Hiqa: Hospital operating theatres not fit for purpose

A major acute hospital in Cork continues to use operating theatres identified as not being fit for purpose by the Health Information and Quality Authority.

The South Infirmary Victoria University Hospital addressed maintenance issues in the four theatres identified by Hiqa earlier this year but the “substantial problem” of poor infrastructure and design remains.

Despite improvements made by the hospital, the four theatres do not comply with international standards and design specifications needed for a safe surgical environment, Hiqa found.

“There is a stark contrast between the design facilities and footprint size of the newer theatres compared to the much older theatres which are cramped, dated and do not facilitate effective cleaning,” the report read.

The voluntary hospital has been selected as a site for elective surgery in the newly configured South Southwest Group which will result in an increase in the number of patients undergoing surgical procedures.

Hiqa said it was crucial the hospital was resourced to implement the necessary measures to ensure all its operating theatres comply with modern standards and design specifications.

During an unannounced inspection last April, inspectors found a number of “high risks” in the infrastructure and design of four of the hospital’s nine theatres.

The hospital had already noted the issues highlighted by Hiqa during a risk assessment it made last year and sought funding to address them. Inspectors were told decommissioning four of the hospital’s theatres would have a significant impact on its ability to deal with elective surgery.

When the inspectors revisited the theatres last May, they found significant improvements.

Inspectors found that hand hygiene compliance in the theatre department was poor and observed unsafe medication practices.

They also want improvements in the infrastructure of the hospital’s oncology unit and in the bed spacing of its paediatric ward to reduce the risk of infection. When they inspected the oncology unit last May, they found injection trays used to bring medication to patients were stained and did not appear to have been cleaned appropriately between use.

Portiuncula Hospital in Galway also required a re-inspection because of serious shortcomings identified in March. When the inspectors revisited the hospital in April, they found that improvements were still needed in relation to the control of Clostridium difficile and other multi-drug- resistant organisms.

While improvements had been made in environmental hygiene, there was “considerable room” for an increase in hand hygiene compliance, they noted.

Helen Donovan, interim CEO of SIVUH, said: “We in the South Infirmary– Victoria University Hospital acknowledge the findings of the recent Hiqa report. We wish to reassure our patients that all steps are taken to ensure a safe and positive patient experience.

“Since 2011, we have invested approximately €6m in our theatre complex.

“We have appointed engineering/architectural consultants to carry out an initial assessment of four of our theatres. This work was identified and commenced prior to our Hiqa visit. This environmental report will identify capital requirements and will further inform our business case to secure capital funding.”