ICM Unit Brief Part 1 Hospital Details 1.1 Hospital name Queen Elizabeth Hospital Birmingham (University Hospitals Birmingham) 1.2 Full address (you must include postcode) 1.3 Hospital Telephone number Mindelsohn Way Edgbaston Birmingham West Midlands B15 2WB 01213713000 Part 2 ICU Department contact details 2.1 Direct telephone number to Department 01213712780 2.2 Faculty Tutor name 2.3 Faculty Tutor Email address Tomasz Torlinski tomasz.torlinski@uhb.nhs.uk Part 3 Unit Structure 3.1 Number of Beds 3.2 Number of admissions 63 Level 3 equivalents, up to 82 physical beds 5546 3.3 Percentage of elective vs emergency admissions Emergencies 20-25% total admissions Page 1 (of 4)
3.4 Overview of case mix within the unit Approximately 80 beds in a one-floor unit divided into 4 areas (A-D). Area A houses elective and emergency liver medicine and surgery patients including liver transplants (about 200/yr), and is a tertiary referral centre for liver medicine including acute liver failure, liver surgery and transplant 3.4 patients; Details also of training accepts opportunities upper GI elective, on the surgical unit and medical emergencies. Area B accepts trauma (hospital is a busy major trauma centre), burns (tertiary referral centre), general medical critically ill patients and a few elective major plastics, maxillofacial and ENT patients. This area also takes all seriously injured soldiers for the RCDM from international war zones. Area C comprises of elective neurosurgical and accepts patients for neurosurgical management from around the region. It also houses emergency and elective general surgical patients, multiple trauma and neurological critically ill patients Area D is the cardiothoracic area mainly comprising of post-operative elective cardiac surgery, but is also a tertiary referral unit for emergency cardiac surgical patients such a dissecting thoracic aneurysms and is a heart and lung transplant unit accepting patients for heart or heart-lung transplant, as well as patients who need ventricular assist devices or ECMO for acute heart failure. It also accepts general critically ill patients. 3.5 Names of Consultants, roles and areas of interest Name Julian Bion (Prof) Role (eg clinical lead, consultant) Past Dean FICM, professor of ICM Areas of Interest health services research and service organization & delivery Nick Murphy Consultant Liver critical care, research Tony Whitehouse Consultant Research, liver critical care Catherine Snelson Consultant, CSL in Intensive Care Medicine Liver, rehabilitation, research Nandan Gautam Consultant Ultrasound, teaching, simulation Nilesh Parekh Consultant Education Sid Khan Consultant Teaching; Liver Critical Care Kaye England Consultant, Audit Lead Burns CC, trauma Sue Sinclair Consultant Ethics, trauma Laura Tasker Consultant Teaching, trauma Steffen Kroll Consultant trauma, neuro- critical care, burns, Organ donation Tomasz Torlinski Consultant, Teaching, Burns and trauma Alex Barrios Consultant, Education Trauma, TOE Lead in Cardiac CC Bill Tunnicliffe Consultant Advanced Ventilation, Research Mav Manji Consultant Renal, Fluids Page 2 (of 4)
Peter Isherwood Consultant Human Factors In Healthcare, LPV, FICE Mentor Neil Abeysinghe Consultant Trauma, pre-hospital care, neuro Brian Pouchet Consultant, TPD HEE WM Liver, surgical CC, teaching Mike Knowles Consultant, Workforce Neuro CC lead Tom Gallacher Consultant, Head of Education, Neuro CC Postgraduate Medical Education (UHB), Chair of Training Assessment and Quality Committee (FICM) Sandeep Walia Consultant Neuro CC Andy Johnston Consultant Military trauma, Resp. disease Deborah Turfrey Consultant Cardiac CC, End- of-life care, teaching Mark Wilkes Consultant Cardiac CC Tessa Oelofse Consultant, CSL in Cardiac CC, TOE Cardiac Critical Care David Riddington Consultant Cardiac CC, Risk management Randeep Mullhi Consultant Burns, Trauma, Vascular, Education Tonny Veenith Consultant Neuro critical care, Neuro sciences Research, Multi Modal monitoring of the brain Anwar Shah Consultant Cardiac CC, TOE David Balthazor Consultant Trauma, ECHO, prehospital care Ravi Heballi Consultant Cardiac, ECHO, TOE, teaching Tom Clutton-Brock Consultant Education, e-learning, simulation, extracorporeal systems Jeremy Willson Consultant, CSL in Anaesthesia Cardiac CC, Information technology Ian Ewington Consultant Trauma, Military trauma, transfer medicine Mansoor Bangash Consultant Liver and research Carla Richardson Consultant ECMO, severe respiratory/cardiac failure, trauma Abby Ford Consultant, Clinical Governance Lead Liver, quality improvement, clinical Page 3 (of 4)
governance John Kelly Consultant Cardiac CC, TOE, research Cyril Chacko Consultant ECMO, Cardiac CC, Echocardiography Mario Cibelli Consultant Cardiac, ECHO, TOE, teaching. Harjot Singh Consultant Blood conservation, haemodynamic monitoring, organ transplantation and assisted circulation. Jaimin Patel Consultant and Clinician Scientist, UoB 3.6 Details of research projects being undertaken within the unit Sepsis, ARDS, Liver Critical Care, Major Trauma, Research The ITU is the lead centre for STRESS-L, a study of beta blockade in septic shock. It also participates in several portfolio studies including REST, EVADE, PEARL, Pandemic Flu, HISLAC. We are one of the largest critical units in the UK using multimodality monitoring of the brain to understand the mechanisms of neuronal loss and impact of neuro-therapeutical options. We currently have 1 research registrars, 8 research nurses. There are a number of grant applications for projects in progress. Interests amongst our research group include sepsis, ARDS, ventilation, ALF and liver transplantation rehabilitation and neuro-imaging. We have been significant recruiters to many national and international trials, and there are opportunities for trainees to undertake postgraduate research in order to develop an interest in aspects of ICU; it is possible for this to lead to masters or PhD programmes in conjunction with the University of Birmingham. We have close working relationship with the SRMRC and University of Birmingham for above mentioned projects. 3.7 How is the unit staffed The Critical Care is subdivided into 4 Areas. Each of them staffed with 2 consultants during day time with total of 3 consultants out of hours covering the on call activities. Across the floor the minimal staffing on junior doctors level is: 2 FY/CT, and 5 ST, with 2 ACCPs on the long day rota and additional 1 FY/CT on twilight shift. On most of the days, although rarely on the weekends, the minimal staffing levels are significantly exceeded. Page 4 (of 4)
Part 4 Training 4.1 Details of training opportunities on the unit The hospital offers all adult specialities, so there is very wide range of patients to manage. As the largest solid organ transplant hospital in Europe there is ample opportunity to learn about transplant medicine, liver medicine, cardiology, renal medicine and burns. As a major trauma centre and a burns centre, trainees regularly manage trauma under consultant supervision, attend trauma calls in the A&E, and look after soldiers with injuries not seen elsewhere in the UK. There are opportunities to visit theatres and see transplants; use skills learnt to manage complex critically ill patients; in-house teaching on general critical care topics and speciality topics such as advanced cardiac support, advanced ventilation techniques and management of major trauma and head injuries, burns, blast lung and related topics. There are many opportunities to gain and consolidate skills in resuscitation, stabilization, team working, team-leading, communication with teams, relatives and patients, and end-of-life care and organ donation. There are also opportunities to take part in research (active research department), simulation, teaching, management and quality improvement projects. 4.2 Details of departmental teaching 4.3 Details of clinical governance meetings days and / or M & M Daily formal teaching inclusive of Mondays Critical Care Seminar Tuesdays Journal Club Friday Cardiac Teaching 2 nd Wed /month regional ICM teaching hosted at our hospital Audits presented on Monday teaching sessions Every Thursday M& M meeting Ad hoc Medically challenging cases series 4.4 Number of trainees on each tier of the rota Across the floor 8 tiers of junior doctors rota in Critical Care are run. Each of the tiers is staffed 1:8 Page 5 (of 4)