UL Hospitals Group CEO Prof Colette Cowan has defended the policy of moving patients on trolleys out of the emergency department on to hospital wards.
The INMO and Siptu Nursing have served notice of a one-day work-to-rule on February 3 across the hospitals group in protest over emergency department overcrowding and a range of other issues.
Speaking at a public meeting of the UL Hospitals board, Prof Cowan, herself a former nurse, said: “we are working with the unions week in, week out on how we will work out these issues and it is my hope that we can come to a successful conclusion and it won’t have to come to industrial action”.
Moving patients on trolleys from the overcrowded emergency department on to general wards is one of the issues nurses have objected to, arguing the wards are not being adequately staffed and the practice is unsafe.
But Prof Cowan insisted the practice is safer than having them on trolleys in an overcrowded emergency department. One of the first measures she had taken since being appointed CEO in November was to set at 20 the number of patients on trolleys in ED, a cap she admits has been broken in recent weeks due to “surges” in attendances.
On Monday and Tuesday of last week, the INMO said there were respectively 34 and 29 patients on trolleys in the ED.
“We have to look after all our sick patients and some days, yes, it will surge. But the cap is there as a directive and we work towards it all day every day,” Prof Cowan told the media after the board meeting.
“I put a cap on the number of patients waiting to 20 because the ED is small and it didn’t make sense to me that all these patients were together in a small department.
“So to ensure we got organisational-wide buy-in to this problem, rather than having it in an ED behind closed doors, we moved one patient to each ward. That incentivises discharges at ward level because people are focused on it.”
Surges notwithstanding, Prof Cowan said the initiative had a generally positive effect and the plan was to reduce the cap “to 18, 15 and downwards”, she said.
On putting patients on trolleys in wards, she said: “I think it is safer practice and the INMO and I are at different ends of the spectrum on that”.
Board member Prof Don Barry said that with capacity a problem, why the hospital could not simply open the new emergency department sooner than the target date of late 2016.
Prof Cowan expects a builder will be appointed next month and explained that one of the factors that would make it “a long and tedious process” was enabling works around ESB substations to ensure a continuity of power supply to the intensive care unit next door.