Plan for a new children's hospital


Sir, – James Sheehan (Opinion, March 2nd) states it is essential that the new national children’s hospital be built on a green field location, thereby seemingly dismissing the use of the Mater site as an option. Before we throw the baby out with the bath water and given that we have already spent €36 million on the current plan, would it not be more prudent to examine the possibility of pursuing the original plan to provide this service at the Mater site, albeit in a smaller building? It is feasible to look at the possibility of moving non-clinical services such as finance, administration and laundry off-site in order to maximise the space available for critical on site services.

Other world-class hospitals such as Seattle Children’s in the US concentrated on patient flow when constructing the design of its new hospital, incorporating Lean Thinking into their plans. Lean Thinking drives different layouts than those typically associated with traditional hospital buildings.

Review of the current plans with the application of process flow design may reveal areas of unnecessary capacity that have been designed without regard for the services that will be delivered in this area. Are we building large waiting rooms when we intend to make excessive waiting a thing of the past? In order to minimise inefficiencies you should design your process before you design your space. Patient-centred and thoughtful facility design incorporating Lean Thinking can dramatically increase quality and safety while reducing costs. It allows clinical staff to spend more time with their patients and less time searching for, or walking to and from equipment.

I note that in the nine points Mr Sheehan has outlined, he has omitted the crucial element of working in collaboration with the front-line staff involved in the delivery of health services to children. They know what the needs are in relation to layout and patient flow. In point eight he actively discourages consulting anyone outside of the design team when making decisions during construction of the building. The staff who deliver services to children on a daily basis are the process experts and they should work in conjunction with the design team but remain responsible for how the space develops and is used.

While I agree with Mr Sheehan that the completion of the hospital would show “a glimmer of hope to the Irish nation” it would be a far greater message of hope to show that we can adapt and deliver optimum care without necessarily having to go back to the drawing board. A simple solution which allows us to best use space and resources would be the most sensible course of action and put an end to this ongoing debacle. – Yours, etc,


Lean Healthcare,

Senior Clinical Lead,

Leading Edge Group,

Harbour Row,

Cobh, Co Cork.