Trolleys at Cavan General Hospital

That further necessary measures are taken in order to reduce patient numbers
on trolleys at Cavan General Hospital.

Submitted by Cllr. Gerry Murray

Response:

The Cavan & Monaghan Hospitals are currently operationalising our
contingency plan to address the issues arising from admitted patients
waiting in the Emergency Department on trolleys for In-patient beds.

Current Local Plan
The current plan consists of the following:

A local escalation policy is activated during peak ED pressure times –
this consists of the key Clinical and Senior managers meeting
(sometimes 3 times daily) to review patient wait times and activity
and instigate contingency actions such as:

1. In creased physical space of ED (which expanded the patient areas
by 100% in 2010)
2. Medical Assessment Unit opened in 2009
3. Paediatric Assessment Unit opened in July 2011
4. Separate area for Minor injuries in the Cavan ED established in 2011
5. Additional staff are redeployed to the Emergency Dept
6. Consultants review all patients in ED and in wards resulting in
higher discharge rates – which allows more patients from the Emergency
Dept to access beds
7. The planned patient activity is reviewed and prioritised with non
urgent cases cancelled if required
8. Additional space is created in ward environments e.g. the Day Ward
– to facilitate the patients from the ED
9. Clinically Discharged patients are found placement in more
appropriate settings in Long term care facilities in negotiation with
the Area Manager

Future Plans
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, Cavan & Monaghan Hospitals are implementing a plan to
management chronic overcrowding in the ED in Cavan General Hospital.
The Clinical Director and the Assistant to the General Manager are the
Hospital lead personnel for the implementation of “managing scheduled
care and unscheduled care” in conjunction with the National Plan under
the direction of Dr. Martin Connor. This work has commenced in
September 2011 and a local action plan specifically focusing on
improvements in the Emergency Department is currently in development.

Leo Kinsella,
Area Manager – Cavan/Monaghan,