Emergency Medicine clinical director
What does your role involve?
My role has the ultimate responsibility of ensuring high quality emergency care for all patients in Taranaki. This involves leading the Emergency Medicine consultants in their provision of care both at Base and Hawera Emergency Departments.
The responsibility of the role includes a focus on the most vulnerable in our community, particularly with improving health equity for Maori. I work with the consultants within and outside our department to develop guidelines and standards that provide excellent care for patients within the EDs. This includes work on preparing for COVID risk in the department as well as efficiency and flow of patients through the department, to their eventual destination of either upstairs in the hospital, transferred to other facilities, or return to their homes.
I work closely with our Directors of Emergency Training (DEMTs) to grow our training programme for our Emergency Medicine trainees. I am also invested in many long-term goals to help bolster our staff to respond to increasing demand and to develop models and an actual new department at Base, to improve care in the future.
I work closely with the leadership at Hawera Hospital to support the service provision in Hawera ED, which has been challenging and exciting as they expand their primary care services. I’m fortunate to engage all of these efforts supported by our SMOs and our hard-working associate-DEM, as well as great ED administrators.
Tell us about your team?
Our team is made of 20 emergency medicine consultants, 17 of whom have achieved the qualification of Fellow of Australasian College for Emergency Medicine (FACEM), a title that demonstrates their high level of dedication and competency in the specialty. This is one of the highest numbers of FACEMs for any DHB outside of Auckland.
Historically the team has been majority American and has worked hard to set a strong department at Base and to support Hawera ED when that service was in jeopardy. Over the past few years we’ve been joined by energetic new graduates who are Kiwi-trained and a great addition to our team.
Overall our team is a great group of consultants who are passionate about caring for our patients and advocating for that care. They are great inter-disciplinary team players working closely with nursing, allied health, providers from other services, and other support staff. They have a keen interest in education, be it for the next generation of doctors, or for their patients to improve their health on a daily basis. This is reflected in our blossoming training programme that continues to grow largely under the efforts of our DEMT.
Are you working on any special projects?
A major project is expanding our training programme so there’s a greater number of junior doctors to help meet the increased demand within the department at Base. It also involves a redistribution of consultant coverage to improve our response during busier, higher-risk, times of the day.
Our Project Maunga User Group has put many hours into the design and layout of the new build which we hope to see completed in 2024. Our current plant and processes cannot match the demand on the department, so we are over-capacity at some point on most days. The new build will increase physical capacity but efforts to improve efficiencies throughout the patient journey are still needed and can help us deal with the confined space we’re in currently.
As part of a nationwide effort within our college (ACEM) our department is embracing the concept of Manaaki Mana, the drive to provide equitable health care for Maori. This involves creating a department which is culturally safe. We have created a special role to assist us with this and have an SMO who dedicates his non-clinical time to this effort. We continue to work with members of Te Pa Harakeke to create an environment that accepts and welcomes cultural practices that benefit the wellness of all staff, patients, and whanau.
When did you start with the TDHB?
I first worked with TDHB in 2004-2005 when I was a nocturnist for Base ED. After several years working in Miami, I returned in 2014 and assumed my leadership role in 2018.
What’s your background?
I was born and grew up near the northeast area of Minneapolis, Minnesota in the United States. I completed my Bachelor of Science in Biochemistry and Bachelor of Arts in Anthropology in 1994. During that time I nurtured my love for travel involving community service in Ecuador and study in Chennai, India. I took a year fellowship after University to work with traditional healers in Malawi and investigate the natural remedies they used to treat malaria.
I completed my medical school in my home state of Minnesota with a 1-year diversion to complete a Masters of Public Health and attained both of my degrees in 2000, but missing the graduations in exchange for studying tropical medicine in the Peruvian Amazon.
I trained in emergency medicine as a junior doctor at Emory University in Atlanta, USA which involved most of my work at Grady Hospital, a large public hospital in the inner city. After a year of emergency medicine work in San Diego, while my wife Lisa completed her fellowship in paediatric dermatology, we brought our new born daughter to Taranaki for our first experience of Taradise.
We absolutely loved it and enjoyed sharing our experiences with friends and family in the US. We returned to Lisa’s hometown of Miami to work and grow our young family over the next nine years. I was able to continue some international work in Central America and the response to the earthquake-ravaged sections in Haiti during that time.
In a decision to experience a new way of life for our family, we decided to return to Aotearoa. Four years later, with the support of my colleagues, I assumed the leadership role for our department.
What’s the best thing about your job?
Knowing we’re supporting an environment that will deliver high quality emergency care to our patients to save lives and give them a chance at a healthier future.
What inspires you to keep doing your work?
Being a part of a hardworking, dedicated team, which strives to provide a crucial service to the people of Taranaki, and seeing those people benefit from all of that effort.
Any big plans or dreams?
The future has great potential for us to develop our department to a point that provides equitable care and sees a workforce that reflects all of Taranaki and is a model for other regional hospitals to aspire. With continued collaboration with other services we can provide comprehensive modern care, continue to train junior doctors at a high level, and contribute to developing new methods of emergency medicine through cooperation in research.