HSE, Hospitals, and staff

What does HSE stand for

Health Service Executive

What is the HSE

Ireland’s publicly funded organisation responsible for delivering health and social care services to all residents of Ireland

What does the HSE operate under and function as

Operates under the Department of Health and functions as the largest employer in the state, with a workforce of over 150,000 people

What does the HSE provide

Provides comprehensive health services, including hospital care, primary and community care, mental health support, and supports for older adults and those with disabilities

When was the HSE established and what did it do

Established in 2005, replaced previous regional health boards, consolidating services under a single body

What is the HSE organised into

National and regional services, including seven hospital groups and several community health organisations, with a move toward six integrated health regions

What is the HSE’s mission

To support the population with high-quality, compassionate care and ensure accessible, equitable healthcare for everyone in Ireland

Values and vision of the HSE

HSE is driven by values of care, compassion, trust, and learning. It promotes accountability, innovation, transparency, and continuous improvement in health services

HSE structure from highest to lowest + roles

1. Minister for Health - oversee health policy and provide political direction for the healthcare system.

2. HSE Board - provides oversight and governance of the organisation

3. HSE CEO - person in charge of running the organisation

4. Health regions (6 in Ireland) - each Health Region is responsible for organising and managing healthcare services in its geographical area

5. Hospital Services and Community and Social Care - services actually being delivered to pts, e.g. ED

How are hospitals structured generally?

1. External - Minister for Health, etc.

2. Executive - CFO, Chief CD, etc.

3. Directorates - e.g. diagnostics, medicine, etc.

Who works in a hospital?

• Operational Support Services e.g. porter, engineering

• Consultants, registrars, NCHDs

• HSCPs e.g. clinical specialists, service managers

• Nursing, e.g. MTA, staff nurse, CDON

• Admin staff e.g. Grade 3-8, GM

Roles in Radiography

Basic Grade Radiographer → Senior Radiographer → Clinical Specialist Radiographers - MRI/CT/US, etc. → Radiography Services Manager

Roles in Radiology

Radiology registrars → Consultant radiologists → medical/clinical director (radiology)

What is the Radiology Clinical Director responsible for and what do they do

Usually a consultant radiologist - lead consultant radiologist in dept

Responsible for all radiology doctors in the department

Provides clinical leadership to dept, with roles in planning, staffing, and management of resources

Who does Radiology Clinical Director work closely with

The RSM (Radiography Services Manager)

What is the RSM responsible for and what do they do

Responsible for all radiography staff in dept

Provides leadership to radiography team

Roles in planning, staffing, and management of resources

What is the Deputy RSM and what do they do

Sometimes called RSM I

Usually point of contact for radiographers in the dept

Roles include planning, managing resources, organisation of the day to day running of the dept such as rosters

What is the radiologist responsible for

Image reporting, approving requests and setting imaging protocols

When do radiologists work closely with radiographers

In areas such as interventional radiology and fluoroscopy in which they physically perform the examination & direct the use of the x-rays

What do radiology nurses do

Pt care pre and post procedure (IV cannulation, sedation, med delivery), assist radiologists during fluoroscopy and interventional procedures, set up of sterile trolleys, handling instruments, etc.

What do Health Care Attendants (HCAs) and Radiography Assistants (RAs) do

Diff roles in each dept:

• Aid radiographers in moving pts

• Stock radiography rooms

• Infection control + cleaning

• Chaperoning US scans

• Preparing pts for MRI and CT

What are Medical Physicists & Clinical Engineers

Quality Control of equipment - annual testing, commissioning and acceptance testing of new equipment

Medical physicists involved in Radiation and MRI safety certification

Clinical Engineering usually separate dept

Some roles of reception and admin staff

• Upload GP referrals and create pt files

• Update pt info

• Schedule appts

• Check-in and registration

• Send reports to GPs

• RIS/PACS

etc.

What are the main hospital depts

• A&E

• Outpatient Dept (OPD)

• Wards and units (Medical/Surgical/Oncology, etc)

• ICU

What is the A&E for

Request radiology examinations

Major and minor traumas, accidents and illnesses

Pts will be discharged or admitted to ward

What is involved in an OPD (Outpatient Dept)

Different specialties e.g. ortho/cardio/rheumatology…

Clinics

Follow up on radiography imaging requests on a medical condition or injury to check healing

What are the wards and units

• Medical/surgical wards

• Oncology wards

• Medical assessment unit (MAU)

• High dependency unit (HDU)

• Intensive Care Unit (ICU)

• Coronary/cardiac care unit (CCU)

• Neonate ICU (NICU)

• Hyper acute stroke unit (HASU)

• Burns unit

What is the ICU about

Critically ill pts

Normally 1:1 nursing care

Life support - intubated & ventilated

Constant monitoring

Specialist care

Portable x-ray imaging as pt is too unstable to leave ward

Who gets admitted to Neonatal Intensive Care Unit (NICU)

Neonate - under 1 month old. Admission within 24h of birth normally

Radiography in NICU

• Portable x-ray as baby too unstable to leave ward

• May require specialist CT & MRI imaging - very complex procedure re moving pt to dept

What is the HDU

• Pt need less care than ICU but more care than a regular ward

• Often come here after improving in ICU

• Portable x-ray as pt still too sick to move

What is the stroke unit

For pts with known/suspected stroke. Allows for fast specialist treatment
Pts often referred for CT/MRI

Rehab and recovery

What is the specialist staff for stroke unit

Nurses, physiotherapists, speech and language therapists

Who goes to Coronary Care Unit (CCU)

Specialist staff

Pts post intervention after a myocardial infarction or cardiac arrest

Pts waiting for procedures such as pacemaker insertion, TAVI

Pts with unstable cardiac illnesses

Radiography in CCU

• Portable x-ray

• Cardiac CT/MRI

• Coronary angiography (Cath Lab)

What do they do in the Speech & Language Therapy (SLT) Dept

Assess, diagnose, and treat ppl with communication difficulties e.g. problems with speech, understanding and using language fluency, voice and the social uses of language, also help ppl with swallowing and feeding difficulties

When do speech language therapists work with radiographers

During videofluoroscopy examinations - live fluoro exam watching how the pt swallows the food coated in barium (Videofluoroscopy swallowing study (VFSS))

What do occupational health do

• Health checks of staff

• Occupational injuries

• Supports

• Health initiatives

What are other hospital depts not mentioned

• Endoscopy

• Paeds

• Theatre

• Anaesthetics

• Pathology