A&E in Drogheda

Motion:-

This Forum acknowledges the distress caused by overcrowding in our A&E
facilities and calls for an action plan to be put in place to deal
with the chronic overcrowding in OLOL Hospital A&E services.

Submitted by Cllr. Michael O’Dowd

Response:

The Programme for Government committed to the establishment of a
Special Delivery Unit in the Department of Health to assist the
Minister in reducing Emergency Department trolley waits, hospital
waiting lists and to support the introduction of a major upgrade in
the IT capabilities of the Health system.

The focus of the Special Delivery Unit is on service improvement, with
a specific focus on the areas of reducing trolley waits in Emergency
Departments and on cutting inpatient, day case and outpatient waiting
lists in the health service.

Currently, Our Lady of Lourdes Hospital Drogheda is implementing a two
pronged approach to management chronic overcrowding in the A&E
Department. The Clinical Director and Group General Manager are fully
engaged in managing scheduled care and unscheduled care under the
direction of Dr. Martin Connor. This weekly process commenced on 7th
September. In addition to reviewing peaks and troughs in
presentations, how to anticipate these peaks and respond to same the
group are also contingency planning for the winter period to ensure
senior decision makers are available at all times.

Firstly, the Louth Meath Hospital Group is actively engaged in the
implementation of the National Clinical Care Programmes which will see
the Acute Medical Assessment Unit extending its opening hours to 24
hours a day, 7 days per week. This unit provides an alternative
appropriate location for the high numbers of medically unwell patients
that attend the ED and seeks to, using protocols, assess and provide
rapid diagnostics to determine the appropriate care pathway for the
patient this may be admission, discharge or follow-up as an
outpatient. The extension of this service to 24/7 requires the
provision of additional staff or their redeployment and associated
service curtailment. In addition, this requires considerable changes
in practice for physicians and their rotas which are being agreed and
implemented. This capacity will go some way to alleviating the high
numbers of patients waiting for admission in the department.

In addition, we operate a three tier response based on the level of
overcrowding, the escalation protocol enables rapid and early ward
rounds and expedited discharge, when appropriate. This response also
allows for the placement of additional beds in ward areas which is
called the full capacity protocol.

Dermot Monaghan,
Area Manager – Louth Meath,
Health Service Executive.