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Ambulance to ED handover time targets being missed amid ongoing capacity deficits

Handover time targets between ambulance crews and emergency department (ED) staff are not being met, against the background of ongoing hospital capacity and infrastructural deficits, a recent HSE meeting heard.

Dr Gerry McCarthy, the Clinical Lead of the HSE’s National Emergency Medicine Programme, made a presentation to the October meeting of the HSE safety and quality committee, where he provided “an overview presentation on improving patient flow in emergency care”. Dr McCarthy referenced “capacity and infrastructural issues” within hospitals, according to the meeting minutes.

“It was noted that the time of handover from when the ambulance arrives to being transferred to ED staff should be under 20 minutes and the time it takes for the crew to be available to move onto the next incident should be under 30 minutes….” However, in both instances, these targets were not being met.

The meeting heard of possible interventions to improve the situation, including virtual consultations, patient care pathways, and outreach services at pre-hospital levels. There was also discussion about availability of senior decision-makers and streaming of pathways at triage stage, as well as optimising clinician hours, improved access to diagnostics, and expediting laboratory turnaround at the assessment stage.

The minutes noted that ED attendances of people aged over 75 were increasing “year-on-year”.

As previously reported in the Medical Independent, at the committee’s meeting in September, HSE National Director of Acute Operations Mr Liam Woods raised concerns that the lack of availability of GP appointments was contributing to people attending “under-resourced and under-staffed” EDs and this may compromise patient safety.

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