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Report on Tallaght Hospital describes emergency department as "unacceptable"

Health watchdog HIQA found that over 80 per cent of patients in the emergency department were kept on a corridor and had to wait around 13 hours for a bed.

Patients at Tallaght Hospital in July of last year, taking part in a protest organised by the Tallaght Hospital Action Group which says the hospital is seriously under-resourced while trying to cater for a catchment area of half a million people.
Patients at Tallaght Hospital in July of last year, taking part in a protest organised by the Tallaght Hospital Action Group which says the hospital is seriously under-resourced while trying to cater for a catchment area of half a million people.
Image: Mark Stedman/Photocall Ireland

THE HEALTH WATCHDOG HIQA has published its report on standards of care at Tallaght Hospital and described the emergency department as an “unacceptable situation for patients”.

The report by HIQA strongly criticised the management of the hospital, saying the hospital board “did not function in an effective way”. It also called for an end to the “cultural belief” among some staff that putting patients on trolleys in corridors is acceptable.

Minister for Health James Reilly said staff at the hospital have an important role in responding to the challenges ahead and restoring confidence in the hospital.

Concerns were expressed last year about patients in the department at the Dublin hospital whose official title is the Adelaide and Meath Hospital incorporating the National Children’s Hospital (AMNCH). The coroner at an inquest into the death of a 65-year-old man there in March 2011 said it sounded like the hospital department was “a very dangerous place”.

HIQA found that over 80 per cent of admitted patients in the emergency department were kept on a corridor beside the department and had to wait an average of 13 hours for an inpatient bed. The longest waiting was reported as 140 hours.

The report found that the mean waiting time in the Emergency Department of the hospital in the first six months of 2011 was between six and seven hours. However it found some patients were waiting for up to 61 hours before being discharged.

HIAQ said that it had found a number of serious issues specific to the use of the corridor as a waiting area.

These issues had the potential to compromise the quality and safety of care for these patients and the capacity of the emergency department staff to provide a timely assessment of newly arriving patients in the emergency department.

The chief executive of the hospital confirmed to HIAQ that the corridor is no longer used to accommodate emergency patients as of August 2011. The report noted:

The cultural belief by individuals in any hospital that the routine practice of accommodating patients on trolleys in  corridors is acceptable should not be tolerated.

The report also found that 14 per cent of patients who attended the Emergency Department at the hospital for the first six months of 2011 left without completing their care. HIAQ said it was not provided with information that the hospital had effective systems in place to monitor and manage these patients who left, which it described as a “shortfall”.

The HIQA report looked at the quality, safety and governance of the system of care for patients in the hospital, particularly those admitted through the Emergency Department.

The report notes that when the investigation began, there were no arrangements in place to ensure the transfer of responsibility from patients in the Emergency Department to a relevant specialty. This has now been rectified.

Tánaiste Eamon Gilmore has said that the Minister for Health wants to see that the recommendations from the report are implemented “with great urgency”.

Speaking in the Dáil this morning, Gilmore said that major changes had been made at the hospital since the concerns were raised.

“The staff of the hospital have a hugely important role in responding to the challenges ahead,” he said.

You can read the full investigation report here as well as an  executive summary of the report here.

- Additional reporting by Christine Bohan

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