Improvements in University Hospital Limerick ED but patients risk still not fully managed, watchdog says

University Hospital Limerick

THE RISK of patients coming to harm at University Hospital Limerick’s emergency department is a concern and a system designed to alert medics when an individual patient deteriorates has not been implemented, a new report has found.

Health watchdog HIQA published a report of its latest unannounced inspection of the University Hospital Limerick (UHL) emergency department (ED) and found that risks are not being fully managed.

An Emergency Medicine Early Warning System (EMEWS) had not been implemented at the time of the inspection, the report said, noting that such a system is “vital” to recognise when patients are deteriorating and allow staff to respond in good time.

The new report comes in the wake of one of the hospital’s own emergency medicine consultants, Dr Jim Gray, describing the ED as “a death trap” while giving evidence at the inquest into the death of 16-year-old Aoife Johnston at UHL.

The HIQA report – following the inspection on November 21 last – notes improvements since the previous two inspections, but noted the “continuous state of escalation in the emergency department is unsustainable”.

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Inspectors found 35 patients waiting in the emergency department for admission to a bed, and 19 on trolleys in corridors. Staff, the report said, “were actively engaging with patients in a kind and respectful manner”.

Overall, the ED was found to be functioning better than the previous inspection in March 2022, but HIQA said that increased capacity is needed.

A statement from the UL Hospitals Group welcomed the report, saying that it “confirms a slow but steady improvement in overall compliance”.

The group said the improvement is attributable to increases in staffing levels, the introduction of new care pathways, and strengthened governance arrangements”.

However, the group acknowledged that one area of non-compliance related to patient safety and dignity “in the context of the severe and persistent overcrowding in our ED”.

“Overcrowding continues to represent a patient safety risk and we are committed to working with the Authority and with all other stakeholders in addressing this through a combination of additional resources and further reforms.”