The Problem with Hospital Systems: Alex Psirides

Alex Psirides discusses the problem with major hospitals and the systems that they use.

Throughout he uses a case example to highlight how and why things go wrong. Moreover, he suggests potential strategies to reframe the way care is provided in the hospital system.

As patients become more complex, the tribal systems we use to look after them remain stuck in the 18th Century. Back when the treatment for everything was amputation and, if you survived, leeches.

The large modern hospital is becoming a battleground of competing specialises, only concerned with their area of expertise. This leads to multiple single organ teams practising their art in a multi-organ (failure) world.

Many staff lack acute medical skills.

Expertise is found far away from the ward in Emergency Departments, operating theatres, and ICUs.

Despite disease not knowing or caring what time it is, all hospitals operate with minimal nocturnal on-site expertise. As nursing & medical staff move more towards rotating rosters where no-one knows more than a single-sentence summary of their patient’s complex physiological, pathological & pharmacological needs, an ever-present vigilant family member may become the only hope of surviving any acute admission.

Compounding these issues is the medial education system that is not keeping up with what happens with patients. Advances in medical care and technology mean that patients who would have been cared for in the ICU 30 years ago are now being looked after on the wards by junior doctors with little training or experience in critical care.

Unfortunately, junior doctors often call for help when it is too late.

Join in to listen to a self-professed middle-aged intensivist rant about how things were so much better ‘back in the day.’

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