One-quarter of patients are admitted to EDs within six hours, survey finds

Barely one-quarter of patients attending hospital emergency departments (EDs) are being admitted promptly, a new survey has found.

Just 29 per cent of patients were admitted to a ward within the HSE’s target waiting time of six hours, according to the 2021 National Inpatient Experience Survey by HIQA (Health Information Quality Authority).

Over 300 people, or 4 per cent of the 10,743 respondents to the survey, said they had waited 48 hours or more to be admitted.

Overall, most patients report having a good experience in hospital, with 83 per cent rating their hospital care as “good” or “very good”. The majority said that they were always treated with respect and dignity, and that they were given enough privacy when being examined or treated.

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Patients also gave very high ratings of cleanliness, pain management and confidence and trust in hospital staff.

The availability of emotional support, time to discuss care and treatment with a doctor are identified in the survey, information on how to manage a condition after leaving hospital and opportunities for family members to talk to a doctor, were identified as further areas requiring improvement.

This is the fourth year the survey has been carried out by the HSE; it began in 2017 but was cancelled in 2020 due to the pandemic. The 2021 survey went ahead but the month it was conducted was switched from May to September due to the cyberattack on IT systems in the HSE.

Most patients surveyed said that they did not feel at risk of contracting Covid-19 while in hospital. However, some said that they could not find a member of staff to talk to if they had worries or fears about the virus, and that they did not receive help to keep in touch with family members.

Many patients expressed their appreciation of staff and the care they received, but missed being able to have visitors. Visiting restrictions posed particular challenges for patients with sensory, physical or cognitive impairments.

Approximately 81 per cent of patients said that they were always treated with respect and dignity in the emergency department, 76 per cent said their room was very clean and 86 per cent were satisfied with the privacy they got during examinations.

Patient discharge

Patient discharge got the lowest rating, with only 69 per cent of patients saying staff completely explained the purpose of medications they were taking home and 45 per cent saying staff completely explained their potential side-effects.

“Discharge or transfer” was the lowest-rated stage of care, with an average patient rating of 6.9 out of 10. 69 per cent of patients said that staff “completely” explained the purpose of medicines they were to take at home, while 45 per cent said that staff “completely” explained the potential side effects of medications.

Patients admitted to small and specialist elective hospitals tended to report more positive experiences than those admitted to medium and large hospitals.

Cappagh orthopaedic hospital in Dublin (9.5 out of 10) and Bantry hospital (9.3) scored highest for overall experience; St Vincent’s in Dublin and Kerry University Hospital in Tralee scored lowest (both 7.7).

Launching the survey, Minister for Health Stephen Donnelly said it was encouraging to see patients continued to have positive experiences of being treated with dignity and respect and having confidence and trust in hospital staff.

“The survey findings also highlight that there is still room for improvement, and it is absolutely essential the health service listens and responds when patients share their experience.”

Mr Donnelly acknowledged EDs are under serious pressure and target waiting times are not being met. “I’m in the middle of a very intensive round of talks and actions with the HSE to make sure we’re putting in place not just a national plan for emergency departments, but to go hospital by hospital to identify what the challenges are and what extra supports are needed.

“We want to look at downstream so before people come to the emergency department, have they got access to minor injury units? Have they got access to a GP on call? Do they have all the information they need before they come into the ED? Do we have enough staff?

“Do they have enough space? Do we have the emergency medicine consultants there not just during the day, but late at night, Saturdays and Sundays? Can patients get access to diagnostics? Critically, can they get access to a bed quickly if they’re admitted? And do the hospitals have what they need to discharge patients in terms of home care packages, staff on the ground and step-down facilities?”

HSE chief executive said the organisation would use use the findings to continue to develop and implement quality improvement initiatives to improve the experience for patients.