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Western Infirmary

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40-702: The Western Infirmary was a teaching hospital situated in Yorkhill in the West End of Glasgow , Scotland, that was managed by NHS Greater Glasgow and Clyde . It was opened in 1874 and closed in 2015. After the University of Glasgow moved from the city centre to the West End in the 1870s, distancing itself from the Royal Infirmary , a new teaching hospital was commissioned for the new university site and opened in 1874. The Western Infirmary opened as

80-507: A residency program to educate qualified physicians, podiatrists , dentists , and pharmacists who are receiving training after attaining the degree of MD , DO , DPM , DDS , DMD, PharmD , BDS , BDent , MBBS, MBChB, or BMed . Those that attend a teaching hospital or clinic would practice medicine under the direct or indirect supervision of a senior medical clinician registered in that specialty, such as an attending physician or consultant . The purpose of these residency programs

120-504: A medical degree in 1872. He was greatly influenced by Joseph, Lord Lister (1827–1912), who revolutionised surgery by developing antisepsis , by the use of phenol , thus decreasing drastically the enormous mortality of surgical patients due to infections. By following Lister and adopting systematically the use of scrubbing (deep cleansing and disinfection of hands and arms), sterilisation of surgical tools, use of surgical gowns, and (recently discovered) anaesthesia , Macewen became one of

160-638: A member of the Royal College of Nursing . Around the time of the first World War a number of nurses who had either been trained or worked at the Western Infirmary went on to have distinguished careers including positions of high rank in both medical and military services. This reflected the high quality of nurse training at the Western Infirmary: Agnes Carnochan Douglas began her nursing career at

200-413: A precise clinical examination to determine the possible site of a tumour or lesion in the brain, by observing its effects on the side and extension of alterations in motor and sensory functions. Thus, in 1876 he diagnosed an abscess in the frontal lobe of a boy, but the family refused permission to operate. When the patient died his diagnosis and localisation were found to be correct. In 1879 he performed

240-544: A teaching hospital in the 1990s, and offers a 6-year MBBS degree. Chris Hani Baragwanath Hospital is a teaching hospital affiliated with the University of the Witwatersrand Medical School, and is the third-largest hospital in the world. Another academic hospital, University of Cape Town 's Groote Schuur Hospital , was the site of the first human-to-human heart transplant . Aga Khan University Hospital (Aga Khan Hospital and Medical College)

280-404: A teaching hospital to be affiliated with a medical school, but plans fell through until 1928, when Royal Prince Alfred Hospital became Australia's first teaching hospital, to educate students of the University of Sydney . William Macewen Sir William Macewen , CB , FRS , FRCS ( / m ə ˈ k j uː ə n / mə- KEW -ən ; 22 June 1848 – 22 March 1924)

320-409: A voluntary hospital relying upon donations and bequests from members of the public. By 1890 there had already been 877 operations performed in the hospital. Although the hospital initially had only 150 beds, by 1911 this had increased to over six hundred. In 1936 the decision was taken to establish a medical department. In 1930 a radiology department opened and, in 1936, a new ophthalmology department

360-441: Is a 721-bed teaching hospital that trains doctors and hospital administrators with support from American and Canadian universities. The hospital also coordinates a network of over 100 health care units primarily in rural or remote areas. In France, the teaching hospitals are called "CHU" ( Centre hospitalier universitaire ). They are regional hospitals with an agreement within a university, or possibly several universities. A part of

400-586: Is divided into small groups of hospitals and universities which are commonly called CHU as if they were separate CHU: There are 32 teaching hospitals in France. Amongst these are 30 University hospitals and only two Regional teaching hospitals. The first teaching hospital in the United States was founded at the College of Philadelphia (now the University of Pennsylvania ) in 1765, when medical students at

440-581: Is to create an environment where new doctors can learn to practice medicine in a safe setting which is supervised by physicians that provide both oversight and education. The first teaching hospital where students were authorized to methodically practice on patients under the supervision of physicians was reportedly the Academy of Gundishapur in the Persian Empire during the Sassanid era. Some of

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480-470: The Macewen's sign for hydrocephalus and brain abscess . Another important contribution by Macewen to modern surgery was the technique of endotracheal anaesthesia with the help of orotracheal intubation , which he described in 1880, and still in use today. Macewen was noted for his early and creative use of photographs for documenting patients' cases and for teaching surgery and medicine. He pioneered

520-912: The RAF Nursing service and was subsequently Matron-in Chief of the British Red Cross . Catherine Roy was Matron-in-Chief of Queen Alexandra’s Imperial Military Nursing service . There was a Maggie's centre at the hospital to help cancer patients, as well as the Glasgow Clinical Research Facility . Teaching hospital A teaching hospital is a hospital or medical center that provides medical education and training to future and current health professionals . Teaching hospitals are almost always affiliated with one or more universities and are often co-located with medical schools . Teaching hospitals use

560-482: The temporal bone and has identified an anatomical structure in this bone, the foveola suprameatica , which was named MacEwen's triangle in his honour. His method of surgical removal of lungs became a major medical weapon in the treatment of tuberculosis and lung cancer, thus saving many patients. His name was also immortalised in Medicine in two other instances: the Macewen's operation for inguinal hernia and

600-614: The Royal Infirmary, in 1877, was in orthopaedics , by means of the development of the first bone grafts, but also in knee surgery using a special instrument (Macewen's osteotome ) both techniques becoming key treatments for the highly prevalent disease of rickets (caused by a lack of Vitamin D ). Macewen was interested in the biology of bone and carried out a classical series of experiments on animals in order to determine how bones grow and may be repaired. He developed surgical treatments for mastoid disease and pyogenic cysts of

640-710: The United States beginning the early 1900s and they largely resembled those established by Johns Hopkins University , the University of Pennsylvania and the Lakeside Hospital in Cleveland. The hospitals that followed the example of these universities were all very large, technologically sophisticated and aimed to have a global impact through both patient care and scientific research. Additionally, these hospitals had large patient bases, abundant financial resources, and renowned physicians, advisors and staff. Many of

680-639: The Western Infirmary came under the management of the Glasgow Western Hospitals Board of Management. A£3.5   million two-phase rebuilding programme was authorised by the Glasgow Corporation in June 1962. The 256–bed Phase 1 block was completed in 1974. After the completion of the nearby Gartnavel General Hospital in 1972, Phase 2 was indefinitely postponed in 1975. In 2002, NHS Greater Glasgow & Clyde announced

720-556: The Western Infirmary closed with the exception of the minor injuries unit. At the end of 2015 the Minor Injuries Unit moved a short distance to the Yorkhill Hospital site and the Western Infirmary closed completely on 6 December 2015. In accordance with a commitment given by the hospital to the university in 1878 that the site would be offered back to the university if it was no longer required for healthcare,

760-576: The Western Infirmary in Glasgow. Macewen died in Glasgow on 22 March 1924. He lived at Garrochty on the Isle of Bute until his death and was buried nearby in the churchyard of St Blane's Church at Kingarth . Following the work of John Hughlings Jackson (1835–1911) and David Ferrier (1843–1924) on neurological mapping of functions in the brain, Macewen demonstrated in 1876 that it was possible to use

800-643: The Western Infirmary, Glasgow where she worked with the surgeon Sir William Macewen . He offered her the position of Matron at Erskine Hospital (formerly the Princess Louise Scottish Hospital for Limbless Sailors and Soldiers) when it opened in 1916. Dame Katherine Watt , DBE RRC, served as a sister in WW1 and later joined the Ministry of Defence as Chief Nursing Officer. Dame Emily Blair , DBE RRC, succeeded her as Matron-in-Chief of

840-547: The college began taking bedside instruction at the Pennsylvania Hospital (an institution that predated the medical school by several years). Following that were King's College of New York in 1768, Harvard University in 1783, Dartmouth College in 1798, and Yale University in 1810 to begin the history of notable university-affiliated teaching hospitals in America. Teaching hospitals rose to prevalence in

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880-767: The earliest teaching hospitals were the Islamic Bimaristans , which included the Al-Adudi Hospital founded in Baghdad in 981 and the Al-Fustat Hospital in Cairo founded in 872. The following definitions are commonly used in connection with teaching hospitals: Many teaching hospitals and medical centers are known for the medical research that is performed in their hospitals. Close association with medical colleges and universities enhances

920-435: The first successful intracranial surgery where the site of the lesion (a left frontal meningioma ) was localized solely by the preoperative focal epileptic signs (twitching of the face and arms in the opposite side of the lesion). On the basis of these signs Macewen thought that there was good evidence of an "irritation to the lower and middle portions of the ascending convolutions…in the left frontal lobe". A trephined hole in

960-528: The medical schools that ensued the prospect of being associated to a nearby hospital tended to be private institutions that received philanthropic support. While some funding comes from Medicaid for the GME process, teaching hospitals must consider paying residents and fellows within their budgets. These additional costs vary between hospitals based on funding by Medicaid and their general salary for residents and fellows. Despite these costs, they are often offset by

1000-741: The medical staff are both medical practitioners and teachers under the two institutions agreement, and receive dual compensation. There are at least one per French administrative region. In the city of Paris and its suburbs, the Greater Paris , it is the local public hospital system called the Greater Paris University Hospitals (in French: Assistance publique - Hôpitaux de Paris , AP-HP) which has an agreement with 5 major universities in Paris. However, it

1040-557: The most innovative surgeons of his time and was able to greatly advance modern surgical technique and improve the recovery of patients. In 1875, he became an assistant surgeon at the Glasgow Royal Infirmary , being promoted to full surgeon in 1877. Around 1880 he began a training programme for nurses (focussing on sterilisation) at the infirmary under the charge of the Matron, Mrs Rebecca Strong (1843-1944). In 1881 he

1080-508: The natural history of pyogenic diseases of the temporal bone and nasal sinuses , in addition to his clear description of cranial anatomy, as illustrated in his Atlas of Head Sections , were especially important in developing his successful treatment of brain abscess. The X-ray had not yet been discovered; Macewen's diagnosis was based on clinical findings superbly illustrated by his three clinical stages of brain abscess development." (Canale, 1996). One of his earliest contributions while at

1120-621: The nursing profession in Scotland. Margaret Wallace, ARRC , was assistant matron at the Western from 1923 until her retirement in 1946. She trained at the Western from 1910-1914. Wallace was awarded the ‘Nightingale’ medal and £5 prize at the end of her training and also gained the first medical and surgical prizes for the November examinations.  Wallace also served in the QAIMNS . She was

1160-662: The prices of procedures which are elevated in comparison to most non-teaching hospitals. Teaching hospitals often justify this additional cost factor by boasting that their quality of care rises above non-teaching hospitals, or ensuring the patient that they are improving medicine of the future by having their procedure done with medical trainees present. According to the Medical Journal of Australia , Australian teaching hospitals typically receive less funding for research than they do in similarly situated countries. The late 1800s and early 1900s saw several attempts at instituting

1200-399: The research programs at teaching hospitals. Some of the more notable teaching hospitals include: The Algerian Ministry of Health, Population and Hospital Reform maintains 15 public university teaching hospital centres (French: Centre Hospitalo-Universitaire or CHU ) with 13,755 beds and one public university hospital (EHU) with 773 beds. Edward Francis Small Teaching Hospital became

1240-620: The results of a three-year consultation, the Greater Glasgow's Acute Services Review, wherein they outlined a £700 million modernisation plan for Glasgow's hospitals. As part of the plan, some services would be transferred to expanded facilities at Gartnavel General Hospital but most of them would be transferred to new facilities at the Queen Elizabeth University Hospital site. By 2010 the Western Infirmary had only 493 inpatient beds. In autumn 2015,

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1280-417: The skull near the purported site of the lesion showed a big subdural tumour. The patient, a teenage girl, lived for eight more years, and a subsequent autopsy showed no trace of the tumour. He later used this many times to successfully operate on brain abscesses (in 1876) and hematomas and on the spine . This was a great triumph of medicine. According to one of his biographers, "his thorough knowledge of

1320-517: The university exercised its right to acquire the site and plans to redevelop it were approved in February 2017. At the time the Western Infirmary was opened individual hospitals conducted their own nurse training programmes. The probationers, as they were known, had to be 21 before they could start their training. The first Matron who trained nurses at the Western was Miss Clyde. She held this position for 22 years. The training included both learning on

1360-418: The use of photos of body parts and pathological specimens, as well as photos taken before, after and during treatment/surgery. After his death, a memorial fund was set up in his name. As part of the late 1970s redevelopment of Glasgow Royal Infirmary, where Macewen spent most of his career, a new laboratory block was named in his honour. It opened in 1981. The archives of Sir William Macewen are maintained by

1400-641: The ward and classroom teaching by appointed lecturers. Successful completion of the four year programme and passing the examination led to the award of the Certificate of the Infirmary. Helen Gregory Smith RRC was appointed Matron of the Western Infirmary in 1906, a position she held until 1933. She completed her training at the Western in 1899. She was awarded a CBE in 1932 in recognition of her role as President, Scottish Matrons' Association, President, Benevolent Fund for Nurses in Scotland and for services to

1440-479: Was a Scottish surgeon . He was a pioneer in modern brain surgery , considered the father of neurosurgery and contributed to the development of bone graft surgery, the surgical treatment of hernia and of pneumonectomy (removal of the lungs ). Macewen was born near Port Bannatyne , near Rothesay on the Isle of Bute , in western Scotland in 1848. He studied Medicine at the University of Glasgow , receiving

1480-611: Was appointed lecturer on Systematic Surgery at the Royal Infirmary School of Medicine. In 1883 he was appointed as Surgeon to the Royal Hospital for Sick Children in Glasgow. In 1892 Macewen became Regius Professor of Surgery at the University of Glasgow (the post which Lister had held when Macewen was a student) and transferred his surgical activities to the Western Infirmary . In 1896, Macewan

1520-696: Was awarded the Cameron Prize for Therapeutics of the University of Edinburgh . He was knighted in the 1902 Coronation Honours for services to medicine, receiving the accolade from King Edward VII at Buckingham Palace on 24 October that year. In 1916 Macewen helped to found the Princess Louise Scottish Hospital for Limbless Sailors and Soldiers in Erskine (now the Erskine Hospital ), near Glasgow, which

1560-610: Was officially opened, named the Tennent Memorial, with an entrance on Church Street. In 1938 the research capacity increased with the opening of the Gardiner Institute of Medicine. Taking its name from the family that had gifted almost £25,000 towards its foundation the institute worked in conjunction with the University of Glasgow. In 1948 with the introduction of the National Health Service

1600-555: Was urgently needed to treat the thousands of military who had lost their limbs in the First World War . Macewen was its first chief surgeon and with the help of engineers and workers at the nearby Yarrow Shipbuilders he designed the Erskine artificial limb . He trained a team of pattern-makers to manufacture them for the hospital. Macewen recruited the first matron for Erskine, Agnes Carnochan Douglas, who he had worked with in

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