Limerick’s fire authority warns it may take legal action against hospital over ED overcrowding
Limerick’s fire authority has signaled its intention to take legal action should the “non-compliance” of a Fire Safety Notice continue at University Hospital Limerick’s Emergency Department (ED).
The fire authority conducted an inspection of the ED on March 26 last after it received “a complaint regarding overcrowding”.
Assistant Chief Fire Officer Seamus Barrett, “noted that 38 patient-occupied trolleys were located in various aisle locations within the care/observation areas of the Emergency Department...this figure exceeds the safe number of trolleys in the Emergency Department set out in the Fire Safety Notice, namely 29,” Chief Fire Officer Michael Ryan stated.
“It is a matter of serious concern that the safe number of trolleys in the Emergency Department specified in the Fire Safety Notice has been exceeded. In the interest of the safety of patients, staff and visitors, it is essential that the number of trolleys is restricted to 29 at all times in the Emergency Department,” Mr Ryan added.
However, responding to the fire authority’s concerns, the chief executive of the UL Hospitals Group, Colette Cowen, said that if it is to keep to the current fire safety notice “at all times”, services would close or be diverted outside the region, “creating clinical risk and a threat to life or limb”.
In a series of candid written exchanges, between the Michael Ryan, and Ms Cowen, released by the UL Hospitals Group under Freedom of Information legislation, Mr Ryan expressed “serous concern” for the safety of patients, staff and visitors at the hospital’s ED, due to overcrowding.
The Limerick ED provides the only 24-hour emergency care unit across a catchment of approximately 400,000, which serves Limerick city and county, Clare Tipperary, as well as part of north Cork and Kerry.
The reconfiguration of all 24-hour services in the region to UHL was signed off in 2009 by the Fianna Fáil-Green coalition government.
The Limerick fire authority conducted an inspection of the ED last March after receiving a complaint about patient safety due to overcrowding levels.
Agreed safety cap exceeded 16 times in just one month
As part of an agreed Fire Safety Notice, a cap of 79 was deemed to be a safe total number of patients in the Emergency Department at any one time, including a cap on 29 patients on trolleys.
Despite implementing extra initiatives at the hospital to “improve patient flow”, Ms Cowen acknowledged in a letter to Mr Ryan, that a breach of both caps occurred on 16 occasions last April.
“High levels of ward bed closures were experienced (in April) due to KPC outbreaks, (which) rescued the number of beds available to the ED and the numbers of trolleys permitted on each ward was rescued,” Ms Cowen stated.
In a letter dated May 8 last, Mr Ryan informed the hospital: “The number of trolleys in the emergency department is a matter of ongoing concern to the fire authority and in particular your non-compliance with the requirement regarding the safe number of trolleys in the emergency Department as set out in the Fire Safety Notice.
“If the terms of the Fire Safety Notice are not being complied with, the Fire Authority will make an application to the District Court under Section 5 and 20 of the Fire Services Acts 1981 and 2003,” Mr Ryan added.
'Our demand far exceeds our capacity'
Last April, Ms Cowen outlined in her letter to the fire chief, “the changes made to ensure we come in line with the Fire Authority’s instructions”, and that, “UHL is the only site serving Emergency Care in the Mid West (with) a population that is socially deprived alongside high numbers of frail elderly people”.
“In comparison to other major centres in Galway, Cork and Dublin, we have 200-250 less inpatient beds, yet UHL is the second busiest hospital for emergency attendances to its Emergency Dept in the country.”
Ms Cowen said she “fully respects the requirements of the Fire Authority” but she argued that with only 451 beds “our demand far exceeds our capacity”.
Despite it all “staff ensure patients are treated and cared for immediately to ensure a speedy recovery or onward treatment, to prevent adverse outcomes”, she said.
