HIQA report critical of emergency department at University Hospital Limerick

Mike Dwane


Mike Dwane

HIQA: patients are being put at risk in emergency department in the University Hospital Limerick
PATIENTS are being put at risk by persistent overcrowding at the emergency department at University Hospital Limerick, a damning report by HIQA has found.

PATIENTS are being put at risk by persistent overcrowding at the emergency department at University Hospital Limerick, a damning report by HIQA has found.

The 100-page report on patient safety and quality of care across the UL Hospitals Group was published this Friday by the health quality watchdog.

And while there were positive findings about how the hospital group - including University Hospital Limerick, Dooradoyle; the Maternity Hospital, Croom Orthopaedic, St John’s, Ennis and Nenagh - has managed reforms, criticism of how the emergency department is run is a familiar tale to patients and staff.

HIQA’s director of regulation Phelim Quinn commented: “HIQA believes the conditions experienced by patients attending the emergency department in University Hospital Limerick are unacceptable. The department was overcrowded and not fit for purpose; this resulted in significant compromises in maintaining adequate levels of environmental cleanliness, and increased risk of healthcare associated infections, impeded access to patients for care and observation, and severely reduced patients’ privacy and dignity.

“Other risks identified within the emergency department were delays in the admission of children to wards, while being accommodated in adult surroundings. This was despite the fact that a new children’s area had been developed but remained unopened. At the same time, staff in all the region’s local injuries units reported under-utilisation of their services. During the review, HIQA raised these risk issues at local and national HSE level.”

HIQA is also concerned about delays “in transferring patients from the emergency department to the intensive care unit and/or the high dependency unit”.

The report outlines a number of priority actions to be taken by the UL Hospitals Group with the support of the HSE nationally in order to reduce patient risk.

HIQA acknowledges that the changes in management and governance across the group are “in the early stages of development” and recognises the “commitment of staff” in meeting these challenges.

“However, the review identified gaps in some of the group’s assurance processes which must be addressed as a priority. These include lack of a statutory framework for combined governance of the group, routine monitoring of patient experience arising out of quality and patient safety audits conducted, complaints management, risk reports, and compliance with healthcare associated infection targets,” HIQA stated.

Phelim Quinn concluded: “Nonetheless, UL Hospitals staff who were met by HIQA are committed to providing good safe care and to improving the services. The momentum witnessed locally must now continue and be supported by the HSE nationally in order to ensure patients in the region continue to receive safer, better care.

“This report – and specifically the risk areas identified as requiring action – must now be reviewed by UL Hospitals and the HSE nationally and reported on in a quality improvement plan.

“It is imperative that the findings of such reviews are used to inform the ongoing reorganisation of acute hospital services across the country.

“Therefore, in the interests of the system-wide dissemination of learnings from such reviews, all public hospitals must consider the findings from this report and benchmark their own services against the progress and challenges reported on in this report.”