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amelioration or refinement of existing
processes. In relation to trainee number
alignment, the College's strategic
initiatives within the new pathway will
be fully informed by the outputs of the
medical manpower planning review
being developed at HSE-MET, under
the direction of its National Programme
Director, Professor Eilis Mcgovern. With
the continued implementation of the
pathway programme, real opportunities
are being created to increase the
intensity of training, sharpen the focus
on competency-based programmes
and optimise the sophistication and
effectiveness of assessment tools.
As we look forward confidently to the
challenges that will face the pathway in
the future, on behalf of Surgical Affairs, I
would like to gratefully acknowledge the
efforts of all those who helped
in making the initial concept
of a Surgical Training Pathway
an effective, functioning and
successful reality. In particular, I
want to thank the outgoing RCSI
President, Professor Patrick Broe
who supported the development
of a blueprint for a new pathway
from the beginning; Professor
Oscar Traynor, Professor of
Postgraduate Surgical Education
for his sustained commitment
through each phase in the
development of the pathway;
and all of our specialties for their
support in getting us to this point
of the journey.
Surgical Bootcamp
The new intake of surgical trainees
in the College began the first `Surgical
Bootcamp' programme in July 2013.
The intensive 40-hour course is now
mandatory for all new surgical trainees
and was created to immediately immerse
surgical trainees in the technical and
non-technical skills needed as a surgeon.
The `Surgical Bootcamp' programme
was developed by the College based
on feedback from consultant surgeons
and surgical trainees and is designed to
better prepare trainees for their early
clinical rotations in surgical training.
Key features of the programme include
simulation-rich training methods, skilled
faculty, human factors training, surgical
techniques, suturing, risk management
and critical care.
Surgical Practice
In the face of unprecedented challenges
to our service delivery model, the
advancement of RCSI's leadership role in
surgical practice remains a priority for RCSI
and Surgical Affairs. Under the leadership
of Professor Sean Tierney, Surgical Affairs
aims to engage with and support both our
Fellows and Members as well as service
and regulatory stakeholders to enhance
the delivery of patient care for Irish surgical
patients.
National Surgery Programme
RCSI continues to play a fundamental role
in shaping the model for surgery provision
in Ireland, in particular, through the work
and dedication of Professor Frank Keane
and Mr Ken Mealy, Joint Leads of the
National Clinical Programme in Surgery
(NCPS), a collaborative initiative between
the HSE's Clinical Strategy and Programmes
Directorate and RCSI. The Directorate,
under the leadership of Dr Aine Carroll, has
played an important role in providing the
impetus for change that has facilitated the
effectiveness of the NCPS and its work.
In July 2013, the Model of Care for Acute
Surgery developed by the NCPS was
launched in RCSI by the then Minister for
Health, Dr James Reilly. Conceived with
the objective of addressing circumstances
whereby up to 60 per cent of the work
undertaken in many surgical departments
is with patients requiring acute surgical
care. This landmark initiative follows on the
publication in 2011 by the NCPS of the
Model of Care For Elective Surgery.
The Model of Care for Acute Surgery
emphasises the importance of separating
the streams and activities of acute and
elective surgery and aims to address the
important issues underpinning successful
management of the acute surgical patient.
Continuing to support critical process
initiatives to drive shorter lengths of stay,
day of surgery admission and operating
room efficiency, the NCSP has delivered
enormous benefit to both the HSE and the
patients it serves.
Under the leadership of Professor Keane
and Mr Mealy, the NCPS has been met with
broad-based acceptance and a genuine
commitment to its underlying principles.
National Office of Clinical Audit
Over the last number of years, RCSI's work,
in conjunction with the HSE's Quality &
Patient Safety Directorate, has supported
the establishment of the National Office
of Clinical Audit (NOCA). The continued
support of Dr Philip Crowley, Director of
HSE Quality and Patient Safety
combined with the determination of
Mr Ken Mealy, long-time advocate
of clinical audit and patient safety,
has enabled RCSI to lead the way
in establishing governance and
framework structures to deliver on
national audit programmes across
multiple specialties.
The NOCA Executive Team,
who are based on campus, work
directly with hospitals and clinical
leads in the scoping, design,
implementation and longer term
monitoring and governance of
audit output.
Since convening in September
2012, the NOCA governance
Board, chaired by Professor Patrick
Broe, President, RCSI, has been overseeing
the design, delivery and governance
of several audit streams, including the
Irish Audit of Surgical Mortality, the
Irish National Orthopaedic Register, the
National ICU Audit linked to ICNARC
(Intensive Care National Audit and Research
Centre) UK, the Irish Hip Fracture Database
and a Major Trauma Audit, which is now
collecting data and monitoring output in
22 of 27 trauma receiving hospitals using
the methodologies and reporting structures
of TARN (Trauma Audit and Research
Network) UK. More recently NOCA have
taken on the delivery and governance of
a Comparative Audit of Hospital Mortality
which will allow hospitals to monitor their
own mortality rates across all specialties.
25
SURgICAL AFFAIRS
surgical training in
ireland enjoys a global
reputation based upon
a proud tradition of
producing generations of
leaders in surgery around
the world.