Survey reveals hospitals’ planning failures

HOSPITALS are failing to deal with violent patients, informed consent and disaster planning, a new report has found.

The report from the Irish Health Services Accreditation Board (IHSAB) also found huge gaps in how patient safety is managed.

Between 2002 and the end of 2004 14 hospitals underwent peer review surveys as part of then IHSAB Acute Care Accreditation Scheme (ACAS).

Results show some hospitals have an uncoordinated approach to risk management, with 14% not having structures in place for identifying, assessing and managing patient safety.

There was an inconsistent approach to obtaining consent and a lack of mechanisms to support staff making ethical decisions.

While 50% have adequate structures in place for obtaining consent, the remainder only partially complied with requirements. Consent policy was found to be very basic in some hospitals or in draft format and in need of formalisation in others.

While some had good systems for dealing with issues where patient competency to give consent is in question, others did not.

In 71% of hospitals surveyed there was insufficient uptake or availability of staff training to deal with aggressive and/or violent behaviour and disaster and emergency plans not tested.

In particular, it found 21% did not have internal disaster plans in place or had not tested their major disaster plans. Only 14% were fully compliant.

Also, 21% were not compliant with standards that recommend an annual review of fire/disaster plans.

IHSAB chief executive, Roisín Boland, said the issues raised in their 2004 report in relation to disaster plans were now being examined by the National Hospitals’ Office.

IHSAB surveys also found 14% of hospitals had not taken sufficient measures to ensure the confidentiality of patient information.

There were inadequate storage of medical records at ward level, inappropriate transportation of records around a site and lack of automatic locks on medical records storage rooms.

Other hospitals had not taken sufficient measures in protecting records from accidental damage or fire.

IHSAB chairman Dan Byrne said 80% of all acute care hospitals had voluntarily applied to participate in the scheme by the end of 2004, a level that exceeded their projected target of 60%. Five that already underwent the survey process have reapplied to participate in the scheme.

The IHSAB has been asked by the Tánaiste and Minister for Heath, Mary Harney, to develop national hygiene standards to deal with problems like MRSA and post-operation infections. Standards should be in place by the year end.