Overcrowding protocol triggered at UHL every day in 2023

UL Hospitals Group chief operations officer Noreen Spillane

UNIVERSITY Hospital Limerick’s high-alert escalation Full Capacity Protocol was triggered on each and every single day last year.

The protocol is designed to be activated in the event of unusually high demand on emergency department (ED) services and beds.

UHL’s escalation protocol was triggered 365 times in 2023, according to information provided at the Regional Health Forum West this week, in answer to a question from North Tipperary councillor Seamus Morris.

UHL chief operations officer Noreen Spillane told the forum that “escalation polices are adopted by hospitals, and by individual departments such as the ED, when responding to an increase in demand or a reduction in capacity to meet that demand”.

She added that the escalation framework for the ED at UHL works hand-in-glove with the overall escalation framework for the UL Hospitals Group.

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“Various triggers are set out in the escalation framework, arising from which staff will follow particular actions. Such triggers include the number of patients present in the emergency department at any one time; the number of patients waiting to be seen; the number of admitted patients waiting for a bed; the acuity of the patients; the availability of staff, and so on”

Ms Spillane told the meeting that the latest available data shows that, up to February 4 of this year, presentations to the ED at UHL increased by 23 per cent on last year and emergency admissions by 14 per cent, with presentations by those aged over 75 jumping by 32 per cent.

In 2019, the escalation plan was activated on 249 days, 260 in 2021, and 227 in 2022. There was no day in 2023 when the escalation plan was not activated.

Ongoing measures in the plan include opening surge capacity across all sites; transferring patients on trolleys to inpatient wards; additional ward rounds by medical teams to expedite discharges or identify patients suitable for transfer to Ennis, Nenagh, and St John’s hospitals; working with HSE Mid West Community Healthcare in order to expedite discharges and regular review of scheduled care.

According to the hospital chief operations officer, the level of the escalation is discussed at hospital management team meetings, which convenes daily, seven days a week.