The HSE is implementing measures which will “significantly reduce” the time it takes patients to be referred to critical care facilities in different hospitals, it has said.
The move comes following the inquest into the death of Dhara Kivlehan from multi-organ failure after a catalogue of errors in her care. Ms Kivlehan (29), who lived with her husband Michael in Dromahair, Co Leitrim, died in Belfast’s Royal Victoria Hospital on September 28th, 2010, a week after giving birth at Sligo Regional Hospital. She had been airlifted from the Sligo hospital four days earlier.
Dr Peter Boylan, an expert witness at the inquest into Ms Kivlehan’s death, said it was clear to him there were deficiencies, in both her clinical care and at systemic level, which were “material contributors” to her death.
The jury in her inquest found she died due to medical misadventure and made a number of recommendations to the HSE, including that a database of all available critical-care beds be made known to all hospitals.
Live information
In response to questions from The Irish Times last night, a spokeswoman for the HSE said they were "currently implementing a critical-care bed bureau which aims to optimise utilisation of critical-care beds nationally by providing live information on bed occupancy in all units".
“This would significantly reduce the referral time for clinicians (referring to another critical care facility in a different hospital),” she said. “The proposed model of care will provide the framework for the future organisation and delivery of critical care services.”
The jury also recommended all blood tests should be followed up by the doctor who ordered them and that any critical issues be flagged by laboratory staff. The HSE spokeswoman said it was “normal practice” for blood tests to be followed up by the doctor.
“In relation to the role of laboratories in this regard, the primary responsibility is with the doctor who ordered the test, but hospitals also have alert processes in place through the laboratories to enable early response and intervention,” she said.
Intensive-care beds
Initially, Sligo Regional Hospital had no bed in the intensive care unit (ICU) for Ms Kivlehan, and there have been calls for an audit of the ICU system.
The number of ICU beds and beds in high-dependency units for adults at public and voluntary hospitals is currently 233.
The HSE spokeswoman said funding to develop an additional 10 critical-care beds is “being considered” in the context of service developments in 2015.
Mr Kivlehan told his wife’s inquest that he was “extremely shocked” by the behaviour of a nurse who grabbed his arm, led him back to his wife’s bed and told him to “stop eavesdropping”, while he was waiting to speak to doctors.
The nurse in question denied this but admitted to telling Mr Kivlehan that if he wanted to make himself useful he should go downstairs and get his wife a drink.
Asked whether bedside manner formed part of the training for such professionals or whether guidelines were in place in terms of how to communicate with patients and their families, the spokeswoman for the HSE said communications training was “an integral component” of doctors’ medical training.
