Kerry hospital: ‘Gross overcrowding’ sees bed wait of up to nearly four days

Gross overcrowding and significant staff shortages pose a substantial patient safety risk at University Hospital Kerry, according to the State’s health watchdog.

Significant deficits in governance and management, and significant patient-flow issues in emergency care, are also identified in an inspection report by the Health Information and Quality Authority.

At the time Hiqa inspectors visited the hospital in Tralee, last September, there were no formal arrangements in place to ensure consultants had oversight of the emergency department 24/7, and there was a significant shortfall of rostered nursing staff.

The hospital was found to be non-compliant with five national standards, partially compliant with seven and substantially compliant with two.

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On the day of inspection, the hospital’s 12 bays in the emergency department were full, and another 11 patients were on trolleys in the main corridor. Upset patients vented their frustrations to inspectors over the long waiting times for a bed.

The time patients spent waiting for a bed varied from 14 to 95 hours.

“Hospital management’s inadequate efforts to address the issue of gross overcrowding in the department compromised patients’ dignity, privacy and confidentiality, especially patients accommodated on the corridor.”

Hiqa says Kerry is substantially behind many other similar-sized hospitals in relation to its efforts to ensure compliance with the national standards, though it acknowledges the hospital management team was in transition at the time of inspection.

Five years after tens of thousands of radiology scans at the hospital had to be reviewed due to concerns over the work of a locum staff member, Hiqa expresses concern at the delay in fully implementing recommendations made in response to this controversy. With a backlog of 450 X-ray and 120 CT scans emerging, it says there the potential for patient safety risk.

The regulator also criticises systems in place in Kerry to respond to complaints by patients and their families, saying these were not as effective as they should be.

“Significant further work, underpinned by effective leadership and support external to the hospital, is required to progress service quality and safety at the hospital and address many of the findings identified on this inspection,” the report states.

A separate report on Tallaght University Hospital found it was non-compliant with one national standard.

Inspectors say the hospital’s management arrangements are “not fully effective” in ensuring the delivery of high-quality and safe services to patients using the emergency department.

The hospital is “challenged” with capacity issues, insufficient isolation facilities and a report deficit in the number of services in the community to which patients can be transferred, according to the inspection report.

The use of trolleys for admitted patients is contributing to overcrowding, it says, while unfilled nursing and healthcare assistant posts are impacting on performance.

“The environment in which care was provided to patients on the day of inspection did not promote dignity, privacy and confidentiality for these patients.”

Inspectors who visited Cork University Maternity Hospital praised governance arrangements and said management were working to address staff shortages.