCESS ENDOSCOPY Tel: (01) 806 5491 Fax:(01) 806 5490 Direct Access Forms are available to download from www.bonsecours.ie/ direct-access-endoscopy-dublin or referrals via Healthlink

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ENDOSCOPY

Endoscopy at Bon Secours The Bon Secours Endoscopy Unit provides a complete range of high quality diagnostic and therapeutic endoscopic procedures, as Dr Conor O'Brien explains.

T

he Endoscopy Dept is collaboratively managed by Clinical Nurse and Unit Manager Maria Roban, and chairman of the Endoscopy Users Group Dr Conor O Brien. It is the largest and busiest private endoscopy unit in Ireland, providing a comprehensive diagnostic and therapeutic diagnostic service.

In 2018, the unit carried out over 13,000 procedures and is on track to surpass that in 2019. The state-of-the-art unit at the Bon Secours Dublin boasts three fully equipped procedure rooms, a first stage recovery area, a 20 bed 2nd stage recovery area

and a discharge lounge with reclining chairs.

Following a €2.5 million investment programme in 2016, the unit was awarded JAG accreditation – the widelyrecognised gold standard for an endoscopy unit. This meant that the unit was the first private endoscopy unit to be JAG accredited, a recognition of the unit's demonstrable competence to deliver the highest quality endoscopic care.

The accreditation is renewed annually and was most recently awarded in July 2019.

Dr Conor O'Brien has served as the unit's clinical lead for the past two years, having started working in the unit in 2008.

“Essentially I work as a go-between between the hospital management, the nursing staff, and the consultants,” he explains.

“There's 32 consultants working in the unit, so I am sort of the liaison between all those consultants and the management of the hospital and the nursing staff. Every three months we have an Endoscopy User Group meeting – so a lot of my work would be based around that as well.”

The Endoscopy User Group meeting involves O'Brien and a number of other senior figures within the hospital

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ENDOSCOPY

discussing the previous three months of the endoscopy unit, in terms of its performance, any issues that may have arisen, and analysing statistics that have been compiled. This is done through the unit's use of an electronic reporting system, which allows the endoscopist to electronically record the results from each procedure carried out there. “Every time we do a procedure, we write a report on that procedure and its findings, the amount of sedation that is given to the patient and we also record how comfortable a patient reported themselves to be during the procedure. The data for Gastrointestinal procedures is then uploaded to a national database – the Gastrointestinal Endoscopy National Improvement Programme Database,” explains Dr O'Brien. “Every three months, as the clinical lead, I'll provide each consultant with a summary of their statistics for the previous three months, in relation to their performance and procedures completed.”

The electronic reporting system allows for previous reports to be quickly and easily retrieved electronically for comparison purposes. It also allows for the electronic storage of images and videos captured during each procedure. This high quality imagery is extremely useful when formulating management plans for patients. The use of the system, as Dr O'Brien has mentioned, enables the endoscopy unit to participate in the National Quality Improvement Programme for Endoscopy, which is vital for maintaining the highest of standards within the field.

GASTROENTEROLOGY Dr Danny Cheriyan Prof Richard Farrell Prof Fergus Gleeson Prof Gavin Harewood Dr Jack Hollingsworth Prof Padraic MacMathuna Prof Frank Murray Dr Aoibhlinn O’ Toole Dr Conor O'Brien Prof Stephen Patchett Prof Barbara Ryan Dr Subhasish Sengupta

an imaging technique to look at the small bowel. The programme was very successful and there was huge demand for it. We are currently exploring with the insurance companies to see how we can go beyond a pilot programme and actually provide the service in the long-term.”

PATIENT CARE The department is focused on patient care and has a very effective strategy in place to ensure that patient needs are always prioritised. Keeping waiting times down and ensuring that the patient is informed at all times is central to this care. The department's aim is to minimise the waiting times within the unit, to improve the overall patient experience, and to minimise any potential anxieties that the patient may experience.

Endoscopy is a constantly evolving field, with new technologies being consistently pioneered. A high-functioning endoscopy unit is going to have to be wise to technological advancement within the field, and this is what will ultimately serve patients. The unit at the Bons is always seeking to innovate, as Dr O'Brien explains, with a number of areas being looked into, including an endoscopic ultrasound and capsule endoscopy (Pillcam). “We ran a six-month pilot programme in 2017/2018 of the capsule endoscopy, which is

Dr Claire Smyth

Mr William Robb

RESPIRATORY Prof Conor Burke Prof Richard Costello Prof Ross Morgan

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

GENERAL SURGERY Mr John Burke Mr Joe Deasy Prof Arnold Hill Ms Deborah McNamara Mr Eadbhard Mulligan Mr Colm Power

DIRECT ACCESS In August 2017, a new direct access endoscopy service at the Bon Secours was launched by Minister for Health, Simon Harris. The launch of this service demonstrates Bon Secours’ commitment to continuously raising levels of access, quality and safety to patients requiring endoscopy procedures. Direct access is a process whereby a GP can directly refer a suitable patient to the Bon Secours for a scope procedure. It thereby bypasses traditional referrals, which involve an initial outpatient consultation. Patients can have a procedure completed within 72 hours of referral from their GP. This means the patient can get immediate reassurance and referral for further treatment by an expert medical team if required, reatly reducing potential delays in treatment and significantly improving the patient's outcome.

Multiple procedures are provided as part of the direct access endoscopy service at the Bons, including colonoscopy and upper GI endoscopy.

If a patient would like to attend the Direct Access Endoscopy Unit, they must first speak with their GP directly and request to be referred to the Endoscopy unit.

ENDOSCOPY DEPARTMENT OPENING TIMES Monday to Friday, 8.30am – 8pm Occasional Saturday Clinics CONTACT NUMBERS Tel: (01) 806 5490 Fax: (01) 806 5346 Note to GPs: referrals can be sent directly to the Direct Access Endoscopy Unit or directly to the individual consultants via Healthlink

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LABORATORY DEPARTMENT

Laboratory Bon Secours has a comprehensive laboratory service on site providing a 24 hour service to the hospital.

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 as soon as they are available and are sent by secure email to GP Healthmail email accounts.

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 turnaround 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.

The current lab manager is Mary Kennedy who took up the role in summer 2019.

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 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.

Recent 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 5323, 01 806 64719 (Results) Warfarin Clinic (01) 806 5494 wclinic@bonsecours.ie Phlebotomy: Walk-in service daily from 8am - 3.30pm

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MEDICAL ASSESSMENT UNIT

Medical Assessment Unit Medical Assessment Unit incl. Chest Pain Pathway gives patients and GPs same day access to consultant review, diagnostic tests and treatment.

At the official opening of the MAU in June 2019 – Mr Bill Meagher – CEO Bon Secours Health System Ireland, Mr Pascal Donohoe TD – Minister for Finance and Public Expenditure and some of the MAU nursing team

T

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 summer of 2016, acting as the clinical

42

“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.” lead to a team of NCHD’s , nurses and allied health professionals in the hospital’s now much expanded Medical Assessment Unit.

Patients are seen by Dr Hosny on entry into the Unit, 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 routine standard investigations done we don't do that,” continues Dr Hosny.

“All of our investigations are tailored to the patients' requirements and presentations

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are completed on-site at the time. The other thing is, because we have immediate access to on-site diagnostic testing, 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. “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 started very quickly.”

MAU EXPANSION The MAU opened in 2016 and was originally located in an existing ward, however due to increasing patient numbers, in 2018 the unit underwent a €1.5m redevelopment and expansion programme to meet the growing demand for its services. The new 10 bed unit including two isolation rooms, specialist air filtration, consulting rooms, waiting rooms and nurse station was officially opened in June 2019 by Minister for Finance and Public Expenditure Mr Paschal Donohoe. In 2018, the unit welcomed over 2,000 patients and by the end of 2019, this number is estimated to increase by 20%.

The new MAU has allowed for the expansion of the services that were initially provided including the introduction of the Chest Pain pathway. The introduction of the chest pain pathway s also made possible with theaddition of cardiologist

Patients presenting with Chest Pain may be transferred to the Cath Lab for Coronary Angiograms on their day of admission to the MAU

Dr Paul Keelan and the imminent arrival of additional cardiologists to the cardiology team.

The continued evolution of the Bon Secours’ MAU 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.

PATIENT PRESENTATIONS There are clear trends in presentations depending upon the time of the year.

In summer the unit sees many dehydration related issues such as palpitations, headaches, collapse, gastroenteritis from creative barbeques, travellers issues such as diarrhoea, DVT and PE etc. and in winter, flu and respiratory issues in addition to weight loss, liver injury, kidney injury and many cardiac issues which are not so seasonal.

CHEST PAIN PATHWAY The development and launch of the Chest Pain Pathway was a natural evolution of the service based on the types of patient presentations and the general expansion of the cardiologist team and diagnostics services within

the hospital. Patients presenting with stable chest pain exclusive of STEMI or stable angina and arrhythmias are provided with a comprehensive cardiac assessment, evaluation and work up within the unit and as necessary are transferred to the CATH lab for cardiology intervention on the same day for the following range of procedures: • • • • • • •

Coronary Angiography Coronary Angioplasty +/-stenting Cardioversion ICD* Loop Recorder* Pacemarker Insertion* Right Heart Catherisation

*It may not be possible for the indicated procedure to take place on the same day

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

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PATIENT SUITABILITY The MAU is suitable for stable, ambulatory patients presenting with the following conditions: Cardiology • Stable acute coronary syndrome exclusive of STEMI • Stable angina, Stable arrhythmias • Palpitations for assessment • CCF • Pericarditis and Myocarditis General • 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 Endocrine • Uncontrolled Diabetes • Thyroid Disease Rheumatology • Rheumatology Disorders Neurology • Headaches • TIAs • Collapse / Syncope • Jaundice • Gastroenteritis Nephrology • UTI/Pyelonephitis • Nephrotic/Nephritic Syndrome • Acute and chronic kidney injury

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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 ten 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 dependent 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 only €150 plus the individual policy excess if applicable will be payable and the balance 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 PATHWAY 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. Once admitted to the hospital, patients are under the care of one of four consultants; Dr Colette Barry, Prof Richard Costello, Prof Ross Morgan or Dr Matilde Zamuner.

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/dublin KEY STAFF • Dr Geraldine Hosny MAU Clinical Lead • Leah Duggan CNM • Dr Colette Barry • Prof Richard Costello • Prof 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, including 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

Vision Science at Bon Secours The Ophthalmology Department at Bon Secours provides the best and latest treatments for its patients. Mr Edward Dervan, Consultant Ophthalmic Surgeon, explains more.

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here have been significant technological advancements in the fields of ophthalmology and vision science over recent years – advancements that have revolutionised the field, making treatments less invasive and much more

There are currently 10 ophthalmologists performing general ophthalmology working in the Bons, and each has their own sub-speciality interests.

These include cataract and refractive surgery, anterior segment, glaucoma, strabismus, paediatrics and medical

accurate. At Bon Secours, specialist patient care is provided by the Consultant Ophthalmology team, each of whom is dedicated to providing the best and most up-to-date patient care.

retina, as Mr Edward Dervan, Consultant Ophthalmic Surgeon, explains: “What we generally do in the Bons is cataract surgery, doing consults for the other specialities and in-patients in a ward.

We also do minor procedures such as lid procedures, and also laser treatments for things like glaucoma and for things that happen after cataracts surgery.”

Mr Dervan completed his ophthalmic surgical training in Ireland and was awarded fellowship of the Royal College of Surgeons in Ireland (Ophthalmology) in 2013. He has completed an advanced surgical fellowship in Perth, Australia, specialising in anterior segment disease and focusing primarily on glaucoma and

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complex cataract surgery. He previously worked as a consultant ophthalmologist in Perth, before accepting a position specialising in glaucoma at the Mater Misericordiae University Hospital. His research interests include understanding the basic science of glaucoma, improving the clinical outcomes and the provision of services to patients with glaucoma.

He was awarded a research medical doctorate from University College Dublin for his research on pseudoexfoliation glaucoma.

Mr Dervan, along with the other Ophthalmologists in the hospital also have other private or public practices – in his case at the Mater Private.

This fosters strong links with teaching hospitals and develops good relationships – communication between other departments resulting in excellent standards of practice and the best useof resources. Ongoing teaching by the ophthalmologists of junior hospital staff, in association with the RCSI, maintains an academic environment, which is important to ensure the education of the next generation of doctors.

SERVICES The focus of the Bons' ophthalmology department is not limited to 'eye diseases' as such, but also includes 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 provided to inpatients. 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 ophthalmologists on staff providing up to a dozen various different medical consultations each week. From a surgical perspective, each ophthalmologist admits their own patients for different surgical procedures.

The most common procedure performed is cataract surgery, which is the most common ophthalmology procedure worldwide. Cataract surgery 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 intralocular 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 in the Ophthalmology department at the Bons are well equipped with all the instrumentation and nursing expertise to facilitate the very best of modern eye care.

DIABETES 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 twenty people in Ireland suffer from diabetes, with one in eight people over 60 having the disease.

Unfortunately, 74 per cent of those who have diabetes for ten years or more will develop diabetic eye disease.

These figures are quite staggering and serve to 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 intralocular 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 more remedial treatment in the form of an operation. 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.

FURTHER DEVELOPMENTS The Ophthalmology Department at Bon Secours includes a dedicated eye theatre and clinical eye room which are well equipped with all instrumentation and nursing expertise to facilitate the very best of modern eye care. Edward Dervan and his colleague, fellow Consultant Ophthalmic Surgeon, Ms Susan Fitzsimon, are continuing to expand the recently developed eye department broadening the diagnostic facilities provided within the hospital.

“What has really changed in the last year is that myself and Susan, in particular, have set up up an eye department with diagnostic facilities, which is an exciting development for the Bons in Dublin,” he explains.

“Somewhere where we have facilities to do visual fields, particularly as these are important for accessing glaucoma.

OCTs, which are an imaging technology that looks at the back of the eye, are very important for glaucoma and retinal diseases. We also have a biometry machine which measures the eye in relation to which lens you need to put into an eye for cataracts surgery.

All of this allows for more of a complete offering for our eye patients.”

OPHTHALMIC CONSULTANT TEAM • Ms Yvonne Delaney • Mr Edward Dervan • Ms Aoife Doyle • Ms Susan Fitzsimon • Dr Aisling Foley-Nolan • Dr Sarah Gilmore • Ms Claire Hartnett • Ms Patricia Logan • Ms Wee Fong Siah • Ms Louise O Toole APPOINTMENTS Tel: 01 806 5625 Email: eyes@bonsecours.ie

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ORTHOPAEDIC DEPARTMENT

Orthopaedic Surgery at Bon Secours The Orthopaedic Department at Bon Secours Hospital Glasnevin combines modern facilities with medical expertise and a traditional ethos of patientcentred care, explains Mr Aaron Glynn, Consultant Orthopaedic Surgeon

THE TEAM The Orthopaedic Department specialises in the evaluation and treatment of disorders of the bones, joints, ligaments, tendons, muscles and nerves. While my sub-specialty interest is hip and knee replacement, the team of expert consultants in the Orthopaedic Department have a variety of interests and specialty training, ensuring that we can provide a comprehensive service to meet the requirements of all orthopaedic patients.

There is a dedicated orthopaedic ward on site, staffed by a very experienced and compassionate team of nurses.

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The department also benefits from extensive medical back-up through a close collaboration with other departments’ medical consultants, and physiotherapists, to give a multi-disciplinary and comprehensive service and the best possible outcomes after surgery.

TECHNOLOGY The orthopaedic department at Bon Secours is at the forefront of modern orthopaedic medicine. Continuous advancements in technology and continued education among the hospital's consultants ensure that the staff of the department are leaders in their field.

In terms of technology, the orthopaedic department at the Bons is home to a digital templating system named TraumaCad, which works so as to eliminate errors in positioning calibration markers on patients.

Calibrating x-rays eliminates the effect of magnification and allows for accurate measurements to 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 osteomies and complex joint reconstruction.

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We want patients to be at the stage where they can return home safely after their operation, and whereas we provide all modern aspects of care, the emphasis remains on caring for the patient throughout their treatment.

Many people tend to worry about whether they will be covered by their medical insurance, but Bon Secours accepts all insurance policies, so patients can be put at ease and focus on their recovery. That is part of the traditional ethos that is central to what we do.

Pre-operative screening clinics for patients undergoing orthopaedic surgery occurs in a combined clinic with a consultant anaesthetist, joint replacement nurses and an orthopaedic surgeon, Pre-operative classes are held for patients due to undergo major joint replacement surgery. This gives patients an opportunity to understand their journey through the pre-operative stage, their admission to hospital and their post-operative care.

Patients are exposed to the aids that would be used to mobilise them post-surgery, in advance of attending the hospital for their surgery. They are also introduced to a range of exercises to promote their health prior to any upcoming surgery.

In addition to accurate pre-operative planning, orthopaedic patients at the Bons are availing of technology aimed at improving the accuracy of total knee replacements. MRI images of a patient's knee are used to create a customised cutting block that is then used in the subsequent surgery.

This 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 vital step in successful joint replacement surgery, and the high degree of accuracy of the systems employed by the Bons place it at the leading edge of orthopaedic surgery. A dedicated orthopaedic ward cares for inpatients recovering from procedures and the surgical

day ward for day patients. Excellent support from medical specialities are available, allowing the department to deal with the complexities of patients presenting for major orthopaedic surgery.

By continuing to expand and stay on top of the technology, the team at the Bons will continue to offer patients the best orthopaedic care available.

EXPERTISE However, while we employ the most up to date techniques and provide top of the range facilities, what is most important is our surgical expertise, and great care throughout for the patient. One big benefit of Bon Secours is the after-care treatment we provide.

We pride ourselves on our diligence and our patient-centred approach, and believe that a caring and supportive environment goes a long way to ensure patient satisfaction and peace of mind.

ETHOS OF CARE There is an ethos of focusing on patients who may need more after-care following an orthopaedic procedure, of focusing on the patient’s needs, their surgical care and after-care. Providing that excellent care in a relaxed and comfortable atmosphere is of most importance. Our department has a lot of experience in knee and hip replacements, the majority of which are in older patients who need more time with rehab, and we are mindful of this fact, and have the back-up support in place through our excellent medical staff.

SERVICES: HIP • Total hip arthroplasty – all types • Revision total hip arthroplasty • Soft tissue surgery KNEE • Total knee arthroplasty •P atient 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 corrective surgery •T reatment of paralytic disorders affecting the ankle and foot UPPER LIMB / SHOULDER • Rotator cuff repair • Shoulder stabilisation • Total shoulder replacement • Shoulder / elbow / wrist arthroscopy • Carpal tunnel release • Nerve decompression • Trapeziectomy

ORTHOPAEDIC CONSULTANTS •

Mr Aaron Glynn

•

Mr Philip Brady

•

Ms Olivia Flannery

•

Mr Darragh Hynes

•

Mr Patrick Kenny

•

Mr Peter Keogh

•

Mr James Walsh

•

Prof. Michael Stephens

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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.

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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,

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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,

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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.” qualifying with his fellowship in 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 and the team has since grown to seven since Mr Paul Sullivan joined the team in early 2019.

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 • Mr Paul Sullivan

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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.

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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 respiratory physicians refer

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patients for testing including, Prof Conor Burke, Prof Liam Cormican, Prof Gerry McElvaney, Prof Richard Costello, Prof Ross Morgan, Dr John Faul and Prof Pat Manning. The department is comprised of two labs: 1. Sleep Diagnostic Testing 2. Respiratory Diagnostic Testing SLEEP DIAGNOSTIC TESTING The Department's 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.

PULMONARY FUNCTION LAB The pulmonary department is responsible for testing the performance 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

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DEPARTMENT OF RESPIRATORY AND SLEEP MEDICINE

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 (completed in physio dept.)

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.

MEDICAL ASSESSMENT UNIT – RESPIRATORY PATIENTS Patients suffering from respiratory infections and illnesses can be admitted to the Medical Assessment Unit (MAU) with a GP referral for timely expert medical opinion, assessment and if needs be admission to the hospital. In addition to Cardiology, Gastroenterology, Haematology, Nephrology, Endocrine, Rheumatology and Neurology conditions, patients with the following respiratory issues are also admitted to the MAU: • Respiratory tract infections • Asthma / COPD • Shortness of breath • Pleuritic chest pain • Interstitial lung disease • PE The unit is headed up by Dr Geraldine Hosny and if patients are required

to be admitted they will normally be admitted under Prof Richard Costello or Prof Ross Morgan.

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 Outpatient apts: 01 808 2300 Email: dublinrespiratorybookings@ bonsecours.ie CONSULTANT LIST • Prof Conor Burke • Prof Liam Cormican • Prof Richard Costello • Dr John Faul • Prof Patrick Manning • Prof Gerry McElvaney • Prof Ross Morgan

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CORCORAN FOOD EQUIPMENT

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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 The Rheumatology team at the Bon Secours Hospital Dublin includes five consultant rheumatologists – Dr Maurice Barry, Dr Ruth Lee, Dr Paul O Connell, Dr Susan Sant and Dr Catherine Sullivan. Most of the consultants have regular clinics in the on-site Bon Secours Consultants Clinic where they see patients for consultation in their rooms while also providing inpatient care.

THE SERVICE The team of five consultant rheumatologists see a broad spectrum of rheumatoid conditions including inflammatory arthritis, osteoarthritis, osteoporosis and soft tissue rheumatic conditions such as tendinitis and fibromyalgia.

The vast majority of imaging investigative requirements are 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 • Dr Catherine Sullivan

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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. Prof Deborah Mc Namara, Consultant General and Colorectal Surgeon discusses.

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 three 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 postoperative 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 for a much shorter period of time.

PATIENT NUMBERS The variety of procedures and the expertise, skills and reputation of our surgical team means that 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 • Prof Deborah Mc Namara • Mr Martin O’Donohoe • Mr Kevin O’Malley • Mr Colm Power • Mr William Robb

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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.

U

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-ofthe-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 nine consultant urologists who collectively provide a complete and comprehensive urology service. Each of the urologists has a specific and complimentary area of interest. Mr Richard Power,

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

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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.”

URODYNAMICS 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 urine and empty steadily and completely.

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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.”

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

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

are reported on and feedback given to the referring GP. The urodynamics team is led by Clinical Nurse Specialist 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 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.”

Mr Denis O'Sullivan and Mr Ijaz Cheema also visit the Consultants Clinic in Cavan where they see patients from Cavan, Monaghan, Donegal and surrounding areas for outpatient consultations.

UROLOGY DEPARTMENT • Mr Tom Creagh • Mr James Forde • Mr Niall Davis (Commencing end 2019) • Mr Ijaz Cheema • Mr Hubert Gallagher • Mr Ponnusamy Mohan • Mr Denis O’Sullivan • Mr Richard Power • 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.

M

r Daragh Moneley, Consultant Vascular Surgeon, has been working at the Bon Secours Dublin for ten years. Prior to that, he completed a fellowship with the University Health Network in Toronto.

His role in the Bon Secours brings him into contact with patients experiencing a range of vascular issues that require ongoing management or intervention.

Mr Moneley and the Vascular Consultant team at Bon Secours treat 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. “About 80% of our work involves treating varicose veins, with the other 20% being on-ward consultation and some angiogram and angioplasty work,” Mr Moneley says.

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. The new form of surgery used at Bon Secours means that the majority of patients can be treated with minimally invasive techniques resulting in small, centimetre long scars. The procedure can be carried out with sedation, averting the need for general anaesthetic, and it can be done on a day-case basis.

“The preconceptions were that varicose vein treatment involved a painful

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VASCULAR SURGERY

procedure that took four to six weeks to recover from,” says Mr Moneley, “but with the new techniques we use, patients can expect to return to work and their normal lives within three to five days.”

The majority of patients seen by Mr Moneley and the rest of the Consultant Vascular team 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 in the legs, angioplasty and stenting.

The Bon Secours has 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.

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 Moneley’s colleague, Mr Peter Naughton attests: “We 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,” he says. “This allows patients to maximise the benefits of their treatment and it can increase the longevity of the treatment benefits over time.”

DEVELOPMENT INCL. NEW VASCULAR LAB. 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.

In early 2019, the Bon Secours opened a new vascular lab, which provides a full range of non-invasive arterial and venous testing using the latest ultrasound scanners, and helps to work up patients with suspected venous or arterial disease.

These include patients with varicose veins, TIA/stroke, abdominal aortic aneurysm or peripheral arterial disease.

All scans are reported on by one of the Consultant Vascular Surgeon team.

Patients with varicose veins, experiencing difficulty walking (to rule out

intermittent claudication), family history of AAA or patients with unexplained neurological testing can be referred to the dedicated clinic, either by their GP or one of the Consultant Vascular team. The scans are covered by all private health insurance companies (partially covered by Irish Life).

“Prior to the vascular lab opening, we would have had to have patients go to other healthcare facilities to have non-invasive scans and then come to see us,” Mr Moneley says, “but now with the lab on site, patients can have their scan in the morning and come to see us directly afterwards. It’s a one-stop shop that allows patients to have non-invasive imaging, followed by a consultant appointment, so they don’t have to attend on two separate days or to two separate buildings.”

Mr Moneley and Mr Naughton also visit the Consultants Clinic in Cavan regularly, where they see patients from Cavan, Monaghan, Donegal and surrounding areas for outpatient consultations. A Duplex ultrasound service is also provided in the Clinic,

Mr Moneley and Mr Naughton also visit the Consultants Clinic in Cavan regularly, where they see patients from Cavan, Monaghan, Donegal and surrounding areas for outpatient consultations. A Duplex ultrasound service is also provided in the Clinic, providing Mr Moneley and Mr Naughton with additional detailed information about patients’ veins prior to their consultation.

providing Mr Moneley and Mr Naughton with additional detailed information about patients’ veins prior to their consultation.

“Also having a vascular lab in the Cavan Clinic, which gives access to patients for same day scanning, is very beneficial,” Mr Moneley explains. “About 80% of what we do now is medical therapy, which means that the patient gets scanned, seen and treated in the same day, with followup scans done in the Bons as well.”

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.

“We are looking at a new device for treating varicose veins, called Venaseal,” Mr Moneley adds. “It is a procedure that has a shorter recovery time. There is less pain, return to work is quicker, post-op recovery is quicker – probably just an hour or so in hospital after the procedure, and again, that is a great benefit for our patients.”

VASACULAR SURGEONS • Mr Daragh Moneley • Mr Ciaran McDonnell • Mr Peter Naughton • Mr Martin O'Donohoe • Mr Kevin O’Malley • Mr Seamus McHugh • Mr Elrasheid Kheirelseid CONTACT DETAILS – VASCULAR LAB Outpatient Apts: 01 8082300

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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.

T

he Bon Secours Hospital Dublin has negotiated excellent health insurance coverage for patients with all of the health insurance providers. 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 health insurance plan are at a minimum. With new health insurance packages coming online regularly, our general recommendation is that all patients should check their plan on an annual basis to ensure that they are getting the best value for their fee, that it is the right plan for their needs, and also to ensure that they are covered for the Bon Secours Hospital Dublin.

The Bon Secours Hospital Dublin has developed an insurance policy checking tool which is available on our website www.bonsecours.ie/Dublin. This tool will give a quick indication as to whether a policy is covered in the hospital.

It is essential to reconfirm directly with your insurance company if a particular procedure (obtain the procedure code from your consultant’s secretary) is covered and also if there is a particular policy waiting period or other restrictions.

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.

If you have been referred to the Bon Secours Hospital for an outpatient test or procedure, the following will help you to ensure that you are covered in relation to the procedure: • Check the name / type of your plan • Check your policy number • Confirm the procedure name and code with your consultant's secretary

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Bon Secours Hospital Dublin insurance and self pay contacts General enquiries – 01 806 5300 Insurance Cover – 1890 50 40 30 Self Pay Prices: 01 806 5305

• Contact your insurance provider to make sure there are no exclusions under the terms and conditions of your policy • Call the hospital to confirm the details: Outpatient tests: 01 808 2300 Inpatient and day case procedures: 01 806 5305 SELF-PAYER OPTIONS FOR PATIENTS WITHOUT HEALTH INSURANCE For patients who may not have health insurance, there are also competitive selfpay options available for most procedures.

In order to check the price of a procedure, please ensure that you have the description and procedure code from your consultant's secretary and contact our credit control department on 01 806 5305. 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 01 806 5305

KEY INSURER DETAILS ESB MPF 061 430581, www.esbelectricmail.com Garda Medical Aid (01) 8991604, www.medicalaid.ie Irish Life Health 1890 714 444, www.irishlifehealth.ie Laya Healthcare 021 202 2000, 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 Total Health Cover www.totalhealthcover.ie

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HEALTH INSURANCE

GP Direct Referral Services (Correct at 1st November 2019)

Referrals can be sent via healthlink or to the individual email addresses as listed below CARDIOLOGY Appointments: Tel: 01 808 2300 / dublincardiologybookings@bonsecours.ie •Ambulatory Event Monitoring €50

DIAGNOSTIC IMAGING Appointments: Tel: 01 808 2300 / dublinradiologybookings@bonsecours.ie •CT Scans - 1 scan

• Ambulatory Blood Pressure Monitor €125 • ECG €40 • Echocardiography (Echo) €267* • Exercise Stress ECG €220 • Holter Monitor - 24 hour €170

- 48 Hour €210

- 3 day €250

- 5 day €295 • Pacemaker / ICD Follow-Up €40

• Syncope Clinic – TILT Test

€366*

INSURANCE COVERAGE: Echo – covered by all insurance companies except LAYA/ Irish Life– only cover the reporting fee Tilt Testing – Covered by all insurance companies – excluding GMA/POMAS All other cardiology tests are covered by POMAS except Device Check, Garda, ESB. Receipts must be submitted by patients directly to POMAS, Garda, ESB for reimbursement.

ENDOSCOPY (INCL. DIRECT ACCESS) Appointments: 01 806 5490/ dublindirectendoscopy@bonsecours.ie • OGD €810 • Colonoscopy €1250 • Both €1550 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.

- 2 scans - CT Colonography - CT Calcium Score - CT Cardiac

€390* €730 €487* €300 €490

• Dexa €110 • MRI €260 • Ultrasound €190 • Duplex/Doppler (Vascular Lab)

- Veins, Carotid, Aorta, ABI €200* • X-Ray €90 -€120

- Complete Spine €211 INSURANCE COVERAGE: CT – Covered by Irish Life Health, Vhi & Laya (CT Colonography only) CT Colon - Covered by Laya and Vhi MRI – Covered by Irish Life Health, Vhi (Consultant Referral) ABI / Duplex – Covered by all Private Hospital Plans excl. Irish Life Health covers Prof fees only Doppler / Ultrasound Scanning - Laya, Vhi – Full Cover, Irish Life (Professional fee only) Most tests covered by POMAS, Garda, ESB.

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

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

VASCULAR LAB Appointments: Tel: 01 8082300

• Initial Consultation €60 • Review Consultation €45

• Duplex/ Doppler

- Veins, AAA, Duplex, Carotid €200 INSURANCE COVERAGE - DIRECT PAY: Service covered by all insurance companies – Irish Life (Professional Fees only)

DIABETES CLINIC Appointments: Tel: 01 806 5488 / diabetesdublin@bonsecours.ie

CLINICAL NUTRITION & DIETETIC Appointments: Tel: 01 806 5488 / ioreilly@bonsecours.ie

• Dietician €75

- Review €26 • Diabetes Clinical Nurse Specialist Consult €75

- Review €42 • Educational Consult (Diabetes Nurse Specialist & Dietician) €110

• Initial consultation (35 – 45 minutes) • Review consultation (15 minutes) • IBS FODMAP (1st visit) • Follow up review

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

€75 €26 €75 €26

MEDICAL ASSESSMENT UNIT (MAU) INCL. CHEST PAIN PATHWAY Appointments: Tel: 01 806 5498 or 086 2098380 / dmau@bonsecours.ie Admitting Hours Monday – Friday 8am – 4pm Suitable Medical Conditions for referral include: Cardiology (incl. Chest Pain Pathway) • Stable acute coronary syndrome excl. of STEMI • Stable angina • Stable arrhythmias • Palpitations • CCF • Pericarditis and Myocarditis 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 Endocrine • Uncontrolled Diabetes • Thyroid Disease 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.

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ARMSTRONG MEDICAL

POINT® High Flow Oxygen support during bronchoscopy “POINT® has enabled the provision of more complex procedures under deep sedation.”

Dr Rachel O’Farrell is a Consultant Anaesthesiologist, working across a variety of clinical areas within the hospital setting. A proportion of her clinical practice involves the provision of deep sedation for patients requiring bronchoscopy. “The location of the endoscopy suite is classed as a remote, or satellite facility.

The provision of deep sedation in such satellite endoscopy units, remote from a suite of theatres, has been the subject of several British and Irish studies. All studies regarding such facilities indicate an increase in Serious Adverse Incidents (SAIs) comparative to procedures undertaken within a dedicated theatre suite”.

The bronchoscopy suite treats a specific cohort of patients, many with advanced chronic airway conditions, undergoing a fibreoptic bronchoscopy for optimal visualization of the affected airway. This procedure enables the clinician to perform bronchial lavage with or without an associated biopsy.

There are several potential problems associated with performing a bronchoscopy: • This patient cohort, by the nature of their underlying pathophysiology, is deemed high risk in relation to deep sedation and anaesthesia.

• Partial occlusion of the patients’ airway after introduction of the bronchoscope.

• Sharing of the airway with the operator, who is introducing the scope into the patient lungs, in conjunction with the introduction of fluid and saline as well as the suctioning of secretions, etc.

• A large percentage of patients undergoing bronchoscopy for investigation of breathing difficulties, have a high body mass inArmstrong Medical Wattstown Business Park, Newbridge Road, Coleraine, BT52 1BS, Northern Ireland

dex (BMI) and thus have a baseline higher metabolic oxygen requirement, secondary to their premorbid state. These patients have an increased propensity for a precipitous drop in oxygen saturations during deep sedation.

• All of these factors combined, deem the patient undergoing bronchoscopy to be at risk of developing persistent desaturations during the procedure, which has a significant clinical impact for the patient and results in intraprocedural delay.

“These patients benefit from heated and humidified High Flow Oxygen therapy. We use the Armstrong Medical POINT® (Peri-Operative Insufflatory Nasal Therapy) device. The POINT® device blends medical air and oxygen to provide High Flow via a specifically designed nasal cannula interface.”

“Since the introduction of the POINT® system, we have observed several benefits: • Increased quality and safety of procedural provision to patients undergoing bronchoscopy.

• Reduction in post-procedure complication rates such as hypoxaemia and/or altered haemodynamics.

• Patients identified as having a high body mass index have received a positive clinical impact in the delivery of clinical care.

• Improved recovery times post-procedure, ensuring that patients are returned to their receiving ward or department quicker.

• POINT® has enabled the provision of more complex procedures under deep sedation.”

T +44 (0) 28 7035 6029 T +44 (0) 28 7035 6875 info@armstrongmedical.net

armstrongmedical.net

MKTG_PO_PointBronch_Jun19_v1

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01/11/2019 27/06/2019 15:19 09:01

CONSULTANT DIRECTORY

Consultant Directory Consultant Name ALLERGY

Dr Ranbir Kaulsay

CARDIOLOGY

Dr Angela Brown Dr Susan Connolly Dr Brendan Doyle Dr Thomas Gumbrielle Dr Paul Keelan Prof Brendan McAdam Prof Richard Sheahan

DERMATOLOGY

Dr Sinead Collins Dr Callaghan Condon Dr Tony Egan Dr Lorraine Jennings

Dr Fiona Keane Dr Sandra Kirke Dr Siona Ni Raghallaigh Dr Brigid O’Connell Dr Nicholas Walsh

ENDOCRINOLOGY

Dr Margaret Griffin Dr Matilde Mijares Zamuner Dr Diarmuid Smith Prof Christopher Thompson

ENT SURGERY

Mr Mohamed Amin Mr Fergal Glynn Mr Michael Harney Mr Stephen Kieran Prof Rory McConn Walsh Prof Tadhg O Dwyer Prof James Paul O’Neill Mr Munish Shandilya Prof Michael Walsh Mr Peter Walshe

GASTROENTEROLOGY Dr Danny Cheriyan Prof Richard Farrell Prof Fergus Gleeson Prof Gavin Harewood Dr John (Jack) Hollingsworth Prof Padraic MacMathuna Prof Frank Murray Dr Conor O Brien Dr Aoibhlinn O Toole Prof Stephen Patchett Prof Barbara Ryan

Phone

Email

085 238 3373

rkaulsay@bonsecours.ie

087 900 4766 049 433 2697 01 806 5617 01 836 0332 041 983 0435 01 857 3721 01 6459537

abrownrooms@bonsecours.ie drsconnolly@bonsecour­s.ie (Cavan Clinic only) brendandoyle@mater.ie tgumbriellerooms@beaumont.ie pkeelanrooms@bonsecours.ie brendanmcadamrooms@beaumont.ie Post or via Healthlink

049 433 2697 01 288 0053 041 984 4489 087 353 5769

cavanclinic@bonsecours.ie (Cavan Clinic only) Post or via Healthlink teganrooms@bonsecours.ie ljenningsderm@bonsecours.ie

087 670 9533 01 645 9444 085 1013296 01 644 9696 01 206 4223

fkeanerooms@bonsecours.ie skirkerooms@bonsecours.ie snderm@bonsecours.ie

nwalshrooms@bonsecours.ie

087 753 1061 01 808 2315 01 857 2979 01 837 6532

mgriffinrooms@bonsecours.ie mzamunerrooms@bonsecours.ie drsmithrooms@beaumont.ie cthompsonrooms@beaumont.ie

01 899 7010 087 667 5847 01 486 5773 01 882 2622 01 206 4561 01 8307565 01 809 3738 051 319 859 01 288 4073 01 884 1255

maminrooms@bonsecours.ie fglynnrooms@bonsecours.ie mharney@bonsecours.ie Post or via Healthlink rmcconnwalsh@bonsecours.ie Post or via Health link jponeillrooms@bonsecours.ie mshandilyarooms@bonsecours.ie Post or via Healthlink pwalsherooms@bonsecours.ie

087 090 2439 01 646 6419 01 837 2721 01 837 5007 01 278 4363 01 830 0840 01 837 5155 01 676 3489 087 244 2116 01 837 7538 01 645 9605

dannycheriyan@bonsecours.ie rfarrellrooms@bonsecours.ie fgleesonrooms@bonsecours.ie gharewoodrooms@bonsecours.ie jhollingsworthrooms@bonsecours.ie pmacmathuna@mater.ie fmurrayrooms@bonsecours.ie cobrienrooms@bonsecours.ie aotoolerooms@bonsecours.ie spatchettrooms@bonsecours.ie Profbryanrooms@bonsecours.ie

Referrals can be sent via Healthlink or by secure email to all listed consultants using your healthmail email address.

If you need any assistance contacting any of our Consultant team, please contact Medical Liaison 01 8082340 Consultant with rooms in the Bon Secours Hospital Dublin.

Consultant with additional rooms in the Cavan Clinic

BON SECOURS HOSPITAL

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CONSULTANT DIRECTORY

Consultant Name

Phone

GASTROENTEROLOGY, cont.

Dr Subhasish Sengupta Dr Claire Smyth

041 983 3851 086 784 8442

GENERAL INTERNAL MEDICINE Dr Colette Barry Dr Geraldine Hosny (MAU)

GENERAL SURGERY Mr Mayilone Arumugasamy Prof Ann Brannigan Mr John Burke Mr Joe Deasy Prof Arnold Hill Prof Deborah Mc Namara Mr Eadhbhard Mulligan Mr Colm Power Mr William Robb

GYNAECOLOGY Dr Kushal Chummun Dr Yahya Kamal Dr Edgar Mocanu Dr Hassan Rajab

NEPHROLOGY Prof Peter Conlon

NEUROLOGY

Dr David Moorhouse

ONCOLOGY

Dr Oscar Breathnach Prof Liam Grogan Dr Patrick Morris

cobarry@bonsecours.ie dmau@bonsecours.ie

01 206 4539 01 885 8673 01 884 1244 01 836 9167 01 809 3760 01 857 4885 01 645 9650 087 233 8235 01 837 3646

marumugasamyrooms@bonsecours.ie abranniganrooms@bonsecours.ie jburkerooms@bonsecours.ie jdeasyrooms@beaumont.ie ahillrooms@bonsecours.ie dmcnamararooms@bonsecours.ie emulliganrooms@bonsecours.ie colmpowerrooms@beaumont.ie wrobbrooms@bonsecours.ie

01 874 2115 087 362 5010

kchummun@rotunda.ie ykamalrooms@bonsecours.ie

01 874 2115 01 836 7610

ORAL SURGERY Dr PJ Byrne Mr Gary Leonard Dr Marie O’Neill

ORTHOPAEDICS Mr Philip Brady Ms Olivia Flannery Mr Aaron Glynn

68

Consultant with rooms in the Bon Secours Hospital Dublin.

Consultant with additional rooms in the Cavan Clinic

emocanu@bonsecours.ie hrajabrooms@bonsecours.ie

01 837 9311

01 836 9043

dmoorhouse@bonsecours.ie

01 857 5880 01 837 7547 01 837 9299

obreathnach@bonsecours.ie lgroganrooms@bonsecours.ie pmorrisprivateclinic@bonsecours.ie

01 838 6733 085 208 2834 01 491 5722 01 832 0248 01 806 5625 01 806 5625 01 885 8622 01 885 8656

OPHTHALMOLOGY (MEDICAL) Dr Ashling Foley-Nolan Dr Sarah Gilmore

drssengupta@bonsecours.ie csmyth@bonsecours.ie

01 808 2335 01 806 5498

OPHTHALMIC SURGERY Ms Yvonne Delaney Mr Edward Dervan Ms Aoife Doyle Ms Susan FitzSimon Ms Claire Hartnett Ms Wee Fong Siah Ms Patricia Logan Ms Louise O’Toole

Email

eyedept@bonsecours.ie edervanrooms@bonsecours.ie eyedept@bonsecours.ie eyedept@bonsecours.ie eyedept@bonsecours.ie eyedept@bonsecours.ie eyedept@bonsecours.ie eyedept@bonsecours.ie

01 884 1288 01 969 5273

afoleynolanrooms@bonsecours.ie eyedept@bonsecours.ie

01 269 2442 01 668 8441 01 853 0744

moneill@bonsecours.ie

01 902 3040 01 645 9526 01 808 2315

pbrady@bonsecours.ie oliviaflannery@bonsecours.ie aglynnrooms@bonsecours.ie

BON SECOURS HOSPITAL

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CONSULTANT DIRECTORY

Consultant Name ORTHOPAEDICS, cont.

Mr Darragh Hynes Mr Patrick Kenny Mr Peter Keogh Prof Michael Stephens Mr James Walsh

PAIN MANAGEMENT Dr Joseph Keaveny Dr David Moore Dr Valerie Pollard

Phone

Email

01 830 0797 01 645 9585 01 645 9586 01 838 1406 087 436 8920

dhynes@mater.ie Post or via Healthlink Post or via Healthlink Post or via Healthlink jwalshrooms@bonsecours.ie

01 526 2260 087 669 4048 01 857 6939

jkeavneyrooms@bonsecours.ie dmoorerooms@bonsecours.ie valeriepollardbpc@beaumont.ie

Consultant with rooms in the Bon Secours Hospital Dublin.

Consultant with additional rooms in the Cavan Clinic

PALLIATIVE CARE PHYSICIAN Dr Liam O’Siorain

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

01 885 8888

01 645 9621 01 857 1384 01 206 4419 087 930 2973 087 277 3116 01 219 6050 086 6004388

RESPIRATORY PHYSICIAN Prof Conor Burke Prof Liam Cormican Prof Richard Costello Dr John Faul Prof Patrick Manning Dr Gerry Mc Elvaney Prof Ross Morgan

RHEUMATOLOGY Dr Maurice Barry Dr Ruth Lee Dr Paul O’Connell Dr Susan Sant Dr Catherine Sullivan

UROLOGY

Mr Ijaz Cheema Mr Tom Creagh Mr Niall Davis Mr James Forde Mr Hubert Gallagher Mr Ponnusamy Mohan Mr Denis O Sullivan Mr Richard Power Mr Gordon Smyth

VASCULAR SURGERY Mr Elrasheid Kheirelseid Prof Ciaran McDonnell Mr Seamus McHugh Mr Daragh Moneley Mr Peter Naughton Prof Martin O Donohoe

najmal@bonsecours.ie bkneafseyrooms@bonsecours.ie Post or via Healthlink bosullivanrooms@bonsecours.ie aryanrooms@bonsecours.ie paulsullivanplastics@bonsecours.ie

01 837 1440 01 645 9540 01 8093762 056 777 5280 01 837 2721 01 809 3764 01 851 1938

cburkerooms@bonsecours.ie lcormicanrooms@bonsecours.ie rcostellorooms@bonsecours.ie jfaulrooms@bonsecours.ie pmanningrooms@bonsecours.ie gmcelvaneyrooms@bonsecours.ie rmorganrooms@bonsecours.ie

01 837 3372 087 900 5451 01 837 6381 01 213 5632 083 898 0054

mbarrryrooms@bonsecours.ie rleerooms@bonsecours.ie poconnellrooms@bonsecours.ie ssantrooms@bonsecours.ie csullivanrooms@bonsecours.ie

01 645 9459 01 837 9350 01 8065656 01 806 5621 01 289 8834 087 434 4264 01 645 9690 01 806 5609 01 806 5622

lcheema@bonsecours.ie tcreaghrooms@bonsecours.ie nialldavisurology@bonsecours.ie jamesforde@bonsecours.ie hgallagherrooms@bonsecours.ie pmohanrooms@bonsecours.ie dosullivanurology@bonsecours.ie richardpowerurology@bonsecours.ie gordonsmythurology@bonsecours.ie

01 808 2340 01 830 8241 01 808 2362 087 615 3372 01 809 3816 01 860 0190

EKheirelseid@bonsecours.ie cmcdonnellrooms@bonsecours.ie smchughrooms@bonsecours.ie dmoneleyrooms@bonsecours.ie pnaughtonrooms@bonsecours.ie modonohoe@bonsecours.ie

BON SECOURS HOSPITAL

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SHANOWEN FILES LTD PRINT & DESIGN

HEALTHCARE PRINT SPECIALISTS • Clinical notes / Continuation sheets • Consent forms / Casenotes • Pre-admission forms and Admission notes • Surgery booklets • Therapy forms • Risk assessment booklets • Prescription pads • History sheets

• Mount sheets • Laboratory forms/specimen bags • Medication kardex • Patient charts • Drug controlled books • Theatre request forms • Letterheads

Units 9 & 10, Shanowen House, Units 9 & 10, Shanowen House, Shanowen Road, Santry, Dublin 9 Shanowen Road, Santry, Dublin 9 Tel: 842 3168, Fax: 842 3182 Tel: 842 3168, Fax: 842 3182 info@shanowenfiles.ie info@shanowenfiles.ie www.shanowenfiles.ie www.printwise.ie www.shanowenfiles.ie www.printwise.ie

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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@dublin.bonsecours.ie 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 case, 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.

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

Ask your pharmacist for a printout of all your medicines or bring in all of the prescriptions your doctor has written for you.

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.

INSURANCE The Bon Secours has arranged insurance cover with the following insurers: • ESB/GMA and POMAS • Irish Life Health • Laya • Vhi

MEDICINES Please bring all your medicines with you and do not put different medicines together in the same container.

BON SECOURS HOSPITAL

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PATIENT INFO / ACCESS TO SERVICES

For security purposes, the hospital gates close each evening at 22:30.

SHOP The hospital shop is located on the ground floor, opposite the lift.

A range of newspapers, magazines, 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.

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 To check if your insurance policy covers you in the Bon Secours Hospital Dublin an insurance policy checking tool is available on our website www. bonsecours.ie/Dublin. This tool will give a quick indication as to whether a policy is covered in the hospital.

Before admission you will need to check directly with your insurance company to ensure 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 admission.

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. Parking can be paid for by cash or card – a change machine is located just inside the main door should you require change.

72

THE RESTAURANT The hospital restaurant is located on the ground 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 first 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.

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.

Mobile:

086 209 8380

Oncology:

(01) 806 5409

GP Liaison Exec.

Lorette Jackson

085 871 7128

GP Liaison and Outpatient Booking Dept:

(01) 808 2300

Fax:

(01) 808 2309

Phlebotomy:

(01) 806 5347

Physiotherapy:

(01) 806 5339

Respiratory & Sleep Medicine:

(01) 806 5479

Vascular Lab

(01) 806 5629

Urodynamics:

(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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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 Bon Secours group of hospitals today and in the future.

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