Review of Department of Anaesthesia The Academic Quality Assurance Programme 2002-2003

An Coiste Feabhais Acadúil
The Committee on Academic Quality Improvement
The Academic Quality Assurance Programme 2002-2003
Report to Údarás na hOllscoile
Review of
Department of Anaesthesia
Self Assessment
Review Group Visit
Follow Up Meeting
Sept 2002 to Jan 2003
11–13 February, 2003
15 July 2003
This Report was compiled for members of Údarás na hOllscoile, NUI Galway and its
committees as a readily accessible but comprehensive source of information on the above
review, its context and its outcomes.
Professor Jim Gosling, Director of Quality, March 2004
Report to Údarás – Review of Department of Anaesthesia 2003
1. Overview of Department
1.1 Aims of the Department
1. To promote the delivery of patient care of the highest quality in all areas of clinical
activity. Specific areas of clinical focus include the delivery of safe, high quality
analgesia, anaesthesia and organ support to patients undergoing surgical procedures,
including labour and delivery; the provision of safe and effective relief to sufferers from
acute and chronic pain; the provision of effective life support and resuscitation measures
to patients with life threatening critical illness; and the provision of an immediate and
effective response to patients suffering in hospital medical emergencies.
2. To deliver the highest standards of teaching of the scientific principles and clinical
practice of Anaesthesia, Intensive Care Medicine, Acute and Chronic Pain Medicine,
and resuscitation of the critically ill to our undergraduate medical students, our
postgraduate trainees in anaesthesia, and to trainees in nursing and the allied health
3. To promote a culture which fosters the development of clinical and basic scientific
research of the highest quality; to develop the research skills and knowledge base of our
students; to develop sustainable, externally funded research programmes; and to
disseminate this research in high impact peer-reviewed journals.
1.2 Background
The Professor of Anaesthesia retired in May 2001 and as of the time of the review visit no firm
decision had been made to refill this post.
1.3 Programmes currently contributed to
Postgraduate Diploma in Periopeartive Nursing
Postgraduate Diploma in Intensive Care Nursing
Postgraduate Diploma in Emergency Nursing
MSc in Anaesthesia (to commence in 2003-04)
1.4 Student and staff numbers
The Department is not credited with FTE staff or students, rather they are pooled with the
Department of surgery total. Four of the consultant anaesthetists at University college Hospital
are clinical lecturers. No administrative or technical staff are supported by the University.
1.5 Costs
The Department is not a University cost centre, but is seen as part of the Department of Surgery.
1.7 Accommodation and facilities
The Department is located in the University College Hospital Galway.
Report to Údarás – Review of Department of Anaesthesia 2003
2. Review Group Visit and Report
This report arises from a visit by a review team to the Department of Anaesthesia on the 11th13th February, 2003. The Department had already prepared and submitted a 'Self Assessment
Report' that, with other documentation, was made available to the review team well in advance
of the visit.
Four Departments were reviewed during the visit: Anaesthesia, Otorhinolaryngology,
Ophthalmology and Radiology. A number of generic issues pertaining to all were identified and
are also discussed in this report.
The review team consisted of: Professor Brian Kavanagh, Dept. of Critical Care
Medicine, Hospital for Sick Children, Toronto (Chairperson); Professor Helen Carty,
Department of Radiology, Royal Liverpool Children’s Hospital; Professor John Reynolds, Head
of Department of Surgery, Trinity College Dublin, and Dr. Geraldine Gaffney, Department of
Obstetrics & Gynaecology, NUI, Galway; and Dr.Iain MacLabhrainn of the CFA acting as
2.1 Summary, and Main Recommendations from Report
The Department of Anaesthesia, one of the largest in the faculty, presented a detailed and
comprehensive report about their activities. The Department has critical mass with respect to
teaching, and is well led, organised and enthusiastic, with a clear academic vision. There has
been no University Professor within the Department for two years, and filling the Chair will
give considerable momentum to the research vision and potential of the Department. The
following is a summary of the recommendations of the review group:
Undergraduate Teaching
Students are demanding more contact time with Anaesthesia and this should be supported. A
longer module within Anaesthesia is best complimented by formal assessment and linkage to
University support with a clear and distinct pay and non-pay budget.
Curriculum Reform
The Professor or Head of Department, or designate, should represent the group on the
Curriculum Committee. Key strategic priorities may be the development of a Clinical Skills
Laboratory, and vertical integration with pre-clinical sciences, in particular, Physiology.
Professorial Appointment
This should be a full Chair (6:5) with a principal commitment to the development of the
research and teaching strategy. Administrative support is essential and expansion of office and
laboratory space within the Clinical Sciences Institute will be required.
The review panel recommended the appointment of a university-funded clinical tutor, as is the
case with the Departments of ENT and Ophthalmology.
Relationship with Department of Surgery
The relationship between the Department and the option for its further development either
alone, in its existing relationship with Surgery, or in a new Department or Division such as
Medicine, was discussed. This was considered to be outside the remit of this review, but the
general consensus is that the long-term strategy should be to establish an independent academic
Department developed through expanded curriculum time, research and scholarship.
The current arrangement within the Department of Surgery could be enhanced through a
defined involvement in the curriculum and assessment. The likely appointment of the new
Chair in Surgery within the next year presents opportunities to establish a new arrangement.
There is a clear potential to establish this Department as a leading academic research centre.
Report to Údarás – Review of Department of Anaesthesia 2003
The academic talent, drive, strategy and vision already exists within the Department and
it would be anticipated that the new Chair will have a major commitment to realise the
considerable research potential of the position. It is essential that the Chair has protected
academic time, and it would be desirable if the position can be strengthened by the immediate
appointment of a tutor and with the possibility of a further senior lectureship in the future.
3. Follow up Meeting
11.30 a.m. Tuesday, 15 July 2003
Present: Professor J Gosling - Director of Quality (Chair), Dr P A Carney – Dean of Medicine & Health
Sciences (hereafter ‘the Dean’ and ‘Faculty’), Dr N Flynn – Acting Head of Department, Dr Geraldine
Gaffney – Review Group Cognate, Dr John Laffey, Dr Brian Kinirons, Ms M Linnane (in attendance)
3.1 Action Plan for the Department:
1. The Department recognises the ambition of its aims and objectives but considers them
realistic, and regards strategic planning as a means of enabling the Department’s full
potential. Dr Noel Flynn, the Head of department will ensure the revision of the
Department’s Strategic Plan by January 2004, with a view to annual revisions thereafter.
2. The Department will continue its endeavours to expediate the appointment of a Professor
of Anaesthesia. It is now two years since Hospital Management agreed with the Acting
Head of Department the clinical component of this post.
3. Recognising the University’s policy of forming larger academic units, the Department
will agree to retain its current affiliation with the Department of Surgery. However, a
fruitful relationship is contingent upon the evolution of a more productive partnership
between the Departments.
4. The Department will nominate an academic member of its staff to the core Faculty
Curriculum Committee and will work with the Faculty to bring about reform of the
undergraduate medical curriculum in the context of anticipated recommendations from
the Medical Council. This will include the matching of assessment and attachments with
the Department’s teaching blocks in more satisfactory ways.
5. The growing contribution of the Department to teaching and learning within the Faculty
is recognised, as is the considerable further potential for the Department to contribute to
the vertical integration of teaching and learning in the undergraduate Medical
programme. The Department will continue to work with other Departments, including
the Departments of Physiology and Pharmacology, to maximise this potential.
6. The Department is willing to work with the Faculty, other relevant departments and the
Hospital to secure the provision, equipping and staffing of clinical skills teaching
facilities, will cooperate with other the other relevant departments in the planning and
delivery of appropriate undergraduate courses, and will assume the responsibility of
managing and maximising the teaching potential of advanced clinical skills and
resuscitation facilities.
3.2 Action plan for University Management:
1. The Dean affirms that the filling of the Professorship of Anaesthesia is an essential part
of the Faculty staffing plan that has been agreed with the Registrar. The Dean undertakes
to expediate this appointment and by January 2004, will propose an explicit timetable for
the filling of this key post.
2. Consistent with the Faculty policy of promoting the formation of larger academic units,
and recognising the inefficiencies that exist in the Department’s relations with the
Report to Údarás – Review of Department of Anaesthesia 2003
Department of Surgery, the Dean agreed that the Department of Anaesthesia will have a
designated budget, with effect from the current academic year. However, with the
appointment of a Professor of Surgery, all relevant interdepartmental arrangements and
procedures will be reviewed.
The Dean will propose to the Faculty Curriculum Review Committee that an academic
member of the Department of Anaesthesia be appointed to the core group of the
Committee. The Committee will consider ways of consolidating the Department’s
abilities to contribute to the teaching and assessment of the undergraduate Medical
The Dean recognises the leading role of the Department in the teaching of basic and
advanced resuscitation and commends its success in securing relevant training
equipment. The Dean also reaffirmed that the establishment, equipping and staffing of a
Clinical Skills Teaching Laboratory is a priority within the Faculty. The Dean (and the
Head of Department) are working with the Management of UCHG with the intention of
gaining space within the Hospital for such a facility and when the clinical skills room is
established, will support the appointment of a specialist tutor.
The Dean reported that subsequent to refurbishment works being completed in the main
hospital, UCHG Management have undertaken to reopen the seminar rooms in that area,
which should alleviate some space problems experienced within the Department.
The Director of Quality will coordinate a study into systems to recognise the
contributions of professionals to the education of students in the Faculty. Support for this
study has been sought from the HEA/NDP Quality Assurance Programme.
The Director of Quality will clarify with the Librarian and the Medical Librarian the
mechanisms by which the Department of Anaesthesia can access Library funds.
The expanding research role of the Department, its future potential, and its success in
achieving peer-reviewed funding nationally and internationally are recognised. The
Dean of Research and the Faculty Vice Dean for Research will work with the
Department, Hospital Management and the CSI Management Board to identify suitable
dedicated facilities to meet its growing needs.
In order to maximise the Department’s future research potential, the Dean of Research
will work with the Department/Faculty in providing/developing:
• An information session on grant applications/proposals to the Millennium Fund and
to the main funding bodies, with emphasis on support for younger staff and for
proposals involving other departments in the Faculty and University.
• Appropriate support for contract staff wishing to establish a research programme.
• Research methodology training.
• A register of research projects in the Faculty of Medicine and Health Science
Approved by: Acting Head of Department, Dr N Flynn, 23rd December 2003
Approved by: Dean of Medicine & Health Sciences, Dr P A Carney, 20th January 2004
Approved by: Dean of Research, Professor G Hurley, 22nd January 2004
Approved by: Registrar, Professor J Browne, 12th January 2004
Finalised: 22nd January 2004, Jim Gosling, Director of Quality