Hospital pilot project cures A&E trolley crisis

A LIMERICK hospital is beating the trolley crisis through a new pilot initiative which grades injuries and illnesses.

After a quick assessment, the less serious cases are handed over to a Minor Injury Clinic, which is part of the A&E department of St John’s Hospital. This year

St John’s Hospital will deal with more than 20,000 patients in its A&E department of which 12,000 will be seen by the Minor Injury Clinic medical team.

Nobody will spend more than a few hours on a trolley and anybody who needs to be admitted is assured of a bed.

St John’s, which is the only hospital in the country funded directly by the Department of Health, has 93 in-patient beds and 10 day-patient beds. It is a registered charity and publicly owned.

The Hanley Report states that the St John’s Hospital initiative should be put in place around the country.

Since the Minor Injury Clinic was opened at the A&E department in 2001, patient numbers have risen from 11,000 to an estimated 20,000 in 2004. However, no patient has been left in a trolley on a corridor for any significant period.

Tim Kennelly, chief executive officer of the hospital, said they quickly categorised patients who arrived at A&E, according to their condition.

Up to 65% of admissions are seen by a doctor within 15 minutes; a further 20% are seen in less than 30 minutes and 85% are medically attended to within an hour. Up to 80% are allowed home after been treated at the A&E Minor Injury Clinic.

“Fortunately, we can avoid having to keep patients on trolleys. A few might have to spend an hour or two on a trolley, while lab tests are awaited. But we never have a patient overnight on a trolley,” said Mr Kennelly.

During winter time when admissions are up, people due to have elective surgery will have their procedures delayed to free up beds for admissions from the A&E.

Mr Kennelly said about 70% of patients who attended the Minor Injury Clinic were referred by their doctor or brought in with an injury or illness.

As it is a pilot project, the Minor Injury Clinic opens 8am to 8pm, Monday to Friday. Mr Kennelly said if the Hanley Report proposals were acted on, opening the clinic on a full time basis would be looked at.

St John’s Hospital A&E department has a staff of 20 of which eight work in the Minor Injuries Clinic. Mr Kennelly said turnover of casualty doctors was low.