Overcrowding in the emergency department of Beaumont Hospital in Dublin creates a “challenging environment” that does not respect patients’ dignity and privacy, an inspection by the health and safety watchdog has found.
On Tuesday the Health Information and Quality Authority (Hiqa) published inspection reports on a number of healthcare facilities. The inspection into Beaumont, which occurred in September 2024, said the hospital was found to be compliant or substantially compliant in seven standards and partially compliant in four of the 11 national standards monitored.
According to Hiqa, the hospital had formalised governance arrangements for assuring the delivery of high quality, safe and reliable healthcare. However, the inspector said these arrangements were “not fully effective at the time of inspection to manage the mismatch between service demand and hospital capacity”.
This resulted in an overcrowded emergency department (ED), non-compliance with HSE targets for patient experience times (a metric used by health services to quantify the length of time patients wait in ED before they are either discharged or admitted to hospital) and accommodating admitted patients in the ED.
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Staff communicated with patients in a manner that respected their dignity and privacy, but the ED’s “challenging environment did not adequately support all patients’ dignity and privacy”.
“Due to high attendance rates, limited facilities within the department and lack of inpatient capacity admitted patients awaiting transfer to a ward were accommodated on chairs and trolleys in the emergency department, overnight in some cases,” the report said.
Eight patients accommodated on additional trolleys were positioned immediately adjacent to one another in the middle of the emergency department, the inspectors found.
Patients were also accommodated on armchairs around the staff work station, and on armchairs in the passageway of the emergency department.
The inspectors also noted that some parts of the building were in disrepair and required refurbishment. There were refurbishment plans in place but there was no definite date provided for the completion of this work.
While the hospital identified the risk of patients contracting healthcare-associated infections due to infrastructure deficits, including dated bathrooms, an ageing building environment had insufficient single rooms and airborne infection isolation rooms to meet the demand for isolation.
In terms of staffing Hiqa found most posts were adequately filled, with the exception of pharmacy. There was a 28 per cent shortfall in the approved pharmacists posts, which had an impact on the hospital’s ability to provide a full clinical pharmacy service.
The executive management team was aware of the risks associated with the pharmacist staffing shortfall, and these risks were recorded on the hospital’s corporate risk register. Efforts to recruit were ongoing, the hospital said, and the hospital was undertaking overseas recruitment in a further attempt to address this issue.
Following the inspection Beaumont Hospital issued ways in which it intends to come into compliance with the regulations, including some longer term plans including a new ED and ward block, which have been submitted for planning and will advance to detailed design this quarter.
The new ED will represent a threefold increase in current physical capacity, the hospital said, while the ward block will deliver an additional 95 medical beds.
In the shorter term construction has commenced on a new cystic fibrosis facility which is on schedule for completion by the end of this year, and which will deliver 20 additional medical beds to the hospital.
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