Acute Program The Acute Program is the largest program at St Vincent’s Hospital with strategic and operational responsibility for the Emergency Department, Perioperative Services, Medical/Surgical and Anaesthetic Services, Intensive Care and High Dependency Units, Acute Wards, Interventional Services, Day Procedure Centre, Renal Services, Trauma Services and Medical Surgical Transit Unit. Emergency Department A major centre of activity, throughout 2010/2011 the Emergency Department treated an increased number of patients from a multitude of Sydney events. Continuing to engage with the community, in 2010/2011 the department continued its services to the City2Surf, providing a multidisciplinary team to treat participants at Bondi Pavilion at the conclusion of the run. In 2011 the department received its first final year medical student from the University of Notre Dame. Having always had a strong commitment to teaching, early feedback has been exceptionally positive. The department also takes students from the University of NSW and overseas elective medical students. Medical staff and nursing staff have generously given training and supervision, which has led to a significant number of students choosing St Vincent’s as a preferred choice for internship in 2012. The department remains heavily supported by the generosity of SIRENS. Intensive Care Unit The Intensive Care Unit (ICU) treats acutely-ill patients with general, neuro, trauma and cardiothoracic complaints as well as being the sole provider of heart lung transplantation in NSW. The ICU is extremely busy with close to 100 percent occupancy (97 percent) most of the time. Currently 17.5 of the 20 acute available beds are funded. These are now being flexed to accommodate High Dependency Unit patients at various ratios, depending on demand and availability. 2010/2011 was a very busy year with 1,419 admissions to the ICU, with an average length of stay of 100.5 hours and long-stay patients averaging 16.4 days per month. Some 65 percent of admitted patients were male and patients had an average age of 59 years. Almost half the department’s admissions were
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emergency admissions and almost two thirds of admissions came to ICU via theatre. As a NSW state referral centre for Extracorporeal Membrane Oxygenation (ECMO), the ICU provides approximately 37 episodes of ECMO support each year. There are approximately 65 heart and/or lung transplants each year and following introduction of the total artificial heart device in 2010, four patients have now been implanted with the device. Education has been provided to all ICU ECMO accredited nurses and doctors for the implementation of the new Cardiohelp ECMO console, which should assist patient transfer and retrievals from other centres and ongoing management. Extracorporeal Membrane Oxygenation workshops are conducted twice a year and are well attended by ICU clinicians from NSW and beyond. The use of Citrate to provide regional anti coagulation of CRRT circuits has exposed patients to less changes of dialysis circuits. Working groups have focussed upon medication safety in ICU, handover, communication, hand hygiene and occupational health and safety. The postgraduate ICU course continues to contribute strongly to the success of students and development of advanced practice ICU nurses and the ICU is involved in a number of Australia-wide ICU trials. Interventional Services Providing a patient focussed model of care, Interventional Services comprises Interventional Radiology and Procedure Suites including Endoscopy, Day Procedure Centre and the Medical Surgical Transit Unit (MSTU). Interventional Services continues to undertake innovative practices under the direction of the Acute Program in close liaison with gastroenterologists, radiologists and researchers. Patient flow has improved and bed block decreased in the hospital following inclusion in the department of the MSTU in 2010, which facilitated the movement of medical and surgical patients from the Emergency Department to theatre.
Medical Sub-Specialities Gastroenterology The Gastroenterology Department offers a comprehensive
gastroenterology and hepatology clinical service, which delivers therapeutic endoscopy, endoscopic ultrasound and capsule endoscopy. The department also services outpatient clinics for patients with gastroenterology complaints, inflammatory bowel disease (IBD) and viral hepatitis. Among the highlights for 2010/2011 was establishment of a new dedicated IBD service, which incorporates the appointment of a care coordinator, multidisciplinary clinics and participation in multi-centre clinical research. There was also the establishment of a study examining screening of patients at high risk of developing pancreatic cancer. The study is supported by a grant from Cancer Institute NSW in collaboration with the Australian Pancreas Cancer Genomic Initiative. There was an upgrade to endoscopic ultrasound (EUS) equipment to enable new techniques, such as EUS-guided pancreaticobiliary access and contrast enhanced harmonic EUS. Neurosciences Committed to the diagnosis and treatment of brain, nervous system and neuromuscular disorders, the Department of Neuroscience amalgamates neurology and neurosurgery. The department provides a comprehensive inpatient as well as an outpatient diagnostic electrophysiological service for neuromuscular and cerebral diseases. It operates a leading Stroke Unit which specialises in clot-dissolving therapy as well as outreach services at Wollongong and Nowra. In addition, the department acts as a consultative service for the MS Society. Sub-specialty expertise are in stroke, dementia, multiple sclerosis, movement disorders, Parkinson’s disease, neuro oncology, myasthenia gravis, myopathies and neurological complications of immune deficiency. All fields of complex neurosurgical practice are undertaken with expertise in pituitary surgery, spinal surgery, functional stereotaxy and skull base surgery. The department continues to actively engage with the National Health and Medical Research Council to attract funding and performs numerous clinical trials in the specialty of neurology.