THE HEALTH INFORMATION and Quality Authority (HIQA) has praised the “good management” of Emergency Departments that were exhibited at Beaumont Hospital and University Hospital Waterford after recent inspections.
HIQA added that in recent years, both services had moved from “a situation of persistent overcrowding in the EDs to one where such crowding was well managed or not present”.
Both inspections took place in April, and the Beaumont was subject to an unannounced inspection while the inspection at UHW was a one-day announced inspection.
At the time of the inspection at the Beaumont, there were 69 patients registered in the ED, with eight patients on trolleys.
Although the inspector described it as “busy”, they added that the ED was “functioning well and there was a calm atmosphere”.
Patients who spoke to the inspector were very positive in their feedback, with one describing their care as “fabulous”, while another patient whose first language was not English praised staff for “explaining everything clearly”.
Inspectors also observed staff “actively engaging with patients in a kind, respectful and helpful manner”.
The inspector added that there was “effective governance, good operational grip and agile management arrangements” in place at the ED.
And while the hospital had further work to do to meet the six and nine-hour ED targets for admission or discharge set by the HSE, no patients were waiting more than 24 hours to be admitted or discharged from the ED.
HIQA also praised the “Beaumont in the Home” initiative which commenced in April 2022.
This was devised to address gaps in provision of care for people who were medically fit for discharge and where a care package was being processed but not finalised.
The scheme provides support through visits from a healthcare assistant until the care package is available through community care.
At the time of the inspection, 100 people has used the services which was described as a “good example of patient-centred integrated care”.
Beaumont Hospital was substantially compliant in the four assessed standards, meaning the service “met most of the requirements of the relevant national standard, but some action is required to be fully compliant”.
Meanwhile, in UHW at the time of the inspection, there were 61 patients registered in the ED, with the inspector finding that “care was being delivered in a calm and controlled environment”.
The inspection in UHW took place just seven weeks after a fire at Wexford General Hospital.
UHW then provided emergency care cover for counties normally serviced by Wexford University Hospital.
However, despite the high level of patient presentations as a result of this, HIQA said the hospital continued to effectively manage its ED.
Patients’ experiences were also very positive in UHW, with one patient describing staff as “nice and very helpful”.
Patients also commended how quickly diagnostic tests were carried out and praised staff for keeping them up-to-date on the results of tests and care plans.
Inspectors also noted that UHW had “effective and robust governance and management arrangements” in place.
Hospital management were also described as “responsive and reactive” and the hospital was also deemed to have a “proactive approach to supporting and resourcing the implementation of measures to enable the effective flow of patients through the ED”.
UHW was deemed to be compliant in three of the assessed standards, and substantially compliant in another.
HIQA’s director of healthcare Sean Egan said that both inspections “show the positive impact of a well-managed service on patient care”.
He added: “Our findings demonstrate that management had implemented effective operational measures and oversight to support efficient functioning of their emergency departments to reduce overcrowding.”
Egan also stated that “a key element in both hospitals had been the increase in available bed capacity both in the hospital and in local step-down facilities to enable patient flow”.
UHW added 72 additional beds in a new block which has been fully operational since 2019, leading to a current capacity of 510 inpatient and day beds, while Beaumont Hospital had “more access to a range of local and private step-down facilities”.
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