Cork University Hospital reported inconsistent data regarding number of patients on trolleys

Hospital excluded people on trolleys in a ward setting from the official figures compiled for the HSE

The hospital confirmed to the auditors that the 16 trolley spaces on its wards were not included in data provided to the HSE nationally, and that those trolleys did not meet the definition of 'an appropriate bed space'. Picture: Denis Minihane

Cork University Hospital (CUH) was found to be reporting inconsistent data in terms of the number of patients on trolleys following an internal audit of its emergency department (ED) last summer.

The audit, aimed at verifying the reliability of the hospital’s ED and waiting time data, was conducted in mid-June and found a discrepancy between the official trolley data being delivered to the HSE and a background analysis report of the situation.

It found that CUH was excluding people on trolleys in a ward setting from the official figures compiled for the HSE, via a system known as TrolleyGAR, the data from which can be used to trigger emergency action mitigation plans should an individual hospital become exceptionally busy.

The hospital confirmed to the auditors that the 16 trolley spaces on its wards were not included in data provided to the HSE nationally, and that those trolleys did not meet the definition of “an appropriate bed space”.

When asked why those trolleys were not included in the hospital’s official numbers, bed management staff informed the auditors that the issue was escalated to senior management within the hospital in April 2022, but that the decision was made that trolley numbers were to continue being reported as they had been previously, according to the audit report seen by the Irish Examiner.

The auditors found the issue to be one of high risk, that is one displaying “major non-compliance with procedures, policies or regulations”, and recommended that the “senior most accountable person”, that being the chief executive of the hospital, should ensure that all people waiting on ward trolleys should be accounted for in the official data compiled on TrolleyGAR and distributed nationally, a change to be made with immediate effect.

On the date of the audit, CUH  had  41 patients awaiting a bed, according to a count by the Irish Nurses and Midwives Organisation.

In addition, HSE management recommended on foot of the audit that background analysis reports and TrolleyGAR itself should be unified, and the amount of data reported “streamlined” to provide “assurance that every hospital in the country is adhering to the data definitions”.

On the date of the audit, CUH — which along with University Hospital Limerick consistently records among the highest figures for patients on trolleys daily — had  41 patients awaiting a bed, according to a count by the Irish Nurses and Midwives Organisation.

Overall however, the audit — which was commissioned on an ad hoc basis by HSE CEO Bernard Gloster — found that “moderate” assurance could be provided regarding the accuracy and consistency of CUH’s emergency department and waiting times data.