HEALTH SERVICES
Patients bypassing minor injury units
June 9, 2014
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Patients in the mid-west who are not seriously ill are bypassing minor injury units and attending instead the region's major ED at University Hospital Limerick (UHL), thereby adding to overcrowding there.
A report by the health safety body HIQA published at the weekend identified serious delays and risks for patients and staff due to persistent overcrowding in the ED of UHL, which HIQA said, was not fit for purpose.
However, the report on its examination of services in the Limerick hospitals group also shows that injury units established in recent years as an alternative to a major ED for patients with minor conditions are not being utilised.
The HIQA report said hospital staff expressed concerns that local communities were not using the local minor injury units at Ennis and Nenagh Hospitals, with patients either self-referring or being referred by their GPs to the ED at Limerick Hospital instead.
Also, patients with minor injuries who were attending the ED at ULH were not being actively directed back to the local units, HIQA was told.
The HIQA report noted that on one day recently when 37 patients were on trolleys in Limerick awaiting admission to a ward, the local injury unit at Nenagh Hospital was empty.
The then HSE Director of Acute Hospitals, Ian Carter, told the HIQA review team, which carried out an on-site assessment in February, that utilisation of local injury units was sub-optimal and there was a need to embark on a communications campaign to highlight their existence and benefits to local communities and referring GPs.
HIQA said such a communications campaign should emphasise the reduced waiting times in these smaller units, which are based in the region at Ennis, Nenagh and St John's Hospital in Limerick.
The safety body acknowledged that diverting patients from the ED at UHL to local injury units would not reduce the number of patients on trolleys in its ED, as these are usually seriously ill.
However, it says any initiative that has the potential to reduce the volume of patients who present in the UHL ED would positively impact on the quality, safety and timeliness of care for all ED patients.
In recent years, a number of minor injury units have been established in smaller hospitals, following the closing down of their 24-hour emergency departments. These units usually open between 8am and 8pm.