Call to find ways to reduce UHL ED admissions and speed up discharges

FEARS have been expressed about the impact of the “never-ending” overcrowding problem in University Hospital Limerick (UHL) after 83 patients were left waiting for beds on Tuesday.
HSE West Forum member, Cillian Murphy has called for an examination of ways to reduce the number of patients being admitted to the ED in UHL, and to speed up the discharge of treated patients in a safe manner.
“From conversations with ambulance crews it seems the ED is the default response for emergencies,” the FF member noted.
“This may only have a marginal impact on trolleys but we have to look at other ways to treat people such as care in the community.
“At some point someone is going to have to say this isn’t good enough any more. Despite all the extra resources that are being fired into the health system, we still doesn’t seem to be able to cope with what is landing on the doorstep in UHL,” said Councillor Murphy.
“We have to look and see if we are maximising step down care. Everything must be examined at this stage.
“There doesn’t seem to be a solution to this never-ending problem. I am not sure is the problem with UHL or the HSE? We are looking for a solution but we don’t seem to be getting one.”
On Tuesday, 137 whole time equivalent (WTE) healthcare workers out of a WTE total of 4,962 were absent from work across UL Hospitals’ Group for reasons connected with Covid-19.
This includes a small number of Covid-19 positive cases, staff who are symptomatic and staying at home in line with public health guidance, those awaiting the results of Covid-19 tests, and workers who are vulnerable to Covid-19 and must remain off-site for their own safety.
The group confirmed the hospital remains under severe pressure as a result of sustained, record-breaking activity levels at its ED and a surge in Covid-19 activity over the last number of weeks.
Since the beginning of December average daily attendances at the ED have reached 216, exceeding 240 on three of the first seven days of the month. This compares to 195 presentations per day during 2019.
The group continues to follow its Escalation Plan, which includes use of surge capacity, undertaking additional ward rounds, accelerating discharges and identifying patients for transfer to its Model 2 hospitals.
However, many patients currently admitted to UHL are sicker with more complicated conditions, and require longer inpatient stays to recover.
UHL had the second highest number of confirmed Covid-19 patients in hospital in the country with 40 patients requiring treatment on Tuesday. Seven of these cases were confirmed in the previous 24 hours, while UHL also has 18 suspected cases of the virus.
Nine patients were being treated for the virus in ICU on Tuesday.
The total number of confirmed Covid-19 cases in Clare is 11,978. The 14-day incidence of Covid-19 in Clare was 1,276 per 100,000 compared to 992 in Limerick and 1,602 in Tipperary on December 6.
There were 1,517 confirmed cases in Clare from November 23 to December 6, 1,935 in Limerick and 2,557 in Tipperary. Over a seven-day period, there were 783 cases in Clare, 941 in Limerick and 1,296 in Tipperary.
The highest incidence of Covid-19 in the county is in the Ennistymon Electoral Area where the current 14-day incidence per 100,000 is 1,602 well above the national average of 1,316. There were 263 new cases in this electoral area over a 14-day period.
The 14-day incidence in the other electoral areas are all below the national average. There were 257 cases in the Killaloe Electoral Area over a 14-day period, which translated into a 1,278 incidence rate.
Ennis is recording a similar incidence rate of 1,274 per 100,000 after 394 cases over a 14-day period. It is slightly lower in Shannon on 1,250 after 380 cases over a two-week period while the Kilrush Electoral Area is on a 1,043 incidence rate after 219 cases in a fortnight.

by Dan Danaher