St James’s Hospital: Developing in and with the community

Mary Day was appointed as Chief Executive Officer of St James’s Hospital in June 2020. She speaks to eolas about her new role, her hopes for the hospital’s expanding campus and how the campus can play a central role at the heart of its community in the Liberties.

“The attractiveness of the role was coming back, because I had worked here from 2000-2006, to a large healthcare campus which has got a huge amount of development at the moment in relation to being part of a campus that will have the Children’s Hospital, the Maternity Hospital, Trinity on site,” Day begins, explaining her rationale for her return, having previously held a similar role at the Mater Misercordiae Hospital and in the Ireland East Hospital Group. She “has an ambition in relation to delivering the first Academic Health Science Centre on the island which is about integrating academia, research, innovation and service delivery”.

Since her return, Day has been developing eight strategic programmes of work that will guide St James’s over the next five to seven years, developing those programmes around a portfolio of services being developed. This hospital is the largest academic hospital in the country and the development of national tertiary level status is seen as key towards deliverance, whilst also servicing the local population health needs.

“In a large teaching hospital, it is important we have a robust organisational system of care delivery,” Day says. “The institute model is a good example of how the biological model for healthcare will drive how services are organised and delivered across a care continuum. like what we’ve developed in the Mercer’s Institute for Successful Ageing (MISA).” Another Institute which is at an advanced planning stage is the Trinity/ St. James’s Cancer Institute which will integrate the cancer healthcare delivery system with academia, research and innovation. The St James’s Hospital and Trinity College campuses house a portfolio of research infrastructure, including a dedicated Cancer Clinical Trials Unit, the Trinity Biomedical Sciences Institute, the Trinity Translational Medicine Institute, the Clinical Research Facility, and Trinity Centre for Practice and Healthcare Innovation. This level of research infrastructure compares strongly against institutions internationally and underlines the institution’s commitment to progressing cutting edge research and clinical care.

The Trinity St. James’s Cancer Institute recently received accreditation from the Organisation of European Cancer Institutes, (OECI). This accreditation, the first and only such accreditation in Ireland, lays a significant marker as the Trinity St James’s Cancer Institute aspires to become Ireland’s first fully Comprehensive Cancer Centre, benefitting cancer patients and their families across the nation.

Day says: “We are also planning to develop the Institute model further in cardiovascular, ambulatory care, adolescents, she believes this is a good model to deliver care across the health continuum.

“There is a programme of work around lean operations and lean management in the healthcare environment. I’ve had experience doing that in past roles and there is definitely a place for how we introduce that process redesign into the healthcare space to deliver operational performance and excellence.

Day took up her new role in June, just as the first lockdown of the Covid-19 pandemic was easing away, and there were lessons in the pandemic for her on how she sees the St James’s developing. “One thing that Covid has taught us is that the majority of the infrastructure in the health system is tired and a lot of it is very old,” she says. “I’ve worked at hospitals at the group level that were over 150 years old, now we’re not that old but you’re looking at a hospital that was designed in the 1970s and developed in the ‘80s, that doesn’t necessarily match the health needs of the 21st century.

“The overall infrastructural developments are about modernising health accommodation, like 100 per cent single rooms. We saw during Covid when you had hospital outbreaks, the difficulty in controlling that without single room facilities. If you look at the Mercer Centre of Ageing, what that has delivered is a very advanced health system for ageing that integrates uniquely for education, research and innovation and it’s all 100 per cent single rooms. There was no disruption in care in that centre during the pandemic.” Day outlines that her key priority is to improve the infrastructure and environment of care for patients and staff.

Mirroring the development of these institutes will be the development of an integrated ambulatory care centre which Day sees as being key to St James’s becoming a more of an anchor tenant in the Liberties community. “The Integrated Ambulatory Care Centre presents an opportunity to transfer services from the main hospital campus which is ambulatory and chronic disease orientated into a facility and really drive the integration with the community and primary care which is aligned with Sláintecare. The campus should also be involved in keeping the population healthy as well as caring for their health needs and provide a population health-based approach to the delivery of care. That’s how the community and hospital can come together to develop an integrated model.

“My ambition for the campus is to develop what we call the institute model. If you look at the Mercer Centre of Ageing, what that has delivered is a very advanced health system for ageing that integrates uniquely for education, research and innovation and it’s all 100 per cent single rooms. There was no disruption in care in that centre during the pandemic.”

“A lot of the work has been done on this in other health systems. We see St James’s as what might be called the anchor tenant; if you look at the north of England, Scotland, those are good examples of how the health system around the hospital and the community can support overarching community benefits. The way I see St James’s supporting that is through provision of employment, education and innovation. We are very well positioned here, if you look at the Liberties and the innovation pathway that has been carved out here, working together with our community stakeholders, I think we can provide a lot of added benefit to our stakeholders in relation to opportunities in education and employment, garnering a passion of working in healthcare in the community.”

Concluding, Day stresses the potential, not just for St James’s but for all its stakeholders to work together to deliver a unique health district in Dublin 8 which has innovation at its core. “It provides a test bed for innovations in clinical care. It’s an opportunity to look at how we can do things better and differently, but we are short on time so it’s a good opportunity to see how working with the wider stakeholder community we can leverage the potential of the campus. What this can provide for the health system is the idea of bringing it closer with industry, digital and the business side, which can only improve care at the bedside.”

Mary Day
Chief Executive Officer
St James’s  Hospital, Dublin 8
T: 01 4162 534
E: mday@stjames.ie / ceopa@stjames.ie