Sunday 15 September 2019

Eilish O'Regan: 'Taoiseach's favourite A&E turned things around - but it enjoyed enviable resources'


Recovery: Patients waiting on trolleys at Beaumont Hospital came down from 8,065 to 3,609
Recovery: Patients waiting on trolleys at Beaumont Hospital came down from 8,065 to 3,609
Eilish O'Regan

Eilish O'Regan

It's the hospital that Taoiseach Leo Varadkar has singled out as the star performer for tackling its A&E trolley crisis.

So how did Beaumont Hospital in Dublin emerge from a trolley gridlock blackspot?

While there were 8,065 patients on trolleys in the hospital nearly a decade ago that was reduced to 3,609 last year.

Mr Varadkar has said the answer is "the obvious good management practices".

But doctors and other envious health managers say it is also about the generous resources that have been ploughed into Beaumont Hospital and the wider Royal College of Surgeons of Ireland hospital group it is part of.

The hospital group straddles various constituencies, including that of the Taoiseach's own heartland of Dublin west.

Just last winter, Beaumont got 20 new beds and Our Lady of Lourdes Hospital Drogheda, also part of the group, received 29. Another 30 are due next year.

It's an embarrassment of riches when compared to the 17 obtained by University Hospital Limerick, despite it being left to cope with the demands of so much of the mid-west.

Other supports were thrown in, such as extra nurses for Beaumont's community intervention teams to keep some patients out of hospital.

And there have also been more transitional care beds to provide a half-way house between hospital and home.

"We all made business cases last winter for extra resources but Beaumont seemed to be granted all its wishes," said one manager.

There is particular concern that the Mater Hospital, also on the north side of Dublin city, has not seen the same bounty, despite a rise in patients.

However, there is also an acknowledgement that the ease in overcrowding is also due to better processes, which help with the flow of patients and reduce blockages.

The chief executive of the group is Ian Carter - a veteran who worked in St James's Hospital, which had a long-held reputation of getting a lot of investment and managing its A&E.

He has no doubt picked up some good tips along the way.

He recently outlined some of his strategy, including making use of a frailty intervention team in the A&E to assess all patients over 75.

They assess the elderly patient, decide on therapies and find those who can be discharged.

There are measures to maximise the available beds across the hospital group, including in Louth and Cavan.

One of the more interesting aspects is the focus on the performance of the various managers of the hospitals in the group.

He described this as "internal accountability".

But he said there is no finger pointing, writing of report cards, blaming and escalating it to higher HSE level.

The focus is on "identifying and solving" rather than describing.

He admitted there is still some way to go and it can still have patients waiting over 24 hours for a bed.

The coming months will be test to see if it escapes the worst and retains its status as the Taoiseach's favourite A&E.

Irish Independent

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