Dr Ko drew attention to a number of strategies to achieving and evaluating high reliability including the Donabedian model of quality which is conceptualised on the basis of structure, process and outcomes. His slide about simple, complicated and complex processes was much quoted throughout the day! 

Ms Gillian Tierney, Past President of the Association of Surgeons of Great Britain and Ireland, current Chair of Surgical Leaders in Management spoke about developing leadership capacity for clinical governance. Touching upon challenges including burnout, poor morale and low motivation levels, Ms Tierney emphasised the importance of clinical leaders engaging in self-care, being optimistic and modelling the positive impact that they wish to see calling on surgeons to step up, join up, speak up and to be kind.  

The final presentation of this symposium was from Dr Colm Henry, Chief Clinical Officer of the HSE who highlighted that clinical governance is something that is often talked about but not always widely understood. Highlighting the guiding principles for clinical governance, Dr Henry noted that they form both a system and a continuum that is fundamental to achieving improved patient outcomes. Noting that the complex origins of hospitals in Ireland remains relevant to the present day, he presented the fundamental design principles that the HSE is advocating to ensure alignment and consistency in clinical governance.  

The first talk was by Prof. Ellen Roche, Latham Family Career Development Professor at the Department of Mechanical Engineering and the Institute for Medical Engineering and Science at MIT. Prof. Roche presented on a range of innovations in robotic heart repair and modelling technologies, which are being developed at her Therapeutic Technology Design and Development Lab in MIT. She spoke about the Lab’s work, which includes incorporating soft robotics, advanced fabrication methods, and computational analysis tools in order to develop novel devices that help to heal the heart, lungs, and other tissues. Innovations include the development of 3D-printed replicas of patients’ hearts to enable testing of therapies. 

Dr Lucy O’Keeffe, Co-Founder and CEO of start-up medtech company CroíValve was next to take the stage. CroíValve focuses on the repair of the tricuspid valve, which Dr O’Keeffe called out as the ‘forgotten’ valve due to the traditionally low numbers of surgery performed on patients suffering from Tricuspid Regurgitation. Lucy – a biomedical engineer – took the audience members through the work of CroíValve from concept to market, highlighting its minimally invasive nature, which is particularly suitable for elderly patients who have multiple comorbidities.  

Continuing in the same vein, the audience heard from RCSI’s Dr Aamir Hameed, who is a Senior Lecturer in the Department of Anatomy and Regenerative Medicine as well as Co-Founder of Pumpinheart Ltd, a spinout company of RCSI. Dr Hameed provided the background to the development of the device that has been designed to treat Heart Failure with preserved Ejection Fraction (HFpEF) through the use of an ECG gated implantable diastolic pump in the left ventricle that reduces left atrial pressure during diastole and in sympathy with elevated pressures during exercise.  The ultimate goal is to assist clinicians to treat HFpEF patients enabling them to live active lives.   

The final speaker of the session, Dr Lara Jehi, Chief Research Information Office at Cleveland Clinic shared insights into the use of AI in epilepsy, exploring the theory versus practice. Presenting on the facts, the theory and current reality, Dr Jehi outlined how the theoretical benefits that machine learning can provide are not yet translating into practice. Acknowledging that validation and testing are necessary, Dr Jehi emphasised the importance of clinical implementation pathways to move from theory to practice, which requires alignment, sufficient infrastructure, a clear workflow and trust. The panel discussion highlighted the challenges and opportunities in building an environment that values and promotes innovation. 

His work in designing the implants and biomaterials that are central to the practice of next generation surgery is world-class and it was a real honour to be present as Fergal delivered his lecture entitled ‘From Colles’ Fracture to Gene-Activated Biomaterials: A Journey Through Tissue Engineering at RCSI.’ Equally impressive was his track record in bringing together teams of clinicians and scientists to solve healthcare challenges. If you were unable to attend, I encourage you to watch the lecture back here.