Sir, – There are compelling reasons why the Health Information and Quality Authority (HIQA) should introduce a standard to monitor the outcome (morbidity and mortality) for subarachnoid haemorrhage (SAH) patients who are denied access to emergency neurosurgical or endovascular treatment. Standards of performance are key drivers of patient safety. They measure not only performance but facilitate comparison with healthcare providers in Europe and elsewhere. This can inform best practice and use of scarce resources.
Untreated SAH patients face life-threatening risks. The cost of an intensive care bed (€1,800 per day) is the same whether a patient is being treated in the neurosurgical centre or is in an intensive care bed in the local hospital – and not being treated. The humanitarian and economic consequences of not securing a ruptured brain aneurysm are immense.
Providing additional neurosurgical intensive care beds addresses the unmet need of patients who require emergency neurosurgical treatment. It also removes the onus on admitting hospitals to provide intensive care beds for SAH patients who are being “managed” rather than treated. Early treatment significantly reduces the risk of a catastrophic rebleed, levels of morbidity and mortality and length of stay, when compared to patients who are not treated.
The refusal by HIQA to introduce a standard to monitor, and then publish the outcome for untreated SAH patients, invites questions regarding the competence of HIQA to assess patient safety risks. – Yours, etc,
JIM LAWLESS, MBA
Cypress Downs,
Templeogue,
Dublin 6W.