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‘Political needs’ impacted hospital quality improvement project – report

The final report of the IHRP, seen by MI following a Freedom of Information request, was highly critical of the HSE’s actions and also stated that the “political imperative for quick solutions” resulted in declining support from then Minister for Health Leo Varadkar.

The IHRP, which was launched in 2014, was intended to improve patient flow and access to emergency clinical care in the Irish public hospital system. It was never implemented beyond the pilot site, Tallaght Hospital, Dublin.

As revealed in MI, the HSE discontinued the IHRP and went to tender for another initiative called ‘Scientific Management Practices in Healthcare to Tackle Patient Flow’.

As a result of the tender, a new National Patient Flow Improvement Programme has commenced.  University Hospital Limerick and Galway University Hospitals were chosen as the initial sites.

“The lack of oversight, shared learning with IHRP, the duplication of effort and waste of resources in terms of personnel and time has been unfortunate,” according to the report, which was completed in September 2016.

It also stated: “At the outset the Minister for Health Leo Varadkar, openly supported and was kept appraised of progress in Tallaght, but this support waned in the face of the trade-off between the necessary methodical pace that quality improvement required and the political imperative for quick solutions.”

The report outlined how the IHRP led to an increase in the capacity of the emergency department in Tallaght, a decrease in use of overflow areas and an improvement in overall processing outcomes. Patient and staff satisfaction had also improved.

In June 2016, the leads of the National Clinical Programmes for acute medicine, surgery, emergency medicine and older people wrote to HSE Director General Mr Tony O’Brien, stating that the programme should be supported.

No formal response was received and the programme was subsequently discontinued.

IHRP-led projects have realised a reduction in average Patient Experience Times (PET) by 72 minutes, a freeing up of the equivalent of 12 beds to reduce trolley waits and bed day savings in excess of €3.7 million per year.

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