Emergency Department in Drogheda – Topical Issue
Check against delivery
Speech by Minister James Reilly TD
In common with many hospitals, the Emergency Department (ED) in Drogheda has experienced an increase year-to-date in ED attendances. For hospitals such as Drogheda, which serve populations with significant numbers of high acuity elderly patients presenting with complex co-morbidities, the requirement to admit patients is similarly high and the nature of these patients’ needs may require longer than average lengths of stay.
However, Patient Experience Times (PET) at Drogheda are roughly in line with national PET times, with approximately 70% of patients being discharged home or admitted within 6 hours and 81.4% being discharged home or admitted within 9 hours; also, despite the increases I spoke of at the outset, the number of patients waiting for ward bed accomodation has decreased by 15.4% in the last 3 years.
The SDU has worked intensively with management and staff at the hospital, and a variety of initiatives which address many of the needs of the local population have been introduced. These include:
- The establishment of a cross-sectoral group to focus on Frail and Vulnerable elderly patients, with representatives from Community, Private Nursing Homes, the Acute sector and groups such as Alzheimer Carers
- Seeking with HSE to expedite the recruitment of nurses particularly for ED and criticial care
- Reconfiguration of Internal Medicine services so as to enable Acute Medicine Assessment Unit (AMAU) Physicians to manage all AMAU and Short Stay Medical Unit patients
- Recruitment of an additional Acute Medicine Physician to further extend these services
- Introduction of twice-weekly Medical Census Meetings and once-weekly surgical and Orthopaedic Census meetings, led by the Clinical Director, at which an overview of each inpatient’s care and potential impediments to their discharge are discussed
- The purchase of 10 Private Nursing Home beds for the provision of Orthopaedic Rehabilitation post hip fracture; this service also utilises a physiotherapist and has significantly reduced orthopaedic patients length of stay.
The Hospital is making progress in implementing all elements of the Emergency Medicine programme. Practice changes and patient pathways put in place for acute medicine remain very effective and a recent audit undertaken by the Quality and Patient Safety Audit (QPSA) validated the hospitals full compliance with the Acute Medicine Programme. The overall length of stay in Medicine, Surgery and Orthopaedics is well within the targets set nationally and by the Clinical Care Programmes.
Our Lady of Lourdes recently got planning permission for Phase 2 of the planned expansion of the hospital, which will provide an enlarged ED and 60 en-suite single accomodation rooms which are fully SARI (Strategy for the Control of Antimicrobial Resistance in Ireland) compliant. The hospital is also actively bringing NCHD rosters into compliance with EWTD requirements, with Medical On call rotas reduced from 24 hours to 12 hours.
The Hospital, supported by the SDU, continues to actively seek improvements in their provision of patient care. Current priorities include:
- the improvement of patient clinical pathways,
- optimizing the use of the Acute Medicine Unit
- and moving patients to lower acuity beds at other facilities, such as Louth County Hospital, when the patient’s condition is sufficiently stable to do so.
Consideration is also being given to nurse staffing of the day ward and transition lounge.
SDU Liason officers continue to engage with Drogheda with regard to these operational issues and I expect to see further improvements in access to appropriate care in a timely manner at this hospital.
The Department of Health and the HSE are focussed on implementing the Government’s reform programme for acute hospitals including establishment of acute hospitals into a small number of groups, each with its own governance and management, to provide an optimum configuration for hospital services for the delivery of high quality, safe patient care in a cost effective manner.