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Extra beds fail to impact UHL overcrowding issue

PRESSURE is growing on the UL Hospitals’ Group to address chronic overcrowding at University of Limerick (UHL) amid calls for an external review to establish why the addition of almost 100 beds hasn’t had the desired impact.
The number of patients on trolleys in UHL has reached 81 in recent weeks; there were 52 patients waiting for a bed on Friday and 44 on Wednesday.
Responding to Clare Champion queries, the Health Information and Quality Authority (HIQA) confirmed it is closely monitoring information related to large numbers of patients in UHL’s emergency department.
HIQA said it is awaiting a response on the issue from the group. The Clare Champion has learned the HSE has told the Irish Nurses and Midwives’ Organisation it is viewing the overcrowding as a serious issue and has sought a response from the group.
The union has requested HIQA to conduct an external inquiry to establish why overcrowding is so high in UHL and to make recommendations to address the issue.
Admissions have increased in hospital groups throughout the country .
According to INMO Assistant Director of Industrial Relations, Mary Fogarty, the INMO is waiting for the group to outline its proposals to tackle persistent overcrowding.
She said nurses are very frustrated that overcrowding in UHL is way above other hospitals that have also seen a large increase in admissions and didn’t get the same increase in bed capacity.
“We need robust recommendations on addressing the overcrowding problems in UHL, which are multi-faceted. We have always said it is not just about beds, it is about processes and patients accessing services.
“The biggest concern is staff and patient safety. There are issues around work-related stress working. There are significant vacancies in the ED.”
Dr Michael Harty said there is increased activity within general practice, which has resulted in an increased referrals to UHL. Doctors are also seeing patients with late presentations of serious illnesses such as cancer, respiratory and coronary disease that also leads to more ED referrals.
Dr Harty said the older demographic in the Mid-West has resulted in greater demands on the health service.
He believes UHL still has capacity issues to cater for its catchment population, despite the provision of extra beds, due to lack of proper investment and under resourcing and also noted activity has to be curtailed due to Covid-19 restrictions, which are now being eased.
Responding to Clare Champion queries, the UL Hospitals’ Group stated over the past number of weeks, University Hospital Limerick, and its Emergency Department, has been managing record demand for its services.
The group’s Chief Clinical Director and the Chief Director of Nursing and Midwifery have met with INMO representatives to discuss specific actions for managing overcrowding.
In the past year, there has been an increase in Covid-19 patients. There remains significant demand for beds from people who have been delisted as Covid-19-positive, but continue to recover from the disease.
“People are getting sicker with more complicated conditions, and patients need to spend longer in hospital.
“The group are also experiencing record levels of presentations. In the 24 hours between 8am Monday and 8am Tuesday last week, 241 people attended our Emergency Department. The following three days brought attendances of 283, 243, and 214.
“Daily emergency presentations at the hospital in excess of 200 are now the norm. The average daily attendance figure for 2019 was 197.
“The group continues to focus on all aspects of patient flow, including access to diagnostic tests that help ensure timely discharge or transfer of patients. No effort is being spared in ensuring that physical distancing in the hospital is maintained, and wait times are kept to a minimum.”
The group stressed all patients continue to receive expert medical care while they wait. Not all patients are waiting on trolleys. Most are in bed spaces cubicles, bays and beds in the ED, and in the non-Covid-19 emergency admission stream of the Acute Medical Assessment Unit and Acute Surgical Assessment Unit. Admitted patients are also waiting in designated surge cap.

By Dan Danaher

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