Tuesday, 25 November 2008
Dáil Eireann Debate
96. Deputy P. J. Sheehan asked the Minister for Health and Children if a culture of acceptance of trolley waits in hospital accident and emergency departments exists within her Department; the reason hospitals have not met trolley waiting time targets as set out in the ED task force report; and if she will make a statement on the matter. [42557/08]
116. Deputy Bernard J. Durkan asked the Minister for Health and Children the steps she has taken or proposes to take to relieve the overcrowding at hospital accident and emergency departments and admissions during the winter months; if it is intended to augment front line staff in these areas; if she has in mind proposals to provide extra beds in line with seasonal requirements; and if she will make a statement on the matter. [42467/08]
278. Deputy Bernard J. Durkan asked the Minister for Health and Children the action she has taken to ensure the availability of sufficient bed accommodation and accident and emergency facilities at all hospitals throughout the country with particular reference to increased requirements of the winter months; and if she will make a statement on the matter. [42788/08]
I do not agree that a culture of acceptance of trolley waits exists. We have made considerable improvements since 2005 in improving the delivery of services in Emergency Departments. For example, the average daily number of patients awaiting admission at 2 pm fell from 179 in 2005 to 92 in 2007. The figures over the first ten months of 2008 show an increase to 103 in the numbers awaiting admission. Patient waits of longer than 24 hours, following a decision to admit, have been totally eliminated in the case of 21 of the 34 hospitals, while a further 8 have infrequent waits of that duration. In addition, the vast majority of hospitals (25) are fully or substantially compliant with the revised 12 hour target introduced in October last year.
The main problems are confined to a small number of hospitals and the HSE continues to work closely with those hospitals to address the underlying issues and to effect improvements. Hospitals need to improve their admission and discharge processes, to ensure that people are appropriately admitted and that their care is efficiently managed, both during their hospital stay and their follow up care in the community. Steps are being taken to ensure that patients have an expected date of discharge within 24 hours of admission, that patients can be discharged in a more proactive manner at weekends and that communication between the hospital system and primary care services is improved. Implementation of a new Code of Practice on Discharge Planning has commenced. This should help to deliver further improvements in overall bed utilisation.
As part of the Winter Initiative, Hospital Managers have been asked to develop an action plan to reduce the average length of stay in hospital of patients, based on the findings of the Bed Utilisation Study and to increase the rate of Day Surgery in line with best international practice. The HSE is also working to increase long-stay capacity and to free up beds in acute hospitals over the Winter period. This is being matched by an intensive focus on improved processes and efficiency.
I believe that setting clear targets for improvement and measuring performance against these targets helps to drive further improvements in services. My Department has asked the HSE to set a revised maximum waiting time target of no more than 6 hours from registration to admission or discharge in 2009 for all patients attending Emergency Departments. The HSE has also been asked to introduce a measurement system in 2009 to record the total waiting time for all such patients. My Department has asked the Executive’s Parliamentary Affairs Division to reply directly to the Deputies on the additional issues raised.
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