Efficiency vital to help ease our A&E crisis

IT was recently reported that the number of patients waiting on trollies in our nation’s A&E departments had reached a record high.

This issue can no longer be considered seasonal as these figures reflected the situation over the month of August when admission rates for medical patients are traditionally quiet and therefore we may expect the number of patients on trollies to rise exponentially as the winter months approach.

In the current political and economic environment, the importance of efficiency in the A&E department is not only about patient safety, but also the need to improve quality of care despite diminishing resources.

The application of process and management methodologies such as Lean and Six Sigma is the approach that needs to be adopted in Ireland based on positive results achieved in other global healthcare systems.

The HSE is attempting to provide services within strict financial constraints due to an ever decreasing public sector budget and in this period of needing to “do more with less” it is unlikely that they will be in a position to open or staff previously closed beds in acute and continuing care facilities. This situation will inevitably continue to place pressure on A&E departments across the country.

However, not having sufficient in-patient bed capacity is not the only factor that contributes to overcrowding.

Managing the complex service environment that is an A&E requires an understanding of the concepts that underpin department operations.

Lessons gained from manufacturing regarding process design and management of variation have been successfully applied to some healthcare institutions in the USA and Australia which have had a positive impact on patient flow through these A&E departments.

It is more about the reconfiguration of services and redesigning of processes than the adding of resources.

Jane Bishop

Cobh

Co Cork