BIOGRAPHY
David is a General Physician and Clinical Leader of General Medicine at Wellington Hospital. He is also an intensivist, and in this capacity has worked in a number of NZ hospitals. His professional interests include working at the coal face, bedside teaching, and systems improvement to improve the quality and efficiency of our care – particularly for those at the sicker end of the spectrum. He appreciates the support of his amazing wife, and is valiantly tolerated by two daughters. When not at work he gardens, mentors young men who have fallen through the cracks, and is the proud holder of an account at a Masterton tractor shop. ABSTRACT Looking After Our Sicker Patients: Who and How? Our sicker inpatients are getting more elderly and more complicated. In the good old days, caring for them fell to General Medicine. Now, not only are our patients and the treatment options available to them more complex, but who cares for them is becoming more complicated, involving general and subspecialist physicians, intensivists, and doctors or specialist nurses from palliative care, acute pain services, and geriatrics. Care settings, and the associated nursing expertise, span assessment units, wards, high dependency units and intensive care units. There is consequently wide variation in models of care for sicker medical patients throughout hospitals in New Zealand. Research around how to care for these “intermediate” or “high dependency” patients is scant, and largely focused on surgical pathways in specific conditions.
This talk will canvas issues around models of care for high dependency patients and systems for recognition and response to deteriorating patients, including the implications for General Medicine departments and the training of our registrars. |
