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Our updated care bundle for sick liver patients - RING Liver! @BASLedu @BritSocGastro @BSGTrainees @djosh78
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Sam Thomson
52 posts
Sam Thomson
@dr_sjt
Father, Husband, Son, Brother, Liver Doctor @UHSussex, Thinker, Not much of a Tweeter
West Sussex, UK Katılım Kasım 2012
249 Takip Edilen98 Takipçiler
@pbendoscopist @WorthingHosp But with that in mind we have recently evolved our admission bundle into an electronic discharge form intended to capture all the vital data for audit & MDT. Next step is achieving CNS support to really take it to the next level 🤞 @UHSussex @HughesGethin @drlhodgson @philaberry
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@pbendoscopist @WorthingHosp Always nice of you to say Jon but we are only trying to do the simple things as well as can be. Nothing too clever! However with high turnover of trainees it is surprisingly difficult to raise awareness even within one organisation let alone nationally - a daily challenge!
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Hugely impressive holistic cirrhosis care by @dr_sjt and the team @WorthingHosp - a real exemplar of 21st century liver services
Sam Thomson@dr_sjt
@OTavabie @abdullahaabbasi @pbendoscopist It is only by ‘stepping back’ that we are now able to provide more responsive specialist services. 24/7 inreach, ambulatory assessment, improved clinic capacity. It is not uncommon now for us to have seen and consulted on the emergency floor before the official PTWR has happened.
Camden Town, London 🇬🇧 English
@OTavabie @abdullahaabbasi @pbendoscopist It is only by ‘stepping back’ that we are now able to provide more responsive specialist services. 24/7 inreach, ambulatory assessment, improved clinic capacity. It is not uncommon now for us to have seen and consulted on the emergency floor before the official PTWR has happened.
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@abdullahaabbasi @pbendoscopist Completely agree with the sentiment. Just think we need to lead that movement as opposed to sit back and criticise - gastro as a whole keeps stepping back from the front door and I think we all know that a hepatologist there will help improve management of the unwell cirrhotic
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👇this. Good cirrhosis care is about nailing the basics and attention to detail. These are the sickest people in most hospitals where margins for error are wafer thin. Make use of all available resources - BASL bundle invaluable for liver docs and non-specialists alike! #NephJC
Wandsworth, London 🇬🇧 English
@KathrynJackNHS @LiverTrust @BASLNF @GINursing @aelsharkawy75 @WorthingHosp @NUHNursing Hi. We run a Palliative Liver MDT and work closely with a community CNS and Palliative Care Physician. Welcome to get in touch for a discussion. DM me.
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Dear Liver Twitter, are there any liver nurses in the UK who focus on Advanced Care Planning/ Palliative care? I’d love to connect for advice? @LiverTrust @BASLNF @GINursing @aelsharkawy75 @WorthingHosp @NUHNursing Many thanks 😊
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Sam Thomson retweetledi
A new dawn @UHSussex @UHSussex_CEO! Here’s hoping for teamwork, service development and excellent patient care across Sussex. Let’s get started!
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Calling all ERCPists. Excellent new consultant opportunity @westernsussex. Friendly dynamic department. South Downs or seaside living. Great for family life. Soon to merge with @BSUH_NHS into ‘mega’ trust. If you know anybody of the bile duct persuasion who is looking pls DM.
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After the meteorological and societal rain must come the sun. Here’s hoping.
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@RutlishSchool Hi @RutlishSchool. Is this an opportunity for old boys to speak? Do you welcome any other topics or career inspiring talks?
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Guardian journalist and prize-winning author Paul Owen came to discuss the upcoming US election, his life and career in London and New York, and the political climate in the UK with Year 12 and 13 Politics students.
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@philaberry Thanks Phil. The power of Twitter huh?! Anyone would have thought we’d been talking about this since 2013...😂 pubmed.ncbi.nlm.nih.gov/24364057/
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Our updated care bundle for sick liver patients - RING Liver! @BASLedu @BritSocGastro @BSGTrainees @djosh78
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@mina_el_naguib Long story. Hard to tweet. But essentially INR in cirrhosis is a complex beast. Not a true coagulopathy as unmeasurable procoagulant factors at play as well so no rush to reverse. Also excessive volume expansion hurts portal pressure. At least that’s my understanding.
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@drkeithsiau I used to pitch it like that in teaching when first conceived but I have shifted now to “put a RING of care around your liver patient”. Bit cheesy but hopefully more engaging and less bossy!
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I love this “RING Liver” care bundle for decompensated liver disease. Please use it before you ring liver! #livertwitter
Sam Thomson@dr_sjt
Our updated care bundle for sick liver patients - RING Liver! @BASLedu @BritSocGastro @BSGTrainees @djosh78
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@NeilRajJ1 @BASLedu @BritSocGastro @BSGTrainees @djosh78 @abhichauhan Had a less pretty version of this on trust intranet for a while and been pushing in teaching sessions but upskilling and ‘teaching’ ever rotating front door docs is a slow process. We’ve just started another local awareness push now so will audit uptake in a few months time.
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@dr_sjt @BASLedu @BritSocGastro @BSGTrainees @djosh78 Interested to know the uptake rate in your centre? On auditing is it well adhered to? Amazes me how often the excellent BASL bundle is not used in some hospitals - with juniors never having heard of it! Or it’s lying hidden in a drawer in AMU/CDU somewhere 😡@abhichauhan
Birmingham, England 🇬🇧 English
Really interesting afternoon zooming online with the BASL SIG. Great efforts to pull it together from @hudsonbe81. Valuable contributions from all involved @MaggieCorrigan @Hazel__Woodland @LuciaMacken Prof Verma et al (and the 🇺🇸 contingent!). Lots to reflect on. #BASLEOL_2020
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Agreed. Simple as in it just involves people and reflective talking. But the subject matter not so simple! Still frequently deceived by changes in trajectory. I am very taken with your model of discussing every index presentation. I think there is great merit to that.
Ben Hudson@hudsonbe81
@javaidhj Has been a relatively simple quality improvement intervention that has tangibly improved care. Lots of excellent models around the UK (@adamgordon1978 @GwentLiverUnit #briliverunit #worthing
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The dog. The legend. Murphy. 14 today. Depending on which website you read that puts him at somewhere between 75-100 dog years! Our original baby. What a guy. Keep going Murph! 💪 🐕 🥳 🎂
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@Breathe_to_win @BromptonBicycle Isn’t the point that you fold it up when on public transport 😂
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Suppose I have a slightly biased view of all things Brompton - but the @BromptonBicycle is fantastic and just sad I didn’t get one sooner. Recommend ++
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Sam Thomson retweetledi
With many thanks to our collaborators for all the hard work! @dr_sjt @WSHTresearch @Marktheliverdoc @UHSFT @DrDSheridan @Derriford_Hosp @BlackpoolHosp #ESLD #cirrhosis #teamwork #palliative #RCT #NHS
roypounder.apt@APandT
'Randomised clinical trial: palliative long‐term abdominal drains vs large‐volume paracentesis in refractory ascites due to cirrhosis' #CLD #cirrhosis #hepatology Read FREE at bit.ly/3ctUO0p "evidence of long‐term abdominal drain acceptability/effectiveness/safety..."
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@EarthCycleUK no sight nor sound of our delivery today. Been waiting for updates from you but nothing forthcoming. Checking your Facebook feed it seems that communication with customers is not a strong point and that I am not alone. Can you acknowledge and feedback please?
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