New ward block key to tackling overcrowding at Mayo hospital - HSE

A Mayo member of the HSE West Forum has today questioned the authority on arrangements being put in place to deal the shortage of beds at the centre over the winter period.

Councillor Michael Kilcoyne also asked if a risk assessment have been carried out to ensure that patients are not being discharged prematurely to make way for other patients

In response to his queries, Ann Cosgrove, chief operations officer, Saolta University Health Care Group, said the Castlebar hospital has two multi-disciplinary working groups looking at all of the factors that will influence trolley numbers in the hospital.

The ‘Length of Stay Working Group’ and ‘ED Quality Improvement Group’ are looking at inpatient flow.

The 'Length of Stay Working Group’ is focusing on the following:

* Maximizing efficient length of stay for patients regarding access to diagnostics.

* Efficient ward rounds, ensuring the right patient is in the right location and the right ward.

* Following up on any delays for patients internally/externally to the hospital.

*Ensuring delayed discharges are at a minimum.

*Reviewing and managing readmissions to ensure early discharges do not result in patient readmission.

The Emergency Department Quality Improvement Working Group is focusing on good flow through the department, ensuring minimal numbers of patients on trolleys.

She elaborated: "Whilst there are patients who will take a longer period of care, it is maxing out on the number of patients who can be seen and transitioned through the department ensuring that we are still meeting all of our decisions on clinical prioritisation.

"We have information for patients that will be displayed in the waiting area identifying wait times, supported the staff by putting an electronic system for viewing at all times the number of patients in the department, where those patients are and how long they have been in the department.

"We are also looking at the softer elements but most important is patient engagement and patient experience in relation to our communication paths, ensuring patients have access to light refreshments while in the department and generally ensuring that patients requirements are met.

"We also have a specific group reviewing admissions of patients over 75 years and also looking at the cause and reasons for patients being admitted to ensure we can maximise alternative pathways with the Chronic Illness Programmes that have been established.

"In particular looking at the cardiology and respiratory pathways for hospital avoidance and supported early discharges.

"As previously highlighted from the hospital on a number of occasions, the full rectifying of having no patients on trolleys would be progress of a ward block in the hospital, and until that occurs we need to make sure we are dealing with every efficiency possible we can internally.

"Some of these take time but there has been significant progress done over the last number of months in the hospital to meet those needs.

"In addition there has been a significant drop in the number of patients in the emergency department on trolleys.

"There is a process nationally that reviews the readmission rates between seven days and 30 days.

"All readmissions are reviewed to ascertain if their latest admission was due to an early discharge following their original stay in hospital.

"The decision to discharge patients remains a clinical decision and is taken on the basis of whether the patient is deemed fit or not fit for discharge.

"Efficiencies have been put in place to ensure that patients received their diagnostics in a more timely manner and that decisions are made faster in relation to home supports and any other inputs required.

"However, this does not impact on the clinical decision re discharge."