The ambition for CUH to develop to become a ‘great hospital’ is both real and attainable, writes Tony McNamara.
Cork University Hospital (CUH) is a very complex organisation with over 4,200 staff and 100 different departments ranging from neurosurgery to portering services, each making its own unique contribution to patient care.
This complexity is a result of very many factors, such as the challenge to coalesce over 150 different professional grades of staff to focus singularly on the delivery of quality care to patients, while simultaneously adhering to regulatory standards set by professional bodies and agencies.
In addition, the challenge to maintain the soul of the hospital as a living, caring entity that has, as its primary focus, the care of those perhaps less fortunate than ourselves, in a world of rapid technological change, is a constant.
As a major teaching hospital, CUH is an important centre for clinical trials which makes available to patients, new drugs that have not yet become available to the population.
In addition, the hospital is challenged to maintain a leading role in the adoption of new technologies that can shorten lengths of stay and improve outcomes for patients within constrained financial resources.
Irish society continues to change with an increasing population that is ageing and it is estimated that within a decade there will be around one million people aged over 65 living here.
We were delighted to welcome @MHealyRae on Friday for the book launch of "Cork University Hospital, Celebrating Forty Years" Thanks to everyone for attending. #CUH40 pic.twitter.com/GlGzdnAnuL— Cork University Hosp (@CUH_Cork) December 3, 2018
The country is also changing, with very many more nationalities represented in our population — a welcome if somewhat belated development.
This trend is also reflected in CUH, with almost 50 different nationalities represented on staff, contributing to a richness of culture and variety in the life of the hospital.
However, multiculturalism poses challenges in the delivery of patient care in settings where conformance to standardised practice reduces risk and makes successful outcomes for patients more likely.
The need for adherence to professional qualifications that are approved by accrediting bodies such as the Royal Colleges, the Nursing and Midwifery Board and CORU, is intended in part to provide assurance that practitioners have the technical competence to provide care to patients.
Furthermore, a challenge for leadership at all levels in the hospital is to create an environment in which all staff are focused on optimising patient care in line with hospital protocols and practices.
It is a constant wonder that regardless of ethnicity, healthcare workers of all professions share a common purpose in seeking to do the very best for patients at all times.
This shared goal is made easier in an environment in which there is a culture of respect, shared values and an openness to soliciting the views of everybody in the team who wishes to contribute to the delivery of care.
In 2016, CUH became the first hospital in Ireland to publish “A Charter for Doctors in Training” which sets out the commitment of the hospital to those doctors who come to train in the hospital and the behaviours that are expected of such doctors.
These commitments are equally applicable to other professionals who collectively make up the staff in the hospital and are an important reference to the behaviours that are and are not acceptable in the hospital.
The public, quite rightly, has an expectation that staff caring for them in hospital have the professional and behavioural competence to deliver care in an empathetic, personal and holistic way but there are other factors that influence patient recovery in the hospital setting.
Research has demonstrated, without question, that the presence of art in hospital settings improves the healing process and assists the recovery of patients.
In respect of staff, it is a catalyst for colleagues of all nationalities to discuss, share opinions and celebrate art and of course, is often a distraction in oftentimes stressful situations.
This commitment to the creation of an environment that is sensitive to the aspirations of our multiple communities is very important to leadership in CUH and applies equally to the internal appearance of the hospital.
The hospital now houses the largest public art collection (320 paintings) of any corporate body in Ireland and uniquely all paintings have been donated voluntarily by patients, friends and those artists who appreciate the contribution the hospital makes to the delivery of healthcare in the Munster region.
The hospital has other commitments that extend well beyond the confines of the boundaries that mark the 50 acres which it occupies in a residential area of Cork city.
These Corporate Social Responsibilities are taken very seriously and in 2014, the hospital was designated (and still remains) the only hospital in the world to be awarded the Green Flag by the Federation of Environmental Education (based in Denmark) for its’ work in supporting a sustainable environment.
In this endeavour, staff of all professions in the hospital have worked to create and support behaviours that are designed to make its’ contribution to
the attainment of the Irish Governments’ 2020 sustainable environment targets.
In doing so, CUH is pioneering the way internationally in the implementation of innovative technologies and practices in partnership with University College Cork which was the first university in the world to be awarded the Green Flag.
This co-operation has created an environment in which research in this emerging area of academia is fostered, nurtured and supported.
Importantly, CUH is a major economic driver for the greater Cork region with a daily expenditure of €1m. In economic terms, the multiplier effect of this level of annual expenditure of roughly €375m is immense, as evidenced by the residential developments adjacent to the hospital and in the businesses that have developed in the area.
Successive governments have funded capital developments in the hospital to a value of €500m over the past 15 years and this development programme will continue with the designation in 2017, of the hospital as one of only two Trauma Centres in Ireland.
It is critically important that these new developments continue to be sensitive to the local environment in terms of design and function with sensitivity to traffic impacts and to the community responsibilities that the hospital owes to the local area and to the people of Cork.
Cork is a rapidly changing city and the recent comments made by Taoiseach, Leo Varadkar that the Government wishes to see the greater Cork area grow at twice the rate of Dublin is both ambitious and welcome.
Health services have a key role to play in very many facets of this goal not only in terms of the continued (and very welcome) improvements in the physical infrastructure of our hospital and healthcare facilities but also in adding value to the offering that those charged with promoting the city as an investment location, can offer to potential investors.
In this regard, CUH has a key role to play in supporting Cork City Council and other advocates to make the city an environmentally sustainable location that allows Cork to become differentiated from other developing cities in Ireland.
Cork University Hospital celebrates its 40th Anniversary today. A Book " Cork University Hospital, Celebrating Forty Years" will be launched later today. #CUH40 pic.twitter.com/tTs8Qyox4x— Cork University Hosp (@CUH_Cork) November 30, 2018
In pursuit of this goal, it is vital that there is a shared vision as to how the various and disparate organisations can contribute to the incremental development of the greater Cork region.
In recent decades, the city has been remarkably successful in attracting environmentally friendly investment that is adding significant value to the region, while spin-off companies such as those that have emerged from the outstanding work of the APC Microbiome Institute led by Professor Fergus Shanahan, exemplify the capacity of health-related research to generate employment.
One of the key criteria for differentiation in the capacity to attract large-scale investment is the quality of health services that the region can offer.
In this regard, CUH has the largest number of medical, surgical and supporting diagnostic services of any hospital in Ireland with 40 different departments — equivalent to the range of services that are available in Addenbrooke’s Hospital in Cambridge, London, a leading international hospital.
The ambition for CUH to continue to develop to become a “great hospital” is both real and attainable in the minds of those who see the potential to give expression to the potential of the excellent staff who work there.
The hospital has many relationships with clinical leaders in hospitals throughout the world and this presents opportunities for the hospital to develop formal, structured relationships with other leading hospitals internationally.
In this regard, the construction of a new €40m Radiation Oncology Cancer Centre, due for completion in Q1 2019, was the catalyst for hospital leadership to couple with The Christie Cancer Centre in Manchester in 2017.
Leveraging the expertise of The Christie has been critical to CUH implementing a change programme in the delivery of cancer care that has the potential to make CUH the leading cancer centre in Ireland.
The relationship offers the opportunity for researchers in cancer care in CUH to partner with colleagues in The Christie in undertaking clinical trials that are leading edge and which will offer patients access to emerging drug treatments that have the potential to improve patient outcomes.
In addition, the creation of a research programme for new drugs in CUH in partnership with colleagues in UCC, offers complementarity with the chemical industry in the greater Cork region and adds value to our collective endeavour — to improve patient care.
Tony McNamara is the chief executive officer of CUH.
CUHis a major economic driver for the greater Cork region with a €1m daily expenditure