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“Lack of clarity” about who is responsible for trolley patients in hospitals, finds a damning study

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According to a new report, large numbers of hospital patients were found on trolleys in inappropriate areas, including corridors where “it was sometimes unclear who was caring for them”.

The review was conducted during the winter of 2018 and 2019 and was shared with the Director of the Irish Patients’ Association, Stephen McMahon, under a freedom of information framework.

It was also noted that staff were fully aware of these safety issues as well as the impact on patient experience.

The staff assured the review that they are doing their best to ensure patient safety at all times.

“However, given the design of many clinical areas and the demands on staff, this remains a concern,” the report said.

Hospitals visited included Naas in Kildare, Tallaght in Dublin, Mater in Dublin, Cork University Hospital and St Vincent’s
Dublin Hospital.

For patients requiring a hospital bed, access was “invariably the cause of delays and overcrowding.”

And while there were issues related to bed capacity, there was also a lack of early specialist review and poor inpatient flow.

Infection control was another reason for bed access delays due to the requirement for single rooms. In some hospitals, up to 20 percent of patients waiting for a bed were delayed because of this.

“While there is a national obligation to provide more bed capacity within the system, the number of beds and increased demand, including higher attendance and admissions, are impacting the level of service,” it said.

“Late in the day discharges and late handovers of care also contribute to high occupancy.”

The study also found that capacity, including staffing levels, was reduced over the weekends.

The review team, which carried out visits over three months, included management expertise from NHS Scotland, the Scottish Government and NHS England.

Mr McMahon, a member of the Emergency Department Task Force, said it took him 17 months to gain access via FOI to the report, which was eventually released by the Department of Health after the HSE denied the request.

He said the report shows we need to “look beyond capacity and critically examine internal elements that impact poor leadership and governance performance.”

He also highlighted concerns about the lack of clinical leadership.

The Ministry of Health’s release of the report comes as emergency rooms are under intense pressure from record patient visits.

In response to Mr McMahon’s request for the report to be made public, the HSE said the relevance of the review had diminished significantly.

It added that some of the recommendations had provided an opportunity for learning and had been included in the winter plan.

While some of the underlying challenges, such as capacity, remained the same, the operational context had changed beyond recognition – to the extent that the completion of a report from a 2019 review had limited the material benefit, if any, “particularly given the existing plans to meet our current and future challenges”.

https://www.independent.ie/life/health-wellbeing/lack-of-clarity-over-who-is-responsible-for-trolley-patients-in-hospitals-damning-study-finds-41517504.html “Lack of clarity” about who is responsible for trolley patients in hospitals, finds a damning study

Fry Electronics Team

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