Mater initiative will speed admission for waiting outpatients

The Mater Hospital in Dublin is to create a "hospital within a hospital" to deal with emergency cases, leaving other beds free…

The Mater Hospital in Dublin is to create a "hospital within a hospital" to deal with emergency cases, leaving other beds free for pre-arranged admissions.

The move is intended to get around a major problem in the health system, where people due to go into hospital for routine operations and investigations have their admissions postponed because all the beds have been taken up by emergencies.

The Mater's initiative is likely to become a model for other hospitals.

According to a document seen by The Irish Times, the Medical Emergency Division Project - which will commence on December 1st - will also improve the care and speed of admission of patients who come through the Mater's Accident & Emergency Department.

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The initiative centralises emergency beds on three floors in the Phase 1A building at the Mater. It is divided into three operational areas: a 38-bed acute cardiology unit; an acute geriatric unit with 52 beds and a 62-bed acute medical unit.

All acute admissions to the hospital will go through the medical emergency division which will have higher than normal staffing levels and priority access to x-ray and laboratory facilities. For example, CT scan reports will be available on a same day basis, seven days a week.

The initiative, which will cost over £2 million a year, is being funded by the Eastern Regional Health Authority. Its success depends on the Northern Area Health Board being able to expedite the return of elderly patients and the young chronically sick to the community following hospital admission and treatment.

Figures seen by The Irish Times show that the Mater had 6,774 emergency medical admissions - representing 64,000 bed days - in 2000. The average length of stay per patient was 10.5 days.

The plan says "a reduction of medical emergency average length of stay by one day will release 6,774 bed days annually".

Sources confirmed they were conservatively estimating an annual saving of 15,000 bed days from treating patients more effectively and discharging them more quickly. The hospital will have five "discharge planners" in place by December 1st, so that a patient's discharge will be planned from the day of admission.

According to the initiative, the 15,000 "saved" bed days will allow the hospital to treat 3,000 more people, who will be taken off waiting lists and offered five-day admissions for procedures such as gall bladder removal or hernia repair.

The acute geriatric unit will accept all patients with strokes and all patients over 65 who do not have predictable discharge dates. It will have a higher than normal number of occupational therapists, speech therapists and physiotherapists.

People with cardiac chest pain will be processed by a new chest pain service in the Accident & Emergency unit.

The acute medical unit will include a six-bed special care unit for high dependency patients.