Patients on trolleys

The annual hospital trolley crisis is not a recent development


According to the Irish Nurses and Midwives Organisation (INMO) the number of patients on trolleys across the hospital system has almost doubled in a week. There were 467 people waiting on trolleys last Wednesday, compared with some 245 on Thursday of the previous week and 205 on December 30th, the INMO’s daily “trolley and ward watch” found.

This annual hospital trolley crisis is not a recent development. Deemed a national emergency in 2006 by then minister for health Mary Harney, it is a byproduct of an event known as “clinical winter”. This occurs in the months when viruses and other infections lead to greater amounts of respiratory illness and when patients with chronic ill-health get tipped into acute illness by the drop in temperatures and other factors. The HSE said last week:“Hospitals are reporting increased admission rates with higher acuity of presentations noted, particularly (among) the frail elderly.”Even the successful efforts of the Department of Health’s Special Delivery Unit have not been uniformly felt. Beaumont Hospital and Tallaght in Dublin remain trolley-wait black spots, while Our Lady of Lourdes Hospital in Drogheda has improved significantly. Dublin’s Mater hospital and Sligo also turned the corner in 2013.

Ireland has one of the highest bed occupancy rates among OECD countries, a statistic that invites hospital overcrowding. Apart from the obvious discomfort and inconvenience involved, the practice is dangerous. According to the Health Information and Quality Authority, there were instances of patients with highly infectious disease placed on trolleys in busy emergency departments. In addition it is difficult to effectively monitor ill patients in overcrowded conditions and even more of a challenge to resuscitate them properly. As illustrated by numerous reports, target-based healthcare may compromise patient safety. Hospital overcrowding must not be allowed to cause preventable deaths.

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