Day 4: Downe Hospital and Dundrum Castle

Good Evening for Dundrum!

Today was the first day of our placements, so I was headed to the Downe Hospital. We got a bit of a late start because we missed the 8am bus. Unfortunately, we had also read ALL the bus schedules incorrectly, so we thought the next bus would come soon, but it wasn’t scheduled to come until 9:30am. We were supposed to meet at the Saint Patrick Centre at 8:45am, but we didn’t even leave Dundrum until 9:15am because we decided to take a taxi. In the end, it all turned out and I arrived at the hospital eventually. The Downe Hospital is new and it is very visually pleasing. Apparently, it has won awards for its design elements. It looks very modern and seems to be quite technologically advanced. I’ll have to post pictures in the next few days when I get a chance to take some.

After arriving at the hospital, I met Karen who is the Clerical Services Manager. Karen supervises all reception areas (each area of the hospital has its own) and the medical records area. I was given about an hour tour of the hospital and got to meet a lot of Karen’s staff, as well as a few others at the hospital. After the tour, I headed to the outpatient reception area. Outpatient care encompasses things like audiology (hearing aids), dental, and medical (patients referred by their general physician.) In order to be seen at the hospital, a patient must have seen their general physician to get a referral. This is referred to as gatekeeping. While I was in reception, I met a young woman named Emma who is the head receptionist. I’m not sure how old Emma is, but she’s younger and I really enjoyed working with her all day. She let me do a bunch of things, like going into the computer system and scheduling appointments, organizing the charts for the next day, doing appointment attendance, etc. It was quite different from the normal atmosphere I’m used to, which is the billing and insurance portion of healthcare.

The plan for the next two weeks at the hospital is to stay with reception for the first week and then during the second week I will get to go up to the wards (patient’s rooms) and shadow different areas. This way, I’ll be able to truly see as many differences between healthcare in the US vs. healthcare in the UK. I have already noticed a few things that were quite interesting. Back home in Waukesha I work at Orthopaedic Associates of Wisconsin (OAW). This is a clinic with 14 doctors. While the Downe hospital is much larger, I was surprised to see that the hospital only has one coder while OAW has three coders. Coders are the people who read the doctors notes and decipher what procedures and diagnosis’s to enter into the computer. In the US, this is especially important because different codes get different levels of reimbursement, so it is important to specify. I also seemed to notice that patients in the UK are more polite. Typically, when a patient in the US is told they will have to wait longer or the doctor is not available, (when they stop in unannounced) the patient will get quite angry with the receptionist, nurse, etc. From my experiences today, that is not the case in the UK. Maybe it’s because patients in the UK are not asked to pay money up front in the form of a co-pay, or they are used to the waits. Other differences are rather small, like sorting charts by alphabetical order rather than the time they arrive. This is not a detail that truly matters, but it’s something I find somewhat interesting because I think it would make more sense to sort charts in the order in which they will arrive. Additionally, patients keep their chart for life. Charts are only kept in the hospital for about 3 weeks after the patient’s case is closed, but then these charts are sent to a storage facility in Belfast. When a patient has an appointment in the future, the chart is delivered from the storage facility. This is why the charts tend to be quite thick. This is not the case in the US. We tend to keep charts for 2 years after any inactivity, and then documents are scanned into the computer to be accessed in the future, at least this is the way it works at OAW. I was quite surprised to see that they do not use electronic medical records, but apparently, it has been discussed and thought about, which is similar to the situation at OAW.


(Dundrum Castle)

At 5pm, I left the hospital and headed back to the Saint Patrick Centre to catch the bus with Ryan, Annie, and Jenn. Then a short time after, Kaitie, Alessia, and Andrea returned, along with Tim and he bought us a dinner of fish and chips. Following our dinner of fish and chips, we decided to go get an ice cream at Brennan’s. Everyone says that Brennan’s has the best ice cream, and it is rather good, but I hate to say it, but I’m more of a fan of Wisconsin’s custard. After all, we are the dairy state! Then, after heading to get ice cream, we headed up to see the Dundrum Castle. It’s an older castle that is in ruins, but it’s still really pretty and it was great to be there. We took tons of pictures and were able to have a lovely view of the bay, Mourne mountains, and town of Dundrum. On the way back from the castle, we stopped at the Dundrum Inn to have a pint with Tim and the group and then we headed home. Most of us are pretty tired from out first day of placements, so we’ll probably go to bed rather early, or earlier than we have been. Tomorrow is another day at our placements, so I will update you more then.


(View from Dundrum Castle)

Slán (So long in Gaelic)