Waterford hospital without patients on trolleys since March 2020
UHW general manager Grace Rothwell monitors delays using the HSE’s trolley-counting system, which focuses on EDs only but does not count trolleys on wards, and said 'we haven’t had a patient on a trolley waiting for admission since March 2020.' Picture: Denis Minihane.
There were 760 people on trolleys in Irish hospitals yesterday, the highest since January 2020, and the second highest since records began.
University Hospital Waterford (UHW) has not had a patient on a trolley awaiting admission since March of that year, however, with patient advocates calling for its systems to be adopted elsewhere.
UHW general manager Grace Rothwell monitors delays using the HSE’s trolley-counting system, which focuses on EDs only but does not count trolleys on wards, and sees cause for optimism.
“We haven’t had a patient on a trolley waiting for admission since March 2020, we actually hit our 1000th day on Saturday,” she said.
Irish Nurses and Midwives Organisation (INMO) data, which is counted differently, shows two patients on trolleys, with 17 in total last week, compared to 115 during the same week in 2019.
Ms Rothwell identified a number of tactics behind this “huge work”, but was reluctant to say what could be copied.
“It is the person in charge, but it is also having everybody on your team.”
Specialist nurses frequently work on wards to fill gaps; they are short 70 full-time nurses despite having 300 more staff than during 2019.
“Then after that it is about managing demand and capacity, obviously if we let everybody in today, we are going to be trouble,” she said.
“So to me it’s a patient safety issue — having zero people on trolleys, that is our standard."
The hospital uses winter funding to cover private nursing home beds; these take “patients who are not quite ready to go home,” she said, which frees up hospital beds.
This has caused concern for some families, with patients worried they were discharged too early, she said.
Elective operations were postponed to make room for emergency cases.
However, she said the hospital does not "have sufficient capacity to meet demand".
“But it is not true to say we have sufficient capacity to meet demand;
"We work very carefully manage our demand in line with our available capacity.” The shock of Covid-19 started this, she said, with constant overcrowding as “a vicious cycle”.
However, despite better experiences for most emergency patients, Ms Rothwell said the system is "not all that sustainable" in the longer term.
“It’s probably in the longer term not all that sustainable,” she said. “You need other bits to come on. Every time you get a few more beds, something else is happening.”
The Irish Patient Association’s Stephen McMahon cautiously welcomed the breakthrough.
“They are performing well versus where they were a few years ago and that is to be commended,” he said. “If there are lessons to be learned by the rest of the acute system, that should be disseminated as quickly as possible.” However, he added:
There are 5,044 patients on waiting lists in Waterford this November, compared to 4,072 last year, National Treatment Purchase Fund data shows.
were 4,072 patients on waiting lists in Waterford last November, compared to 5,044 in November this year,
INMO general secretary Phil Ní Sheaghdha said it is “unacceptable“ and "a danger" to have 760 people waiting for a hospital bed.
Chief Medical Officer Breda Smyth has highlighted the strain on hospitals from an increase in Covid-19 and flu cases requiring admission, as well as high numbers of children still presenting with RSV.
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