Monday 24 November 2014

Report slams hospital overcrowding

Published 06/06/2014 | 11:37

GPs are spending an average of just 12 minutes with patients
GPs are spending an average of just 12 minutes with patients

Overcrowding at a major hospital emergency department has made it impossible to clean and is threatening the safety of up to 60,000 patients every year, a damning report has found.

The State's health watchdog has slammed conditions at University Hospital Limerick - previously known as the Mid-Western Regional Hospital - as unacceptable.

Patients are stripped of their dignity, put at heightened risk of infection and are openly treated on trolleys in public areas of the hospital in Dooradoyle, the Health Information and Quality Authority (Hiqa) investigation uncovered.

Phelim Quinn, director of regulation at Hiqa, has warned managers to immediately bring in interim measures to deal with the substandard conditions.

"Hiqa believes the conditions experienced by patients attending the emergency department in University Hospital Limerick are unacceptable," he said.

"The department was overcrowded and not fit for purpose."

University Hospital Limerick is the main hospital for the population in Limerick, Clare and north Tipperary.

The emergency department deals with 60,000 patients a year.

During the long-running investigation, Hiqa found up to 37 patients waiting on trolleys at any one time during inspections which were tipped off to medics in advance.

Such is the overcrowding, doctors and nurses found it hard just to move around the emergency department with the sick being treated in open areas because there were no private bays available.

"Ill patients were placed close together with little or no privacy or dignity," the report states.

It was also "impossible" to properly clean the area because there were so many trolleys on corridors and open areas, it found.

Furthermore, patients known to have infections which were threatening the health of others around them could not be moved to an isolation area as there is none.

One critically ill patient who needed a bed in the high dependency unit was forced to wait in the overcrowded emergency department until their grave condition improved.

"This practice is unacceptable," the Hiqa report warns.

A new emergency department is being built at the hospital but is not expected to be open before 2016.

The watchdog said management and the Health Service Executive (HSE) urgently need to find a range of interim solutions to the conditions which are posing a serious risk to patients at the hospital.

"Other risks identified within the emergency department were delays in the admission of children to wards, while being accommodated in adult surroundings," added Mr Quinn.

"This was despite the fact that a new children's area had been developed but remained unopened."

There were further delays in transferring patients from the emergency department to the intensive care or high dependency units.

However, Hiqa said there was a clear willingness to change and improve conditions at the hospital.

"The momentum witnessed locally must now continue and be supported by the HSE nationally in order to ensure patients in the region continue to receive safer, better care," said Mr Quinn.

In a statement, the HSE said management at the hospital have brought in a number of interim measures to improve overcrowding ahead of the new emergency department being built.

These include the opening of a short stay unit, an acute medical unit and a surgical assessment unit.

New systems to monitor the numbers of patients on beds and trolleys, including daily reviews, have also been set up, according to the HSE.

Ann Doherty, chief executive of the UL Hospitals group which controls University Hospital Limerick, said she is " very aware" the emergency department is not acceptable for patients or staff.

"However we are in the middle of the construction of our new emergency department (ED) which is being built to 21st century standards and will be a vast improvement on our current ED," she said.

"In the interim we have put in place a wide range of initiatives to offset the current limitations of the old ED."

Ms Doherty said patients were turning up at University Hospital Limerick every day who could be treated for injuries at smaller hospitals at Ennis, Nenagh and St. John's in Limerick.

Public information campaigns are planned over the summer to advise patients of the alternatives.

Niall Collins, Fianna Fail TD for Limerick, said hospital staff repeatedly pleaded with the HSE to tackle the conditions at the emergency department but were consistently ignored.

"It is shocking and appalling to read the words 'persistent overcrowding', 'unacceptable' and 'not fit for purpose' in a Hiqa report on the A&E department at University Hospital Limerick," he said.

"The chronic lack of funding and resources at the hospital cannot be allowed to continue.

"Patients' lives are literally being put at risk on a daily basis and this must stop."

Mr Collins said p atient complaints are also being ignored.

"There are due to be over 600 million euro in cuts from the health budget this year, but where can these savings be made if, for example, University Hospital Limerick is experiencing such problems?" he added.

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