Roscommon University Hospital welcomes publication of HIQA report following inspection

Roscommon University Hospital (RUH) welcomes the publication by Health Information Quality Authority (HIQA) of its report into its inspection St Coman’s Medical Ward, the Injury Unit and the Medical Assessment Unit at the hospital. An announced inspection was carried out in RUH on 02 March 2023, the focus of which was to monitor compliance with the National Standards for Safer Better Healthcare.

During this inspection, HIQA looked at 11 National Standards in relation to Capacity and Capability of the service, and Quality and Safety. Of these, Roscommon University Hospital was compliant with three National Standards, substantially compliant with six National Standards and partially compliant with two National Standards.

It is encouraging to see such positive feedback about RUH staff reflected in HIQA’s report. Throughout the inspection HIQA observed effective communication between staff and patients, RUH staff were “actively engaging with patients in a respectful and kind way, taking time to talk to and listen to patients.” Patients were very complimentary about staff and the care they received in RUH which aligns with the findings of the 2022 National Inpatient Experience Survey in which 92% of patients who completed the survey had a ‘good’ or ‘very good’ overall experience in the hospital, above the national average of 81.9%.

Significant work has been carried out by the hospital in all areas where compliance issues were highlighted. Roscommon University Hospital has a comprehensive Quality Improvement Plan in place with scheduled meetings taking place. Currently 3 out of 15 action plans are completed, and the majority of the remainder will be completed by the end quarter three 2023 with good engagement from staff and stakeholders. 

The report noted that the hospital’s physical environment did not adequately support the delivery of high-quality, safe, reliable care. A number of infrastructural issues on St Coman’s ward had the potential to impact on infection prevention and control measures in the hospital. For example, the lack of isolation rooms with en-suite facilities and the access to St Teresa’s ward through St Coman’s ward.

In response to these risks the hospital will continue to progress the development of a new 50 bed medical ward block at the hospital. A brief was submitted to HSE Capital Estates in 2016 for the replacement of St Coman’s and St Teresa’s Wards with a new 50 bedded medical ward block, which will provide all single occupancy rooms with en-suite facilities. The development of a replacement medical ward block is included in a briefing document for a revised Spatial Plan for the hospital, which was submitted to HSE West Capital Estates in 2022, and is awaiting progression by HSE West Capital Estates.

In the interim measures have been taken to mitigate risks including the replacement of non-compliant hand hygiene sinks. In 2022 the hospital replaced seven sinks using minor capital funding approved for this purpose. A submission has been made for minor capital in 2023 for funding to replace all non-compliant hand hygiene sinks.

The vacant radiology position was identified as a risk by the hospital and recorded on the hospital risk register. A locum Consultant has been in place since June 2023 with a permanent Consultant in place from this month.

The report recommends that RUH should ensure that systems are in place to support monitoring and reporting of national metrics in the area of patient complaints and the hospital is now fully compliant in this area. The National Complaints Management System was put in place in April 2023, the system is working well and increasing organisational learning to improve the quality of care we give to patients.

HIQA recommended that governance of the injury unit should be formalised through more long-term sustainable arrangements. The hospital is finalising plans for governance of the Injury Unit to be shared out across a number of ED Consultants once they take up their posts in UHG.

RUH is also designing a standard operating procedure around the governance of the Injury Unit to include formalised recording of ANP’s attendance in the Galway ED and other training/peer support arrangements. This will be operational by end of Q3, 2023.

In line with good governance arrangements, Hospital Performance Management meetings with the Saolta Group continue to take place regularly throughout the year and did so in 2022.

Work will be undertaken in relation to patient transfer documentation to ensure a comprehensive handover for the patient.

The hospital is also taking steps to enhance medication policies including the introduction of Ipads at ward level so as to ensure up to date medication information at prescribing and preparation of medicines for patients on the ward. 

Claire Conlon, Hospital Manager in RUH 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.”