James Reilly (Dublin North, Fine Gael) | Oireachtas source

I thank the Deputy. In common with many hospitals, Our Lady of Lourdes Hospital in Drogheda has experienced an increase in attendances at its emergency department in the current year. For hospitals like Our Lady of Lourdes Hospital that serve populations with significant numbers of high acuity elderly patients presenting with complex co-morbidities, the requirement to admit patients is similarly high. The nature of these patients' needs may require longer than average lengths of stay. Patient experience times at Our Lady of Lourdes Hospital are roughly in line with national patient experience times. Approximately 70% of patients are discharged home or admitted within six hours. Some 81.4% of patients are discharged home or admitted within nine hours. Despite the increases I mentioned at the outset, the number of patients waiting for ward bed accommodation has decreased by 15.4% in the last three years. The Deputy quite rightly pointed out that it is unacceptable to have patients on trolleys for eight to ten hours. While I agree with him, he should acknowledge that such waiting times represent a huge improvement on the waiting times of three or four days that were experienced when he was in government.

The special delivery unit has worked intensively with management and staff at the hospital. A variety of initiatives which address many of the needs of the local population have been introduced. A cross-sectoral group that will focus on frail and vulnerable elderly patients, with representatives from the community, private nursing homes, the acute sector and groups such as Alzheimer's disease carers, has been established. The HSE is seeking to expedite the recruitment of nurses, particularly for the emergency department and for critical care. Internal medicine services have been reconfigured to enable acute medicine assessment unit physicians to manage all acute medicine assessment unit and short-stay medical unit patients. An additional acute medicine physician has been recruited to further extend these services. Twice-weekly medical census meetings and once-weekly surgical and orthopaedic census meetings, led by the clinical director, have been introduced. At these meetings, an overview of each inpatient's care takes place and potential impediments to their discharge are discussed. Ten private nursing home beds have been purchased for the provision of orthopaedic rehabilitation following hip fractures. This service also utilises a physiotherapist. It has significantly reduced orthopaedic patients' length of stay at the hospital.

Our Lady of Lourdes Hospital is making progress in implementing all elements of the emergency medicine programme. Practice changes and patient pathways that have been put in place for acute medicine remain very effective. A recent audit undertaken by the quality and patient safety audit validated the hospital's full compliance with the acute medicine programme. The overall length of stay in medicine, surgery and orthopaedics is well within the targets set nationally and by the clinical care programmes. Our Lady of Lourdes Hospital recently got planning permission for the second phase of its planned expansion, which will provide an enlarged emergency department and 60 en suite single accommodation rooms which are fully compliant with the strategy for the control of antimicrobial resistance in Ireland. The hospital is actively bringing NCHD rosters into compliance with the requirements of the European working time directive. Medical on-call rotas have been reduced from 24 hours to 12 hours.

The hospital, supported by the special delivery unit, is continuing to actively seek improvements in the provision of patient care. Current priorities include the improvement of patient clinical pathways, the optimisation of the use of the acute medicine unit and the movement of patients to lower acuity beds at other facilities, such as Louth County Hospital, when his or her condition is sufficiently stable to do so.

Consideration is also being given to nurse staffing of the day ward and transition lounge.

Special delivery unit liaison officers continue to engage with the hospital on these operational issues, as a result of which I expect to see further improvements in access to appropriate care in a timely manner. The Department of Health and the Health Service Executive are focused on implementing the Government's reform programme for acute hospitals, including the organisation of these hospitals into a small number of groups, each with its own governance and management, to provide an optimum configuration for the delivery of high-quality, safe patient care in a cost effective manner.

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