HSE defends increased trolley figures in Tullamore

The HSE has defended figures released recently by the Irish Nurses and Midwives Organisation (INMO), which revealed a 142% year-on-year increase in patients spending time on hospital trolleys at Tullamore hospital in 2011. A HSE statement gave bad weather and an increase in presentations as two reasons for increased numbers experiencing waiting time on trolleys. The statement said wait times in emergency departments (EDs) are "regrettable", but said steps are being taken to cope with additional demand for service and prioritise care for those who need it most. The HSE said there were a total of 28,047 attendances at Tullamore hospital's emergency department in 2011, with 80% of those triaged, treated and discharged in less than six hours (the target set nationally). "From November 2010 to March 2011 the country experienced one of the worst severe weather periods which impacted on the attendances in the ED and the subsequent numbers being admitted to the ED," the statement continued. "The main presentations were with joint injuries from falls and accidents together with an increase in medical admissions with chest complaints. In addition to this the hospital also had different periods throughout 2011 where there was an increase in presentation as a result of Flu or Noro Virus which also restricts the bed stock available for admissions via the ED." The HSE statement said enhanced plans were put in place last December to manage the numbers and length of time patients would await a bed once a decision to admit was taken. "For example, over the Christmas and New Year 2011/2012 the numbers awaiting a bed at any one time did not exceed seven patients," it said. The statement also gave details of an Acute Medicine Programme, which hospital management are working to implement in order to provide a framework for the delivery of acute medical services. "The programme, once fully implemented, will have a significant impact on the flow of patients into the hospital system, the speed at which they are assessed by a senior clinical decision maker, whether through an Emergency Department or Medical Assessment Unit, and are then treated and/or admitted," it said. The Acute Medicine Programme of work is clinically led by a team including doctors, nurses and therapists. The HSE say it has fully engaged with and been supported by professional groups and patient representatives and is based on international and national best practice. However, the HSE statement warned it would take "at least one year" for the benefits to be realised across the hospital system. Finally, the HSE statement said Tullamore hospital has an escalation policy for dealing with surges in activity, which includes increasing the number of clinical ward rounds to ensure any patients ready to go home are discharged, temporarily opening beds where deemed necessary and managing the volume of elective surgeries being undertaken in the hospital.