Audit of Connolly hospital exposes patient care issues

A report on one of Dublin’s main hospitals is critical of cultural problems contributing to overcrowding and an overreliance on hospital trolleys.

The audit of Connolly hospital in Blanchardstown outlines serious concerns including a lack of resolve among senior medical staff to change current practices.

The unpublished document, seen by The Irish Times, was produced following a visit by the Special Delivery Unit which was established to reduce waiting lists and times in hospitals.

Its visit to Connolly last June revealed, on average, 18 people a day waiting on trolleys.

“There is an apparent lack of urgency felt within the specialities to deal with these patients and at times a lack of ‘push’ from the ED [emergency department] itself,” it noted.

“The senior management team appears willing to accept and drive change and has a patient-centred focus but there was little evidence during our visit that the majority of clinical teams or departments had the same focus.”

The report cites staff shortfalls due to an ongoing public sector moratorium compounded by retirements and resignations and a “culture of seeking external support to address these issues rather than a culture of seeking solutions from within the existing resource”.

This has resulted in “challenging situations which on occasion descend into crisis before a solution is agreed”.

Connolly has more than 1,000 staff and dealt with nearly 20,000 patients last year.

But there was found to be difficulty in filling rosters with non-consultant doctors in the emergency department and an unwillingness on the part of some staff to multi-task.

“There appears to be some reluctance from the ANPs [advanced nurse practitioners] who do not generally come out of the minor’s area to support the staff on the floor if minor injuries are quiet and the department is busy.”

Waiting times

The report is also critical of waiting times, observing that it “is not unusual” to find patients waiting 12 hours without review by an emergency department physician.

It was more complimentary of nursing staff who were found to be motivated and competent and aware of a need for change.

The HSE said the hospital was now addressing all aspects raised in the report.

It said in particular that opening hours in the Acute Medical Assessment Unit had been extended since November, improving waiting times.

“The hospital has managed its waiting lists well in 2012 with no surgical patient waiting more than nine months (national target) for admission.”