The UL Hospitals Group says a change in its methodology for reporting the number of patients in the Emergency Department reflect changes they have made there in response to COVID-19.
University Hospital Limerick is consistently the most overcrowded hospital in the country, with 41 patients on trolleys there today, among them 26 in the Emergency Department, according to the INMO.
However, the HSE’s own TrolleyGAR figures showed just seven patients on trolleys there this morning.
The UL Hospitals Group says their methods of reporting are in line with agreed national frameworks, but it has sparked concern among nursing representatives.
Mary Fogarty of the INMO in the MidWest says it’s confusing.
In their response to Clare FM, University Hospital Limerick confirmed that additional beds have been placed in the Emergency Department “for the greater comfort of patients.” When asked what difference the additional beds would make to trolley statistics, including the HSE’s TrolleyGAR figures, they stated that “the TrolleyGAR system is used for reporting the total picture of those waiting beds to give a total site status at 8am, 2pm and 8pm. We report those patients waiting on trolleys on corridors in ED, those waiting for beds in both the Acute Medical Unit and Acute Surgical Assessment Unit and finally those patients in surge areas we have opened to deal with demand. For patients awaiting transfer to inpatient wards in cubicles in ED, we count these as surge capacity as these cubicles are considered high spec single room accommodation in line with the national criteria. The placement of beds in the ED was purely to ensure we can provide comfort to frail and elderly patients while they do wait in ED.” They insisted patients being accommodated on beds, rather than trolleys, would not be treated differently and that there would be no change in the priority of when they’re admitted to hospital.
In further comments on the TrolleyGAR reports, the UL Hospitals Group stated that “the daily TrolleyWatch Report is published by the INMO and is not a matter for UL Hospitals Group.
We do, however, collect and report data three times a day for the HSE TrolleyGAR reports which are published daily on the HSE website.
The changes in how our TrolleyGAR data has been reported since August 11th reflect the reconfiguration of our Emergency Department as part of our response to Covid-19 and are also consistent with the national agreement from 2013 on how TrolleyGAR data is reported.
Separate emergency presentation pathways have been developed as part of our pandemic response, streaming suspect COVID-19 cases from non-suspect presentations. Three of the zones in ED at UHL are designated for patients in the Covid-19/query Covid pathway. As the ED is equipped with state-of-the-art single rooms and cubicles – and because we are challenged on isolation facilities around the hospital – the ED is an appropriate environment for suspect COVID-19 cases requiring single-room isolation pending a swab result or clinical decision.
No patient will be moved to a ward until such time as all the necessary precautions have been taken. It is essential that these measures remain in place to minimise the risk to patient and staff safety.
In addition, admitted patients in single rooms or cubicles in ED are considered to be in an appropriate bed space as per the 2013 agreement mentioned above. In recent weeks we have placed a number of beds in ED cubicles for the greater comfort of frail and elderly patients in ED. While using additional surge capacity is not the optimal solution, it provides more comfort and dignity and an improved patient experience for those who unfortunately do wait. We regret that any patient has to wait for a bed and they continue to receive expert care while they do wait.
Since August 11th, we have been reporting to HSE TrolleyGAR the numbers of admitted patients who are waiting on trolleys on corridors in the ED. In addition we continue to report through the daily HSE SBAR reports, the number of admitted patients waiting for a bed in areas such as the Acute Medical Assessment Unit and Acute Surgical Assessment Unit, which for the last number of months have been serving as EDs for medical and surgical patients in the non-COVID pathway.
Since the beginning of the pandemic, there have been no patients on trolleys on the general wards at UHL.
The unique challenge faced by UHL in terms of its bed capacity is acknowledged by all stakeholders. The 60-Bed Block at UHL is on course to open before the end of this year. Another 62 beds will be added between the three projects in UHL and Croom commenced under the national action plan in response to Covid-19. And earlier this month, a planning application was lodged for the 96-bed block for UHL approved under Project Ireland 2040.”
