Patients endure longer delays as hundreds wait over nine hours for a bed
Patients on hospital trolleys are being forced to endure even longer delays year on year as the overcrowding crisis escalates, according to internal HSE figures.
By 8am yesterday, there were 219 patients on trolleys who had been waiting more than nine hours for a bed. This compared with 150 who faced the same delay two years ago.
On January 6, there were 150 waiting over nine hours, compared with 147 a year ago.
There continues to be a great disparity in trolley numbers in hospitals across the country with some emergency departments apparently better at managing overcrowding and avoiding gridlock.
However, hospital managers have insisted there are many variables which influence overcrowding, including the size of the emergency unit, the type of specialities available in the hospital and also the age structure of the surrounding population. A number of factors have been identified which can impact on trolley numbers.
Admission rates - these vary widely from hospital to hospital. In some cases, you are twice as likely to be admitted to hospital than in others.
This can be cultural or can be down to the fact that a particular doctor will admit more patients than is necessary.
Elective admissions - this involves patients being brought straight in for surgery, or from a clinic, into a hospital bed rather than through emergency departments.
Some hospitals manage this better than others by taking more people in when trolleys are low and restricting them when trolleys are high.
Others manage things less effectively.
Length of stay - some hospitals can sort the average patient out in four days.
Others might take a week, thereby using twice as many beds to do the same work.
This is often linked to delays in getting tests and scans done, or skeletal services at weekends.
Ambulatory care - some hospitals are able to complete a test in a single day, so the patient does not need to be admitted. Others have to admit a patient, which then requires a bed to be allocated.
Bed capacity - some hospitals may just not have enough beds. Dr Gary Courtney, clinical director St Luke's Hospital, Kilkenny, said yesterday it was important to ensure they were the right kind of beds to meet needs.
Delayed discharges - some areas don't have enough nursing home capacity or home care packages, which means that patients are delayed leaving hospital.
Some are more pro-active than others in getting patients to move on.
Others will allow patients and families to refuse several nursing home options and to stay on in the hospital.
Primary Care - where community intervention teams are in place, patients can avoid admission or be sent home early as nurses from community intervention teams are able to administer IV at home or check wounds.