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New Echo Clinic at Tallaght University Hospital aims to improve patient outcomes

 Dr Aoife Doolan looking straight ahead. Behind her is a large sign that reads: Innovate Health Tallaght University Hospital

Dr Aoife Doolan has recently set up a high-risk anaesthesia transthoracic echo clinic at Tallaght University Hospital (TUH), with funding from the Hospital Foundation and in collaboration with cardiology and surgery. A consultant anesthesiologist with a special interest in intensive care medicine at TUH, Dr Doolan is the Echo Lead in the hospital’s  Anaesthesiology and ICU (Intensive Care Unit) Departments. Echocardiology is widely used to diagnose and monitor critically-ill patients, providing the medical team with vital information about the patient’s heart.

Dr Doolan explains that they are “further developing the ICU echo service, particularly out-of-hours. ICU patients need serial echos as part of advanced hemodynamic monitoring, a process which checks the patient’s blood circulation to evaluate how well their heart is working.” Dr Doolan also supervises a twice-weekly echo training programme in the ICU.

Outlining the development of the service, Dr Doolan notes that “point of care echocardiography in anaesthesia and intensive care has been growing exponentially in the last 10 to 15 years. Echo is crucial in differentiating shock, and starting emergency therapy in the ICU. In 2017, the NHS outlined standards of care that should be achieved for diagnostic imaging and this included echocardiography being available within one hour in an emergency. Basic echo-training is now a core competency for intensive care medicine trainees in Ireland.”

The consultant anaesthesiologist finished her training in 2019 and recognised the need for advanced echo training in anaesthesiology and ICU. She explains that “at that time, there were no anaesthesiology or ICU consultants accredited in advanced adult transthoracic echocardiography in Ireland. I gained adult transthoracic echocardiography accreditation at proficiency level with the British Society of Echocardiography in 2023, whilst on a critical care echocardiography fellowship at John Radcliffe Hospital in Oxford. I am motivated to develop TUH as one of the leading centres for echo in anaesthesiology and ICU.”

When Dr Doolan returned from her fellowship, she was aware there was an expanding surgical portfolio. Given her new skillset, she saw an opportunity to set up a high-risk anaesthesia echo clinic:

“This is a new and innovative project. Alongside one other hospital, we are the first in Ireland to have developed a high-risk anaesthesia echo clinic led by anaesthesiologists. Our aim is that this Echo Clinic will reduce surgical waiting lists, reduce cancellations and improve patient outcomes.”

Sharing her experience in relation to innovation at TUH, Dr Doolan advises those considering any innovative project to “reach out to your colleagues. Speak to as many people as possible, as early as possible. Staff here in TUH have been very supportive and help may come in many different ways. Innovation requires collaboration and we should remember to reach out to our colleagues for advice and support.”

In relation to the future, Dr Doolan outlines how she plans to set up an Advanced Anaesthesia and Intensive Care Medicine Echo Training Programme in the hospital: “I aim to secure funding for more echo machines and more licences for the high-risk anaesthesia echo clinic and ICU. Dedicated consultant supervision will provide a unique training opportunity for trainees and this will help support the hospital’s application for a final year Intensive Care Medicine Echo Fellow from the Joint Faculty of Intensive Care Medicine.”