OVERCROWDING IN SLIGO University Hospital is negatively impacting the privacy and dignity of patients, as well as risking their safety.

A new report by the Health Information and Quality Authority (HIQA) shows that, for the third time in three years, trolley numbers are too high and patient experience targets have been breached.

It found that privacy, dignity and autonomy were upheld insofar as was possible in the emergency department cubicles. For example, curtains were secured around patients for privacy when providing personal care. They had a call bell, a locker and a chair for visitors or to sit in outside of bed.

However, inspectors found that these facilities were not available to admitted patients being cared for on trolleys on a corridor in the ED, where there was considerable traffic.

These patients didn’t have a locker for their belongings, a table for meals, a place to charge their phone or shower facilities. 

Patients told of the “excessive noise” and bright lights they had to sleep under.

Inspectors found that discussions with patients were overheard by others in the vicinity.

All of the HSE targets for patient experience times  were breached in Sligo Hospital on the day of the HIQA inspection.

This meant that patients waited too long to be seen in triage and too long to be admitted or discharged.

As a result, the ED was overcrowded and was being used to accommodate admitted patients.

The acute assessment unit was also being used to accommodate admitted patients, “which in turn impacted upon its performance and efficiency in seeing, treating and or admitting patients”.

“This requires significant and ongoing efforts to ensure that patients can access emergency care and can either be discharged or admitted to a hospital bed on a ward in a timely manner,” the report said.

St Vincent’s University Hospital

St Vincent’s University Hospital in Dublin 4 was also inspected by HIQA.

Inspectors found that although patients were triaged and medically reviewed promptly in the St Vincent’s emergency department, none of the HSE’s patient experience time targets were met on the first day of inspection.

Inspectors also found out-of-date medications, medication with no date of opening, and decisions to discontinue medication were not always dated.

Patients in the emergency department told of being triaged quickly, although delays had been experienced in waiting for a review by a specialist doctor.

It was mentioned to inspectors that there was no place for patients to go to get something to eat. Inspectors noted that there was no vending machine and limited amount of cups for water in the ambulatory waiting area, but this was remedied when it was brought to the attention of management.

Emergency department staff were described by patients as “brilliant” and “empathetic”.

St Vincent’s was compliant or substantially compliant in most areas, such as ensuring the dignity and privacy of patients and promoting a culture of kindness and respect.

Connolly Hospital

At Connolly Hospital in Blanchardstown, inspectors found the governance structures supported high-quality, safe, and reliable healthcare, and patient feedback was used to inform ongoing improvements.

However, a strategy to address vacancies had not been developed.

The pharmacy department reported a 20% vacancy rate. A clinical pharmacy service was not available for five inpatient wards or in the emergency department, and the antimicrobial pharmacy service was limited.

In the ED and on the Walnut ward, nursing vacancies “posed potential risks to patient safety”.

Not all staff had access to up-to-date medicine information at the point of medicines preparation or administration and some printed material seen on inspection was out of date.

Some 35% of patients audited did not have discharge summaries issued to their
general practitioners in a timely fashion.

Inspectors found a lack of higher-dependency beds and the clinical coordination team were only available during daytime hours from Monday to Friday.

HIQA noted that there was a culture of kindness and patient preferences were taken into consideration. Patients were also encouraged to raise any concerns they had about their care.