THE INTRODUCTION of admission lounges adjacent to hospital emergency departments has lengthened rather than shortened the time patients have to wait for a hospital bed, research published yesterday has found.
Following the declaration of a national accident and emergency crisis by the Minister for Health, Mary Harney, in March 2006, the Department of Health proposed the introduction of admission or transit lounges as a means of providing greater comfort for emergency patients waiting for a hospital bed to become available.
A study published in the latest issue of the Irish Medical Journalhas found that the average waiting time before a patient was transferred to a ward bed was just over 23 hours after the introduction of a 10-bedded admission lounge at Dublin's Beaumont hospital, compared with a waiting time of 17 hours and 40 minutes one year earlier.
Dr Peadar Gilligan, consultant in emergency medicine at Beaumont, and his colleagues also found there was no statistical difference in the number of patients waiting for emergency admission in a three-month period in 2007 compared with the same three-month period in 2006, when no transit lounge was in use.
And compared with those admitted straight from the emergency department, patients sent to the transit lounge were significantly older. Some 30 per cent of people who were ultimately admitted to a ward spent time in the transit lounge.
"I would like to see a situation where a patient requiring hospital admission are taken within a matter of hours to a ward bed," Dr Gilligan told The Irish Timeslast night.
“Research from Australia shows that excessive waiting time in emergency departments impacts negatively on patients’ wellbeing, leading to increased mortality and a prolonged stay in hospital.”
He said the solution to emergency department overcrowding with patients who require acute hospital admission was the provision of additional acute beds.
But Dr Gilligan acknowledged that patients based in the transit lounge on a bed were more comfortable than those who waited on a chair or a trolley in the main emergency department.
Noting that €200,000 was spent providing the pre-fabricated transit lounge at Beaumont, the authors of the research said it was disappointing that people requiring hospital admission waited even longer for a ward bed after the lounge was opened in February 2007.
“It was envisaged that the transit lounge would provide only a short stay area for patients but as evidenced by the daily turnover of the lounge it is not being used in this manner,” they said.
The transit lounge continues to function at Beaumont and a number of other Dublin teaching hospitals.
According to the Irish Nurses Organisation (INO) “trolley watch” numbers for yesterday, some 22 patients were waiting for hospital admission at Beaumont, a figure that does not include patients occupying the 10 beds in the hospital admission lounge.