A two day course on advancing Emergency Medicine in a Nordic country
Emergency medicine was officially recognized as a medical specialty in Iceland in 1992. Since then there has been a steady growth in the field and EM has become an integral part of the Icelandic health care system. The Icelandic Society of Emergency Medicine, ISEM, was founded in the year 2000 and a curriculum for post-graduate training in EM was adopted in 2003. An EM faculty post at the University of Iceland was started in 2003 and a partnership was formed in 2008 with the Beth Israel Deaconess Medical Center in Boston, MA, for a two year program advancing EM at Landspitali University Hospital in Reykjavik.
Today the Emergency Department at Landspitali is mostly staffed with specialists certified in EM. Medical students at the University of Iceland all do a 2 week dedicated ED rotation where they are introduced to the specialty. An active residency program has been built up currently training 12 residents but it is designed to provide only the first two years of training. Trainees will subsequently have to go abroad for a minimum of two years to fulfill requirements for specialty certification in Iceland. The program has been very successful and can currently only accept a quarter of applicants for training posts. In 2012 the University of Iceland established a research center in EM which currently has over 30 ongoing research projects.
Adopting the model of EM in Iceland has however not been easy. Multiple battles have been fought and most of them won, both within the hospital and on a political level. Many things have been tried, not all of them worked out as planned but overall the field of EM has managed to progress rapidly in Iceland.
Today, when EM is still in the early stages of development in most other Nordic countries, ISEM feels that the group of EM physicians in Iceland has learned some valuable lessons from this process that may be of use for fellow physicians in other Nordic countries interested in adopting EM on their homeground.
For this reason, we offer a two day course in Iceland on how the Icelandic experience might be used to adopt Emergency Medicine in a Nordic country. Practical information will be provided on ED management, novel IT solutions in healthcare, building a residency program, ED design and other issues helpful for those actively trying to adopt the model of EM in their hospital. A tour of the department will be provided. Ample time will be allowed for discussions, both during the scheduled course and the social program offered at the end of each day.
- History of EM in IcelandJon Baldursson will provide an overview on how EM got started in Iceland and developed over the years. It has not always been easy so, learn the do's and dont's from someone who has been fighting for EM in a Nordic country for a quarter of a century.
- ED and lean managementHilmar Kjartansson will discuss how adopting lean management has improved patient flow and decreased cost. The ongoing project of designing new facilities for the hospital will be outlined with an introduction of the 3P concept of design. Several quality improvement projects will be presented.
- DocumentationHjalti Már Björnsson will talk about how EM can be improved by going back to basics. Too much emphasis in modern health care is often on buying the latest expensive high tech equipment. More value can be added to patient care by increasing awareness of how important a good history taking and physical exam is, and of course writing a detailed chart. The use of smart-texts, legal pitfalls and other issues will be discussed. After all, the quality of your medical note is an important detail in shaping other doctors' opinion of your work.
- Technology in EDIn year 2015, not much is done without the use of IT in some way. Currently our ED is using the novel approach of designing a new system for documentation, orders and patient tracking in a browser-based environment. This allows a very dynamic design process where clinicians directly influence how the system works and David Thorisson will introduce our use of IT and technology to improve ED efficiency. Don't just stay frustrated with an outdated system, learn how to work with your IT department.
- Owning traumaFew patients are as challenging in terms of multidisciplinary cooperation as the trauma patients. Jón Magnús Kristjánsson, the head of Landspitali's trauma committee, will report how trauma management has been radically reviewed at the hospital with revised prehospital trauma transfer criteria, trauma alert criteria, regular rehearsals and animal labs.
- Research in EMIt's not enough to just work on building a good clinical department, your ED has to look good on paper. Brynjólfur Mogensen will discuss how the research institution in EM was founded and a part of its ongoing projects.
- Building a residency programA specialty is nothing without well trained doctors. The ED at Landspitali has tried different ways in building a residency and now finally is in the position to choose among highly competent applicants for training positions. The program and its mentors have repeatedly won teaching awards within the hospital. Hjalti Már Björnsson will provide details on how the program is managed.
- Northern collaborationEmergency medicine is not a new thing in the world, even if it still is a new specialty in many Nordic countries. International collaboration with an established EM center and having trainees do a part of their training there is invaluable. David Caesar will give an overview of the UK training model in EM and discuss options for future collaboration between emergency physicians in Scotland and the Nordic countries.
See also programme for EMI 2015 (final version)
Hjalti Már Björnsson MD
Graduated from the University of Iceland in 1998, trained and bored as an internist before finally completing an EM residency from the Eastern Virginia Medical School, VA, USA in 2010. Hjalti has worked in the ED at Landspitali since 2011 and served as the program director for Emergency Medicine since 2012. Active in Emergency Ultrasound as well as research in prehospital cardiac arrest and other areas. Would spend most free time hiking, biking or skiing if it were not for four young daughters.
Jón Magnús Kristjánsson MD
Assistant Medical Director, Chairman of Trauma Committee
Jón graduated from the University of Iceland in 2000. He trained in internal medicine and emergency medicine in the University Hospitals in Reykjavik, Iceland and Lund, Sweden 2001-2007. He was appointed assistant medical director of the department of emergency medicine and internal medicine in Lund University Hospital 2008. After returning to the University Hospital in Reykjavik, Iceland 2009 has pursued a strong interest in trauma and international emergency medicine and was appointed the chairman of the hospital´s trauma committee in 2015. He is currently the assistant medical director of the department of emergency medicine and has been a delegate for the international red cross working as an ED specialist on missions in Haiti and Yemen.
He has published several peer-reviewed articles and participates frequently in teaching for medical students and residents in emergency medicine.
He enjoys scuba diving, bicycling and hiking and hopes to have traveled to all 7 continents within 5 years.
Davíð B. Þórisson MD
Tech, IT & social media explorer
David graduated from University of Iceland in 2004 and became attending in EM at University Hospital in Lund 2013 and has special interest in trauma, resuscitation and ultrasound. In Lund he started the first swedish EM blog, Aklutläkarbloggen.
His other speciality is technology/IT and he has spent much time bringing state of art technology to practical care for optimising physician time spent at the computer screen. He serves as a clinical consultant for the HIT department and is working closely with the development team on a local EMR solution.
He also is a heavy consumer of FOAM as well as contributor and started the icelandic Emergency Medicine Iceland blog and is perhaps better known in the FOAM galaxy as Zonofthor and an author of Priceless Electrical Activity, a tech/IT blog for emergency physicians. David has lectured this topic on several occasions, amongst others in Kos, Greece at MEMC VI.
When not at the compuer screen he stretches his muscles jogging, cycling and swimming in the Atlantic ocean.
Jón Baldursson MD, EMPH
Jón received his medical degree from the University of Iceland in 1984, completed his internship and subsequently worked as a senior house officer in Reykjavík for two years. He received his residency training in Emergency Medicine at the University of Cincinnati Medical Center, served as Chief Resident in his final year and graduated in 1991. Since then he has dedicate his career to the development of emergency medicine as a specialty in Iceland and became the first certified specialist in EM in his country in 1992. He held the positions of Medical Director of the ED at the University Hospital 1994-2005 and of EMS 2005-2010. He was a Clinical Assistant Professor at the University of Iceland 1994-2002 and 2006-2011. He also received an Executive Master of Public Health degree from the Reykjavík University in 2010, worked as a senior advisor in the Icelandic Ministry of Health and Welfare 2010-2012 and was appointed Deputy Director of Health 2012-2013. Dr. Baldursson became the first president of ISEM in 2000 and served on the board for two years. He has been involved in the development of residency training, advanced life support courses, injury prevention, helicopter flight physician program, disaster preparedness, search and rescue to name a few fields. In 2003 he was awarded the ACEP recognition for Individual Achievement in International Emergency Medicine Development.
Hilmar Kjartansson MD, FACEM
Consultant in EM, Medical Director department of Emergency Medicine Landspitali University Hospital, Reykjavík Iceland
Hilmar graduated from the University of Iceland in 1998. He initially trained in General medicine and then in 2004 moved to New Zealand and signed up as a trainee with the Australasian College for Emergency Medicine where he completed his training in EM and became a consultant EM and a Fellow of ACEM in 2009. He worked for 2 years as a consultant in both New Zealand and Australia and relocated back to Iceland in 2011. During training he developed a keen interest in many areas of Emergency medicine, including Research, Risk Management, Trauma and Ultrasound to name a few. He has been involved in multiple lean projects across many specialities within Landspitali-University Hospital. Interests are too numerous to account for but most involve some form of physical exercise and time with the family.
Brynjólfur Mogensen MD
Brynjólfur graduated from the University of Iceland in 1974. Trained in orthopaedic surgery in Sweden from 1975 and completed his PhD program from Lund University in 1982. Consultant in Orthopaedic Surgery at Landpitali University Hospital from 1982 - 2000. Medical Director of Dept. Orthopaedic Suregery from 1994-2000 and the Emergency Services from 1994-2007. Director of the Research Institute in Emergency Medicine at Landspitali University Hospital and University of Iceland from 2010.
Associate Professor in Traumatology from 1994 - 2001 and Associate Professor in Emergency Medicine from 2003. Chairman for the Icelandic Prevention Council 2003-2011 and member of the Icelandic Transportation Safety Board from 2009. Main interest is research in many areas of Emergency Medicine and with the family golf and hiking.
David Caesar MD
Consultant in EM - NSH Lothian, Clinical Diretor for EM - Royal Infirmary of Edinburgh and St John's Hospital Livingston
David graduated from the University of Edinburgh in 1997, having been educated in Aberdeenshire, Sarawak, and Dorset. He joined the South East Scotland Emergency Medicine Training Programme in 2001, and, with a year’s sojourn in Christchurch New Zealand, completed his training in 2006. He was appointed as a substantive Consultant in Emergency Medicine at the Royal Infirmary of Edinburgh in 2007.He has been Lead for Clinical Governance, Training Programme Director for SE Scotland, and is currently Clinical Director for the two adult Emergency Departments in NHS Lothian.
He has a strong interest in Medical Leadership, writes a regular column for the Edinburgh Evening News, and has lectured on Leadership to the Ernst & Young “Connecting Emerging Leaders” network, the University of Edinburgh Business School, and to the UK Chartered Institute of Public Finance Accountants. He has a very tolerant wife, a boisterous son, a shoe-obsessed daughter, and not quite enough bicycles.
John L Holmes MD, FACEM
John graduated from the University of Melbourne in 1975 and has been a Fellow of the Australasian College for Emergency Medicine since 1989. In addition to being a staff Emergency Physician in Brisbane and Director of EM in Queensland, Melbourne and Brisbane, he also has also obtained a unique experience in the implementation and development of EM through this international sabbaticals in Ireland, Netherlands and Fiji. Currently John is working at the ED in Landspitali, as a visiting staff specialist.
During EM Iceland, John will give a talk on common obstacles to developing the concept of EM in a health care system and how to overcome them.
The course was held first in September 2015 and will eventually be repeated in following years. Those interested can register on our postlist and will be notified of future events.