Theatres service manager:
Clair Mullins
Overview
The theatre department at Harefield Hospital can offer qualified theatre staff an unparalleled opportunity to gain experience in adult cardiothoracic surgery, including transplantation. The five-theatre complex is situated on the ground floor in close proximity to the Intensive Therapy Unit (ITU) and recovery. All aspects of adult cardiac and thoracic surgery are performed and a heart/lung transplantation programme is fully established.
The cardiac service includes all routine cardiac procedures. Aside from on-pump surgeries, we perform off-pump coronary artery bypass graft (CABG) surgery and endoscopic vein harvesting (EVH) for approximately 99 percent of our CABG cases where vein is utilised - endoscopic radial harvesting is also undertaken.
Minimally invasive procedures are performed for:
- MIDCABs
- AVRs
- MVRs
- Lung transplantation.
Minimally invasive techniques are positive in that the surgical site is lessened and encourages shorter recovery times. We have a well-established aortic dissection program, and partake in the London Aortic Dissection On-call Service. The Thoracic service carries out a broad range of thoracic surgery (including cryotherapy), and minimal access approach is widely used. EBUS is also undertaken here.
The team
The theatre team has a full complement of:
- Consultant Surgeons
- Consultant Anaesthetists
- Surgical Registrars
- Anaesthetic Registrars
- Nursing Staff
- Anaesthetic Practitioners/Operating Department Practitioners (ODPs)
- Surgical Assistants
- Perfusionists
- Healthcare Assistants
- Porters
The approach is collaborative, multi-skilling is encouraged, and the team dynamics is very positive.
Each year, at least one practitioner is supported to access an anaesthetic course and is encouraged to strengthen their knowledge in anaesthetics for a further year after successfully gaining qualifications. Strong partnerships with the surrounding universities allows our staff to access a variety of postgraduate courses, as they actively support new learners and students on the job, and assist to take new initiatives forward.
The department is overseen by the intervention lead, and led by the service manager. A chief perfusionist, two senior clinical leads, a practice educator, and transformation lead also support the service. There are excellent opportunities for staff showing motivation and commitment. The service is supported by a shift system, on-call commitment and a night practitioner.
Organ retrieval
A big part of providing a transplant service is the requirement to partake in the National Organ Retrieval Service (NORS). The Team who supports the on-call national roster consists of:
- Surgical fellows
- Anaesthetic practitioners/Operating Department Practitioners (ODPs),
- Perfusionists
- Scrub nurses.
The Harefield retrieval team are committed to optimising donor organs for transplantation and utilise the Organ Care System (OCS) to assist with this. Ventricular Assist Devices (VADs) are used in a variety of clinical support situations, along with Extra Corporeal Membrane Oxygenation (ECMO). Organ retrieval is a huge part of our Harefield work, it provides a very unique and challenging experience for our staff that is also very rewarding.