Portiuncula University Hospital welcomes publication of HIQA report following inspection in May 2023

Portiuncula University Hospital (PUH) welcomes the publication by Health Information Quality Authority (HIQA) of its report into its inspection of the Emergency Department, St Joseph’s ward and St Francis’s ward at the hospital. An announced inspection was carried out in PUH on 09 and 10 May 2023, the focus of which was to monitor compliance with the National Standards for Safer Better Healthcare.

HIQA’s inspection focused in particular on four key areas of known harm: infection prevention and control, medication safety, the deteriorating patient (including sepsis) and transitions of care.

Of the 14 National Standards against which Portiuncula University Hospital was inspected, the hospital was found to be compliant with one National Standard, substantially compliant with eight National Standards, partially compliant with four National Standards and non-compliant with one National Standard.

We welcome the finding that the hospital is compliant with Standard 1.7: Service providers promote a culture of kindness, consideration and respect. It is encouraging to see such positive feedback from patients about PUH staff and we commend our hospital team for their commitment to person centred care. Throughout the inspection, staff were observed to be actively listening and effectively communicating with patients in an open and sensitive manner, in line with their expressed needs and preferences. This was validated by patients who spoke with inspectors. Staff were described by patients as ‘very nice’ and ‘excellent and friendly’.

Significant work has been carried out by the hospital in all areas where compliance issues were highlighted by HIQA, we continue to prioritise safeguarding patient care and the promotion of our patient’s dignity, privacy and autonomy in the hospital.

Physical Environment

The HIQA report notes that at the time of inspection PUH was challenged by outdated infrastructure in particular in the distinct lack of single rooms and ensuite facilities in the hospital. It is deeply regrettable that the hospital was found to be non-compliant with Standard 2.7: Healthcare is provided in a physical environment which supports the delivery of high quality, safe, reliable care and protects the health and welfare of service users, however, significant progress has been made in this area since the inspection took place.

In September 2023 a major infrastructure project was completed in PUH with the opening of the Dunlo Ward. The Dunlo Ward is a new build 12 bed ward comprising of eight single ensuite rooms and two double ensuite rooms. It is providing additional bed capacity, improved accommodation for our patients and easing patient flow from the Emergency Department and throughout the hospital, while meeting delivering enhanced quality care to our patients.

The 50 bedded replacement ward block will further alleviate our infrastructure and capacity challenges at the hospital, this build is progressing with an expected completion date of August 2024. The new unit will provide single room accommodation with ensuites and will have two compliant negative pressure rooms on each floor, which has been raised by HIQA as a risk.

Emergency Department

We welcome the report’s finding that staff working in the hospital’s Emergency Department were committed and dedicated to promoting a person-centred approach to care. Staff working in the ED were observed providing assistance and information to patients in a respectful and dignified manner. This is consistent with the results of the 2022 National Inpatient Experience Survey in which were patients were asked if they felt they were treated with respect and dignity while in the ED. PUH scored 9.3, higher than the national average of 8.7.

In PUH we make every effort to promote and maintain patient’s dignity and respect and we deeply regret the need to accommodate patients on trolleys on the ED corridor. We acknowledge that this measure negatively impacts on our patient’s dignity and privacy and we apologise for the distress this causes to our patients and their families.

As a solution to the sustained pressure on the ED, the hospital is in the process of appointing a Design Team for a modular expansion build to the Emergency Department. Capital funding has been sanctioned for this expansion. This development will improve the toilet facilities, which was reported as a risk by HIQA, and will have a direct impact on safeguarding patient care while offering service users’ dignity, privacy and autonomy. This proposed expansion along with opening the new 12 bed Dunlo Ward will also us to improve patient flow issues as reported by HIQA.

Work Force Planning

The hospital is also taking steps to address staffing levels in the ED which were raised within the HIQA report.

A submission has been approved at Group level for a for a Consultant in Emergency medicine. The application process is in process. Once successful recruitment has occurred, this will reduce the 1 in 3 on-call work schedule.

On the day of inspection there were five nursing vacancies at the hospital, we are engaged in an on-going recruitment campaign to fill all outstanding vacant nursing post in the Emergency Department and across the wider hospital.

The hospital has been approved to hire a Clinical Pharmacist to provide services to new 12 bedded Dunlo Ward and to the Emergency Department.

At the time of the inspection the security detail were providing cover from 8-8pm. This has been extended to 24 hour cover since June 2023.

James Keane, Hospital Manager at PUH said, “We welcome this report and recognise the important and valuable role of HIQA in promoting safety and quality in the healthcare services. As a hospital team we work very hard to ensure that good governance structures and monitoring systems are in place so we can identify and act on opportunities for improvement. I want to acknowledge the incredible commitment and dedication of our staff in providing a patient centred approach and we will work together to build on the good practice highlighted in this report.”

ENDS