Speaker 1 0:00 Welcome back to building the hospital of the future. In this episode, we turn to two of the core services at the new Limerick hospital, Cardiology and Diagnostics. Together they demonstrate how advanced medicine is being delivered faster, safer and closer to home. Our consultants and partners share how new facilities are expanding capacity, reducing waiting times and providing world-class care for patients in Limerick, and beyond. As part of the new hospital, the expansion of diagnostic imaging is an integral part of improving patient care. Bon Secours Hospital Limerick has an existing partnership with Alliance Medical, Europe's leading provider of imaging services. I sat down with Edward Madigan, Unit Manager of Bon Secours Diagnostic Imaging, and asked him about the partnership and service expansion. Speaker 2 1:04 Hi, good morning JP and thank you for having me here today. Edward Madden is my name. I'm the unit manager of the diagnostic imaging department in Bon Secours Diagnostic Imaging in Limerick. My background is I'm a qualified radiographer. I graduated from UCD in 1999 and I worked in the Matter Public Hospital in Dublin for 10 years. The opportunity came up in 2009 for me to move to Limerick. I got the opportunity to work with Alliance Medical who were providing the MRI service in the Barrington's hospital site at the time. I am the communication link really between the other heads of department and the hospital and my own team. There's about 40 people there all together with a different skill mix of radiographers, radiographers assistants and admin staff. And of course we also have diagnostic imaging group of radiologists who provide the reports for all the scans and X-rays that we take in the department Speaker 1 1:57 Super. And can you briefly explain that collaborative partnership with the Bon Secours and Alliance Medical? How long that's been going and how it feeds into the new hospital? Speaker 2 2:07 Absolutely. So in June 2018, a joint venture was agreed between Alliance Medical and Bon Secours Hospital where we would take over all diagnostic imaging services within the hospital environment. This opened a very successful partnership that we've had going for the last seven years and it's been an integral part in the patient pathway from pre and post operative imaging for patients who have joint replacements, ultrasound and CT imaging for inpatients, pre and post procedures for departments like endoscopy and urology as well as providing outpatient services on the day for consultant clinics on-site. Diagnostic imaging obviously plays an integral part in the patient pathway and helps to diagnose and plan treatments for patients. And also, I mean, it is reassurance for patients as well. Thankfully, lots of patients get negative results and you know, reassurance for them that they're OK. Speaker 1 2:56 Absolutely. And we're currently recording our podcast today in the clinical services hub and I believe there's a role between the Bon Secours diagnostic imaging here and how it's going to link in with this new hospital? Tell us a little bit about that. Speaker 2 3:08 On the ground floor of this building and on partial part on the 1st floor of the clinical services hub, we have a new state-of-the-art custom built diagnostic imaging department that we're very proud of. There's been a lot of work on Intuit in the last few years. This diagnostic imaging department will meet the needs of the referring physicians, including GPs and consultants across Limerick. It's going to be a continuation of the excellent service we currently provide in Barrington's environment. There will also be consultant rooms on site here with the consultants we have to link in with us in the diagnostic imaging department, if patients have had scans here and there needs to be a follow-up procedure or they need some kind of intervention, then that will link in with the main hospital across. So there will be that part of the patient pathway. So diagnostic imaging will provide a very important role in that. Speaker 1 3:51 Brilliant. It sounds like it's really going to benefit the patient, this new setup. Speaker 2 3:55 The outpatient and inpatient building, the link there is is essential for the full patient pathway. You know, when they come in first, the first part will maybe see the consultant. See us get the results. That might be the end of it if there's nothing more to be done. But if something does have to be done, at least we have the link to the hospital now as well where any intervention or any procedure needs to take place will do in the in the main hospital. Speaker 1 4:20 That's wonderful. And tell us about the services that are going to be available to patients. Speaker 2 4:26 Across both sites. We'll have the following modalities, which would be CT, X-ray, MRI and ultrasound in the hospital as well. We'll have my team of radiographers who will be supporting. The multidisciplinary teams in the brand new state-of-the-art cardiac Cath lab and also in the new interventional vascular suite. There's also going to be the day procedure unit where pain injections take place. Radiographers direct the live radiation in those areas with a thing called the C-arm. So in the clinical service hope then on addition to the modalities I've just mentioned with CT, X-ray, MRI and ultrasound, we'll also have a DEXA scanner and new venture for us will be mammography and PET CT. Speaker 1 5:04 That's wonderful. It's great to see. The expansion of services. So in terms of these advanced diagnostics that you're bringing in, why are they so critical to modern medicine, especially things like cardiology? Speaker 2 5:17 Yeah, I mean, advanced diagnostics are essential. Again, as I said, in the patient pathway, you know, it's it's the guide for the consultant or the refer what does have to happen next for the patient. So I suppose in particular with cardiology. This it's been around a long time that you've got CT coronary angiograms, you've got. MRI functional testing, so CT coronary angiogram is a non interventional procedure where you can look at the coronary arteries and see if there's any disease with them or any early disease on patients that have no symptoms. So it just avoids having a conventional angiogram first. So if intervention is required, then that links in with the Cath lab where they may need to do some intervention then. And then with regards to the MRIs and you're looking at the function of the heart, looking at the ventricles and the anatomy of the heart to see if it's functioning properly. So this is all key in, in cardiology and all cardiologists would would utilise that service. Speaker 1 6:13 That's super. It seems like it's going to make a huge difference for the patient. What are those big differences between what was previously offered and what's offered now and how is that going to impact the patient? Speaker 2 6:23 Yeah, look, I, I, I've been in Barrington so long as such a strong affiliation with, with the, the building and I will miss the work environment. But from a patient perspective, I mean, access is, is a huge thing going down to the service itself we have all these modalities almost doubled in the amount that we have, so it's better access for patients. The waiting list should be shorter. You're going to have a hospital access unit where patients can come in. They're going to be able to access the services, CT, MRI, X-ray, ultrasound there and then on the day if required. Getting that kind of rapid service is going to like affect their treatment and what their prognosis could be, you know, and again in the clinical service hub, hopefully patients will have less waiting time. They're also now going to have the first PET CT scanner that's within the Midwest region. So there's so much to look forward to for patients and that is all going to be based within Limerick and people don't have to leave the county to to go for service somewhere else. It's just phenomenal. Speaker 1 7:18 Sounds really important. And you mentioned it earlier about the integration of the consultants in this whole piece. How does that integration between the consultant LED care and diagnostics actually benefit both the patients and the staff? Speaker 2 7:32 Oh, I mean, having the consultants on site is, is great because they're being on site, they can actually come and communicate with us in the department, so as I said earlier on, we've got a diagnostic imaging group of radiologists who do the reports to interpret the scans and the images and the consultants will have access to these people. They can discuss them. There could be, we could lead to multidisciplinary meetings to discuss the patients diagnosis, prognosis, treatment, all of that, you know. So that's, that's essential. And being able to speak to us they can say, look, this is urgent, this maybe isn't as urgent. So we have that, that feed through and for staff as well that that gives us guidance on what we need to do and what is prioritised over things that maybe aren't as urgent, you know, and it's important to streamline patients and their needs. Speaker 1 8:17 Fantastic. And maybe from a patient's perspective, can you give us an example of a scenario where diagnostics can speed up the treatment decisions, especially with this new setup we have? Speaker 2 8:30 Absolutely. I suppose I'd probably go back again to the hospital access unit. I'll give you a very good example. It would be a patient that maybe is a query stroke, so they come in and they meet the consultant if they go and have a CT scan and the CT scan shows a certain pathology that will straight off affect their treatment and a patient can make a full recovery from that. That kind of rapid access is essential. The same could be said, I suppose, for the colonoscopies some patients are having sometimes when having a colonoscopy to certain areas that can't be seen. So they're referred for a CT and that helps to clarify that region a lot better and could essentially pick up pathology that you may not have have seen on the scope at all. Speaker 1 9:09 Super Ed, and as a radiographer yourself, are there any particular diagnostic tools or technologies that you're excited about bringing to the patients locally? Speaker 2 9:18 As I said, MRI is the big thing that I like and it's it was the one that I was interested in the most. But over the last few years, I'm interested in everything now, you know, so I guess you have to look at the PET CT scanner. You know, as I said, the first PET CT to come into the Midwest region is great for Bon Secours diagnostic imaging and Alliance Medical and I think it's a real milestone when we do open and we do our first scan. So just to explain PET CT patients injected with a radiotracer and PET CT scan helps detect radiation emitted from the radiotracer, which helps identify abnormal activity and early signs of cancer that may not be picked up on a normal CT scan. So what does that do? It helps to determine whether cancer has spread in the body or whether it's localised. PET CT can be used to assess the effectiveness of treatment. When a patient has had treatment, determine if the cancer has returned after a treatment. And evaluation of the patient's prognosis. So all that is just great. Speaker 1 10:15 It's very exciting. And before the new PET CT scanner came into the new Limerick hospital setup, what would the patient journey be like for someone in the Midwest region? Speaker 2 10:25 Quite difficult. Obviously, in this region, PET CT didn't exist. So, you know, the referrals normally come from an oncology consultant, so they would have had to maybe go to Cork, Galway or Dublin. So, yeah. And like, when you're going through a period like that in your life, I think having to travel for these scans is really not ideal. So I think for the patients of Limerick, this will be a real game changer Speaker 1 10:48 Super Ed, I'm sure it's exciting just to be driving past the place and know that it's going to have big impact on the people, your community essentially. Speaker 2 10:54 The local thing for me is is very important and I'm very proud of what Bon Secours produced here and Alliance Medical with them, you know. Speaker 1 11:02 You know, that's fantastic. Thank you so much for being fantastic talking to you today, Martin and a pleasure to be here. Dr Ali Al dujelli and Manish bhat. Welcome to the podcast. Firstly, can we start with Dr Ali? Would you be able to introduce yourself and briefly your areas of specialty? Speaker 1 11:03 That's fantastic. Thank you so much Ed, it's been fantastic talking to you today. Speaker 2 11:06 And a pleasure to be here. Speaker 1 11:09 Doctor Ali AlDujeli and Manish Bhatt, welcome to the podcast. Firstly, can we start with Doctor Ali? Would you be able to introduce yourself and briefly your areas of specialty? Speaker 3 11:18 Thank you for having me. My name is Doctor Ali Aldujeli I'm consultant interventional cardiologist here in Limerick and associate professor of cardiology. My specialty as a cardiologist is in diagnosing and treating heart condition conditions ranging from blocked arteries and heart attacks to rhythm disturbances, heart failure and preventative care. For those listening who may not have worked in medicine, Cardiology is essential branch of medicine that focuses on keeping the heart and the blood vessels healthy. That includes everything from prevention to using sophisticated imaging tests to life saving procedures such as opening up blocked arteries and a heart attack, for example. In short, our goal as cardiologists is to make sure the heart functions at its best so patients can live full and active lives. Speaker 1 12:13 That's a fantastic overview for everyone. Manish Bhatt, could you introduce yourself? Speaker 4 12:18 Yeah, thank you for having me here. I am Manish, proud working as a cardiology services manager for Bon Secours. I've recently joined the team since June this year. Before this, I've been working in cardiology practises since 2017. So I've been in cardiology business operations since 2017 till date. Speaker 1 12:38 Wonderful. And what has been the journey of cardiology at Barrington's up to now? Speaker 4 12:44 Up to now, at the moment you can look at Barrington's in Limerick as from a cardiology perspective they provide only outpatient diagnostic services. So basically your routine diagnostic tests like an echocardiogram, a stress test, which is a treadmill test, holter monitors, blood pressure monitors, ECG recordings and device checks and then consultations with the consultants like any kind of interventional diagnostics, invasive testings that will probably be done in a Cath lab premises will not be done in Barringtons because they don't have a Cath lab facility. So it'll be primarily if you can call it a secondary care in terms of cardiology pre op and post op. Speaker 3 13:23 What I want to add to what my colleague Manish have said is that we don't only lack the interventional perspective of cardiology, but also the diagnostic perspective of cardiology. So currently many of our patients have to travel up to Dublin, Cork to do, for example, cardiac MRI's, some sophisticated imaging such as PET CT scans. Although these are not interventional procedures, are not related to the Cath lab, but many of our patients are waiting. Speaker 1 13:51 Yeah, and I suppose Manish, you said you've been, you've been in the limerick area for a few years now. I guess you're probably excited about the new services that are going to be able to be offered to the community here. Speaker 4 14:03 Absolutely now, if you look at Limerick as a geography in itself, if you have access to private healthcare, it opens up your options for testings or kind of getting the diagnosis done quickly, probably getting them treated much more faster, unless what happens At the moment is people with access to health cover private health insurance and things like that, who are happy to pay for private services, they will probably end up in either places like Galway or Dublin, even for a diagnostic angiogram procedure, which would be a daycare procedure, they will have to travel all the way to Dublin or Galway. Now, if they are waiting on a public list, the public hospital would be providing that service. But from a private hospital perspective, there is no service to a larger scale anywhere in Limerick. So it's a big opportunity for us as a hospital, and it's a big, I suppose, service for the GP. You know the GP group as well. And. And the patients to kind of look forward to. Speaker 1 15:03 It's a really exciting period. And I suppose the patients probably want to know, what will the new cardiology service at the new hospital offer to patients, what's being expanded, Dr Ali? Speaker 3 15:13 from my point of view, it's not just an expansion, actually, actually, it's a total transformation of service within the region. For patient, this means, like comprehensive one stop cardiology service on the diagnostic side, we'll have advanced echocardiography, stress testing, cardiac CTs, very advanced holter monitoring devices, state of art imaging devices, PET CT and later on, as as as we know, the cardiac catheterization laboratory. On the interventional side, we will be performing complex cardiac catheterizations, angioplasties and standing procedures with the state of art technologies. I believe this is a huge step forward. Patients will be able to come to us for consultations, diagnosis, intervention and follow up, all within one hospital, all delivered by a team of highly experienced cardiologists, nurses and allied professionals, and crucially, we will also emphasize prevention and rehabilitation. I'm a huge fan of prevention. I believe preventing coronaries from being booked is much better than treating them as we are looking to open our first lipidemia clinic, like cholesterol clinic in the Midwest, trying to address cholesterol, blood pressure, lifestyles and recovery problems, so that patients not only survive their heart disease, but thrives afterward in their life. Speaker 4 16:37 Yeah. And just to add to Dr Ali's point as well, apart from interventional side, we also have a subsection of cardiology as cardiac electrophysiology. So we will be also providing cardiac electrophysiology, apart from interventional service. So if you look at, from a service perspective, as a hospital, we won't be only limited to diagnostic angiograms. We would be also doing procedures as device implantations or ablations, you know, treating arrhythmias. So there is a very large subsection of cardiology, which is mostly untouched to this side of the country, you know, like Galway has places where you can have this, them services provided, but a large amount of patients I've seen in the past, they'll probably end up in Dublin. Speaker 1 17:19 Manish, you started talking about there, but how will this improve patient access to timely treatment and reduce referrals from outside of the region? Speaker 4 17:28 Like Dr Ali was mentioning, if it is a one stop shop, if patients over here at the current service we provide in Barringtons, if they were to be seen as a cardiology patient in outpatient diagnostic clinic, if there was any further intervention or further diagnostics to be done, and even if it was something like, like a minimal, invasive diagnostic procedure, they would have had referred patients to Galway. They would have had patients referred to Dublin. So wherever Dr Ali currently does a list in Galway, so he would have brought patients to Galway instead, like there is an opportunity that patients could be brought in for diagnostics, literally next door, in the same premises. So that increases the possibility of us providing the service that bit faster. People won't have to wait on a waiting list for weeks. It could be done instantly or immediately, you know? Speaker 1 18:15 Dr Ali? Speaker 3 18:16 Yeah, in my opinion, perhaps the single best benefit is timely access to treatment. Until now, many patients in the Midwest face delays or had to travel to Dublin, Cork or Galway for a certain procedure. To be honest, this can be very stressful and in some cases, even dangerous if they feel unwell. This is not only causing burden on the patients, on themselves, but it's causing burden on their family members. With the new facility, patients will have access to the same, if not better, actually, world class service right here in Limerick. That means heart attacks, coronary disease can be treated faster. Routine procedures can be scheduled sooner, and patients can stay close to their families and support system. As a clinician, I can say the support system, the family support system, family members being able to visit the patient, be with him during these procedures or in their during their in hospital stay, is as much as important as the treatment procedure itself. From a system perspective, this reduction in the number of referrals outside the region will take the pressure of other centers in Galway, Dublin and Cork, and will create a truly regional model of care. The impact is both in the personal as I had mentioned, and on the systemic point of view. And this will, I believe, will strengthen the healthcare capacity in Ireland in general. Speaker 1 19:41 Fantastic. Now we're currently in the clinical services hub, and within it, we also have the advanced diagnostics that are being done by Alliance medical. What is this new pathway going to be like for patients, and why is it going to be beneficial for them that they're so close to the New hospital. Speaker 4 20:01 So I suppose you can take the clinical services hub, the building we are talking about we are in at the moment as Barringtons, from a cardiology perspective, everything that cardiology provides through Barringtons is going to be moved to clinical services hub, because it's an outpatient diagnostic clinic. All the outpatient services, pre op, post op will be done over here, so if a patient has been referred by a GP, will be referred over here. The consultant will triage the letters they'll have earlier. Diagnostic testings will be done into the clinical services hub. The consultants will review if they were to forward refer the patients onto the cath lab list. It will be done literally, the building next door, and then the post op care will be followed back again into the clinical services up. So it's, it's, it's a secondary care model in the clinical services up, pretty much a replica of what we do in Barringtons, you know, but with an addition of cath lab service, which is a significant jump from a service we provide now to a service we'll be providing very soon. Speaker 1 21:01 Wonderful, and looking ahead. What excites you, Dr Ali, about delivering Cardiology in this new hospital? Speaker 3 21:10 What excites me most is that chance to transfer heart care for an entire region. I'm looking forward to developing a truly multidisciplinary service. Cardiologists, radiologists, as you have mentioned in alliance medical, nurses, physiologists, all of us working together under one roof, collaborating with diagnostics is a game changer. I believe having access to advanced imaging and intervention side by side means we can provide seamless, consultant led, patient centered care. On a personal level, I put that patients from Limerick, county Clare, Tipperary and beyond, will no longer have to travel hours for treatment that are considered routine in major cities. Instead, they will receive world class, timely, compassionate care here in their own communities, with their family support around that, to me, is the true meaning of advanced medicine in action. Speaker 1 22:06 Lovely, and Manish. Does anything excite you about the new offerings? Speaker 4 22:09 The fact that everything is under one roof, and we are catering to a population that has been long waiting for a service like this, if you're not just talking about Limerick, we go far, as far as Tipperary, to the west of Kilkenny side, you know, all those people who have been either traveling to Galway or to Waterford or towards Dublin will be thinking towards Limerick as well, you know. So to be able to provide all those services under one roof, and having the accessibility to be able to provide it with the consultants presence, I think that kind of excites me the most. Speaker 1 22:44 I think patients listening to this and GPs are going to be really reassured by listening to you about today. Speaker 4 22:50 Thank you, yeah. Speaker 1 22:50 Dr Siobhan Grimes, great to have you back on the podcast. Today, we've been discussing diagnostic imagery and cardiology, but as clinical director, how are you viewing the close integration of these going forward? Speaker 5 23:04 One feeds the other in that the diagnostic imaging has gone on a pace. There are images now that are non invasive, that help with the diagnosis of cardiac disease. We're using MRIs. Were using CAT scans, so there aren't so many invasive procedures being done on patients. Having said that, there is still a requirement to do those invasive angios, and what we are going to provide is state of the art diagnosis for the patient and then for escalation for the patients who actually do need the invasive angio, we have a cath lab, and the cath lab is state of the art, coupled with the expertise that we're going to engage with to provide that service. We have Professor Aldujeli, and we also have Professor Kiernan, who is well known in the region. He is the professor of Cardiology in UHL, and he will be joined by five of his consultant comrades, and they will be all working in our cath lab. So we're getting state of the art diagnostics feeding a state of the art cath lab, and it's populated with consultants who are at the top of their game. Speaker 1 24:23 Wow, it really sounds like cardiology and diagnostics together are really showcasing what advanced medicine is going to be like in the new Limerick hospital, would you say? Speaker 5 24:33 Absolutely, absolutely. The original premise of the new hospital was to cater for patients who had to leave for something that should be provided here, and that is, in a nutshell, diagnostics for cardiology. And that means whether there is non invasive or invade, what I call invasive. So that means, do you need to have a little procedure, or do you need to just have some kind of X rays done? That's what needed to be provided here, because there were hundreds of people going out of this region every year to have those basic things done, and we are doing them. And because we've been able to engage with groups like GE and Siemens, we are using state of the art facilities. We are using their top of the range machinery and innovations, and we have the expertise here to use all of those innovations. Speaker 1 25:29 And you started talking about it there, but maybe you could go in a little bit more detail, like, why are these services so important for the future of healthcare in this Midwest region? Speaker 5 25:39 Yeah, we really are at the beginning of something because, to date, the facilities that are available for cardiothoracic surgery, for coronary surgery, for valvular surgery, these are all available in Dublin, and that's where everybody goes. But on the western seaboard, we have nascent surgical hubs, if you'll call it that, in Cork and in Galway. So we will be working closely in the beginning with those nascent facilities so that we can keep patients close to home when they need to have something like an aortic valve replacement or to have cardiac surgery done. We won't be doing that in Limerick to start off with. But, you know, we will be feeding those hospitals. We will be feeding places that are providing state of the art surgical procedures. And who knows, in time, we may well develop something that we can keep even closer to home. But for the moment, we are working with other hospitals on the western seaboard to develop a full cardiac surgery and cardiac diagnostic pathway for patients without them having to leave this part of the country. Speaker 1 26:58 And I suppose, with the consultants and that advanced diagnostic imaging so close by in the clinical service hub. How do you think this is actually going to support the delivery of that world class care, with the meeting right beside each other? Speaker 5 27:12 The proximity is obviously something that lends itself to a streamlined pathway for a patient. We also are introducing an electronic health record, which will have an ambulatory module, which means when the patient comes to see the consultant in the outpatient clinic, their journey on the electronic health pathway starts there. All of the diagnostics will be available all the way through then. So when, if somebody is seen in outpatients, and then they go to theater for any kind of procedure, the consultant who is performing the procedure can go back and can see everything that has been done, either through radiology or labs or consultations, that's all going to be visible. There is going to be a seamless process between the clinical services hub and the things that are available in the hospital. Not everybody will need that. Some people will come to the clinical services hub, and that's as much as they will need, but there will be that streamlined process, and access is everything, and everybody's time is really precious, and in this way, we're not sending people away for a number of weeks to wait for a CT scan and then to come back and have an ultrasound and then to come back and have an x ray, all on different days. This will be a one stop shop, and you will be able to have all of your diagnostic procedures done in a timely fashion and in a time that suits you. Speaker 1 28:46 Sounds like a really interesting mix between clinical proximity and digital efficiency, and that combination of the two, hopefully is going to result in, you know, really good patient care. Speaker 2 28:57 That's the idea. Speaker 1 28:58 Dr Siobhan, you've been on a huge journey over the last two and a half years, and it's an incredible achievement to be at this point as the hospital begins to see its first patients. What moments stand out for you during the journey from Barringtons to the current time now at Ballysimon? Speaker 5 29:15 I suppose the very first point is going into Barringtons and realizing that everything was so small and everything was on, you know, it's beautiful, lovely building, but everything was on top of everything else. And I was contemplating writing up my thoughts, and I called it the diary of an accidental hospital designer, because I'm an anesthetist, and what do I know about designing hospitals? But I went back and looked at my diary from the very first meeting, which is almost five years ago now, and the first thing I had written was, what do you actually want in a hospital and why do you want it? So that's where we started. So that would be one point that I would think of the very first time I went into Barringtons and thought, Oh, my Lord, this is actually very small. And then having that meeting and starting the design process at that point. I also think the day that Jason Kenny went out and bought himself pair wellies so he could walk around the sites with Dennis O'Sullivan. There were, I think, 10 sites that they walked around and he they came back from here, and you know the two big grins on them. They, you know, they had decided, they had found where they wanted to go. I think that's another pivotal point. We have to give credit to Bon Secours Mercy Health, for supporting us. So that's another pivotal time. Is the time when we were actually told, yes, you do have the budget and yes, you can go ahead. Then I suppose the excitement of people outside of ourselves, when it's started to look like a reality, I think when we got the planning permission, another big day, and there still was a question mark, because so many private hospitals have not actually got off the paper in Limerick, and it was very easy for people to feel that we also might not deliver. But definitely the planning permission was one breaking ground was another, actually putting the hoarding up, where people could see a picture of what it was going to look like, looking at all of the cranes from the window of the project office, which was then across the way. And I have a lovely photograph of of Jason in his office, and there's three big cranes behind them, behind him. That was progress. Then we start seeing the building take shape. People are impressed with the shape of it. We start putting on the glazed architectural terracotta, and people see this iconic building coming out of the ground. And I have to say, another pivotal day would be the other day when they took down the hoarding, and you can actually see it from the road in all its glory, and then going into it. I have a series of photographs of me standing on a square piece of ground that had nothing on it, then something that had walls, then something that had bits of wires hanging out of it, plaster board. And I'm standing in the same spot, because it is the spot where the anesthetic machine will be in theater four, which is the orthopedic Theater, which is where I will spend a lot of my time. And there's a kind of time lapse in my brain of standing on the concrete and then standing on the plaster. And yesterday I was in there, and the anesthetic machine is in, and all the surgical equipment is in, and it is finished beautifully, and it's going to be such a fantastic space to work in. So there's a list of moments for you. Speaker 1 33:09 An incredible journey it sounds like, but beyond size and design. What makes the new Limerick hospital different for patients and consultants, is there an extra bit of magic? Speaker 5 33:20 I would say the thing that we are proud of is designing the hospital for the patients and how they can access what we can do. I have said before that. My husband saying is, if you keep the patient in the center of your decision making. It doesn't matter if that's building a hospital or if that is running a theater or if that's doing a ward round, if you remember that you were there for the patients, then you're on a winner. And this hospital, when you walk in the door, it is very obvious that it's built for the patients. It's easy to access. The portals of care are right in front of you. You're not going to get lost, and we will couple that with the ethos that we bring from Barringtons. The patient will be in the center. Speaker 1 34:13 Fantastic. And you told us about all the ambition you have for the future of the new Limerick hospital, but I suppose if we sat down again in five years on the same table, what would success look like to you over that period? Speaker 5 34:30 The place is full. Place is doing what it's supposed to be doing, and we've already started or finished the next phase. And I hope to God, I'm not a patient at the time, but if I was to be a patient, that I would be happy to be a patient here. Speaker 1 34:49 Brilliant. The new Limerick hospital is part of a wider health system. How does this hospital position Bon Secours within the Irish healthcare system as a whole? Speaker 5 34:59 Oh. It advances it definitely we are now pushing the boundaries of technology, the integration with companies like GE who are interested in not only giving us their machinery that they have made, but also engaging with us, to expand how we deal with the patients, to solidify the safety, to use best practice from other parts of the world that they have access to because they're in all those countries, to bring it back here, to give us the tools to create guidelines that push us forwards. Speaker 1 35:42 Now, finally, you went through all your milestones, but personally, when you look back, what makes you proudest as you stand here at this point, when patients are starting to come through the door? Speaker 5 35:54 I guess we started with a plain sheet of paper, and we've ended up with something you can't but be proud of and you know, personally, I'm amazed that you know, in an anaesthetist after 35 years has got anything to do with designing a hospital. So I'm very proud of that. But as a team, literally, it came from a blank sheet of paper to something that hundreds of 1000s of people are going to use. So how could you not be proud of that? Speaker 1 36:27 That's wonderful. Dr Siobhan, thank you so much for joining us. Today is great. Talk to you. Unknown Speaker 36:30 Thank you. Thanks. Speaker 1 36:33 Cardiology, diagnostics and consultant expertise together bring advanced medicine into action at the new hospital. It is a step forward for healthcare in the region, and an example of how modern facilities and specialist teams can transform care. Thank you to our guests and to everyone listening for joining us on this journey. The new Bon Secours hospital Limerick is more than a building. It represents shared vision, clinical leadership and a commitment to better health care for the Midwest. This is both the culmination of years of work and the beginning of a new chapter. I, for one, can't wait to see how the hospital continues to grow over the coming years. Thank you for joining us throughout this series. We hope you found it insightful. For more information about the new Bon Secours Hospital in Limerick and the services available, visit bonsecours.ie.