A Message From Nepal - Dr Richard Lyon & UKISAR

It feels a long time ago now since we left the UK and the 4-hours per night sleep is definitely catching up! As the rescue mission is now over, the focus is switching to the massive humanitarian efforts that will be needed.

We have been using helicopters to access remote villages, some now completely cut off from the outside world by landslides. When we land, we can be overwhelmed by villagers as the first rescue teams they've seen.

The breathtaking natural beauty of the Himalayas is awe inspiring from the air but the overwhelming, destructive power of mother nature seen on the ground. We were forced to land in the middle of a landslide today and trek to the village. The resilience, friendship and tenacity of the Nepalis is staggering - they smile in the face of disaster and offer us food they don't have. In a village of 2,000 people today, every single house was flattened. 4 shepherds had vanished when half the mountain slid, entombing them in earth.

We completed detailed UN Health Assessments and carved a helipad into the hillside to allow vital follow-up relief air drops. With our limited kit, we treated the injuries we could, calling in an extra flight to medevac a 4-year old girl with femoral fracture, taking her directly to the Israeli Field Hospital. Paediatric care is in high demand and have been asked to help out with several critical operative procedures in remote mountain medical tents.

We had short, but wonderful, moment of laughter and smiles at my pathetic attempts to give instructions in Nepalese on how to take paracetamol! I don't think I'll be speaking Nepali anytime soon!

Hopefully we'll be getting back to the UK later this week. Thanks so much for all the messages - much appreciated and looking forward to catching up soon,

Dr Richard Lyon

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Richard is an Emergency Medicine consultant from Edinburgh and is part of UK International Search & Rescue Team (ISAR) of 67 firemen, rescue experts, dog handlers, engineers and medics. His role as an ISAR team doctor is to provide full medical support to our team, provide emergency care for rescued casualties and assist with humanitarian care.

RIE Emergency Department Kaizen update

Andy Currie posts the update of our Kaizen workstreams:

I.  One Patient Pathway

The One Patient Pathway is progressing well and we plan to run a trial day of the new process on the 4th Feb (there has been a delay in this due to the delay in changing the front door access to the Department). This will be followed by a full weeks trial-  WC 10th Feb. Our plan is to learn and adapt, where needed, the process as a result of this testing ahead of a projected go-live date of 17th March.

2. Management system

The escalation loop and performance charts will be piloted at the same time and amended where needed. Meantime you should be aware of the new “ED Huddle” which takes place daily at 8.45am every day – each role from the Department is represented and it’s an opportunity to understand exactly how the Department is performing, any shortfalls in staffing levels, issues within the hospital etc. – your team leader should then be feeding back to you all, so that the full department has sight of this info on a daily basis.

3. Recognition

We have introduced a new “recognition” system which is a direct result of the staff survey. A lot of feedback was received concerning the lack of recognition for a job well done, so this new process will allow feedback from your peers and from your patients. You should see a “Have your say” box in the staff room. There are nomination forms for recognising a colleague who has gone above and beyond their normal duties as well as forms for patients who may want to thank a specific member of the team. I have attached a flyer to this newsletter with further details, can I encourage you all to consider filling one of these in for someone you would like to recognise?

4. Communication

We are working on producing a weekly news bulletin that will come out hardcopy and by e mail that will be used to summarise any communication relevant to the department over the previous week. It will contain only the top-line info and will signpost you to further details as  well as say how long it will take to read and its importance level, so you can judge what’s relevant to yourself in your role.

5. Road-show

We are planning a road-show WC 3rd March where you will all be invited to attend a working lunch (similar to the one done when care rounding was introduced) to hear from the project team first hand on the changes we have developed and what it will mean for you. We are also keen to hear your feedback on making this a continuous improvement cycle.