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The May 2016 risk register, seen by the Medical Independent (MI), describes “insufficient capacity and capability” to treat patients requiring critical care with the “potential for adverse patient outcomes”. The rating denotes a risk that is “almost certain” in likelihood and would have a “major” impact.
The risk is described as patients not being able to access level 2 and level 3 critical care beds, inadequate isolation facilities in critical care, insufficient space between beds increasing the potential for healthcare-associated infections (HCAIs), infrastructural deficits and lack of air-filtering units.
Difficulty recruiting and retaining competent medical, nursing and allied health professionals in critical care is also referenced. The impact is the “potential for poor patient outcomes”, such as increased morbidity, mortality and HCAIs.
Actions required to mitigate the risk include extra funding for critical care beds and recruitment of specialist nurses, states the risk register. The risk applies to the Group but also nationally, notes the document.
Insufficient critical care capacity was highlighted recently by new IHCA President Dr Tom Ryan. Dr Ryan, a consultant in intensive care, said he was “very concerned” that the lack of intensive care unit (ICU) beds nationally was putting lives at risk.
“The reduction in ICU beds in recent years contrasts sharply with the recommendations of the HSE-commissioned Prospectus Report. Prospectus recommended in 2009 that the number of ICU beds increase by 45 per cent immediately and double by 2020. These recommendations have not been acted upon,” said Dr Ryan.
An RCSI Hospitals Group spokesperson told MI: “The RCSI Hospitals Group have made a submission to the estimates process for a high-dependency unit in Beaumont Hospital and five extra critical care beds across the RCSI Hospitals Group. The Group has also made a submission to upgrade the existing Neurosurgical Intensive Care Unit in Beaumont Hospital.”
The submissions have been made to the HSE Acute Hospitals Division and will be considered for inclusion in the 2017 Estimates, said the Group spokesperson.
Inadequate physical infrastructure across sites is referenced on the Group’s risk register, with specific mention of Beaumont Hospital, Dublin, and the Rotunda Hospital, Dublin.