The tragic events surrounding Aoife Johnston’s demise at University Hospital Limerick (UHL) on 19th December 2022, was alarming even to healthcare sector veterans. She checked into the hospital’s Accident & Emergency (A&E) department on 17th December, presumed to be a victim of sepsis. After two days and a failure in swift diagnosis and effective treatment despite her prescriptions, she passed away. The staff described the situation in the A&E at the time as a chaotic, war-like scenario, far from a safe setting.
Dr Jim Gray, who was the duty consultant in emergency medicine over the weekend, compared the condition of the department to an airplane full of passengers blocking the corridors too. Patients were cramped in trollies occupying every available space, leading him to describe it as a “death trap”.
Several questions are now being raised by concerned citizens:
If one of the country’s primary A&E departments is referred to as a ‘death trap’, how concerned should we be about the safety of our struggling national health system?
UHL has long been an area of concern. Following the closure of acute facilities at Nenagh and Ennis hospitals, the bed shortage has seen the hospital feature in numerous critical reports by the health regulator, Health Information and Quality Authority (Hiqa). Hiqa recently pointed out that significant patient safety risks persist in the A&E section of UHL, even with some measures of progress.
Nevertheless, UHL isn’t the only hospital causing concern. Noteworthy deficiencies have been identified at University Hospital Kerry, University Hospital Galway, and others, featuring in the Hiqa reports. A combination of inadequate infrastructure, a lack of frontline medical staff, and ineffective and shortsighted mismanagement are all contributing to the problems.
Data shows that patient admission delays over five hours correlate with a higher risk of death. This irrefutable metric confirms that patients are dying in Ireland’s public hospitals owing to time wasted in A&E departments.
How can one tell if their local A&E department is secure or not?
One must follow the Trolley Watch national statistics which are maintained daily by the Irish Nurses and Midwives Organisation (INMO). The INMO reported in April that more than 11,000 patients had been hospitalised without being provided with beds.
The list of the five hospitals with the most overcrowded condition included:
– University Hospital Limerick with 1,971 patients
– Galway University Hospital with 1,208 patients
– Cork University Hospital with 1,096 patients
– St Vincent’s University Hospital with 650 patients
– Letterkenny University Hospital with 594 patients.
Could any action be taken to improve the circumstances?
Based on an unexpected scrutiny report by Hiqa from the previous year, Beaumont Hospital’s emergency department showed to be overall compliant with the National Standards for Safer Better Healthcare. They were fully staffed in the emergency department and provided convenient access to consultants and senior decision-makers. They provided great access to transitional facilities, which improved patient flow from the hospital.
Moreover, Hiqa observed that “within the recent years, [Beaumont] had successfully transitioned from a state of constant overcrowding in the emergency department to a state where the overcrowding was efficiently managed or not even present”.
In the past eight years, there has been a momentous change. It was indeed impressive to observe the transition in performance in the Irish hospital system, particularly considering its initial notoriety for trolley watch statistics.
What could I do if an emergency arises and University Hospital Limerick (UHL) is the closest hospital?
It is recommended to only visit the UHL ED when it is critically necessary. Seek your GP’s guidance initially. If they advise you to get emergency department care, ponder about going to the closest immediate care facility run by Laya or the VHI. Avoid calling an ambulance for minor issues.
Cases brought in by an ambulance are bound to be taken to UHL. Instances such as being a victim in a severe traffic accident or experiencing an acute coronary event leave no other option.