Audit criticises elderly care at Beaumont

An audit into one of the largest hospitals in the Dublin region has criticised its care of elderly patients as being detrimental to their health and wellbeing.

The inspection of Beaumont Hospital found there were not enough beds, that patients were being kept on trolleys for long periods, and that there were insufficient psychiatric services to meet demand.

It said the existing ward was “poorly designed to meet the needs of frail elderly patients”, and that other shortfalls in the system, including a lack of “step-down” facilities, were also a hindrance to appropriate care.

The confidential report obtained by The Irish Times details an overall assessment carried out last July by the Specialist Delivery Unit (SDU) at the behest of Minister for Health James Reilly.

Waiting on trolleys

Beaumont is the largest public hospital in north Dublin with 815 beds, serving over 290,000 people. It has consistently had the highest number of patients in the country waiting on trolleys.

A spokesperson for the hospital said that before the publication of the report efforts were in train to amend its shortcomings. In many cases the audit was complimentary of the attitude of staff but problems were pervasive.

The SDU recommended a focus on alternative community care for the elderly and investment in home-care packages.

Elsewhere the report noted delays in emergency department (ED) turnaround times where patients can spend up to two days on a trolley or sitting in a chair waiting for a bed “sometimes in the corridor . . . without privacy, often packed close together”.

Emergency department attendances are constantly increasing, and the SDU said “a greater institutional-wide acknowledgement that the present crisis is a hospital-wide problem and not simply a problem at ED level” was necessary.

In general the report found a lack of communication or organisational culture regarding the monitoring and expedient passage of patients through the system. Staff were “quite resigned” to the status quo.

Cllr Kieran Dennison, a Fine Gael member of the Regional Health Forum for Dublin and the northeast, acknowledged the presence of excellent staff but said the audit revealed a “day-to-day operation often dysfunctional and wasteful”.

Older patients

“Nowhere is this more evident than with the care of the elderly where older patients are spending too long on trolleys and in acute beds.”

Beaumont has said that since the SDU publication there has been “continuing positive progress” on many of the recommendations despite reduced budgets – a cumulative 25 per cent since 2008.

“In mid-October the Minister made an unannounced visit to the hospital at which he expressed satisfaction with the significant performance improvements,” a spokesman said.