"Significant improvements across all aspects of service delivery" at Portlaoise hospital

New Year message from the Midland Regional Hospital Portlaoise General Manager

Michael Knowles, General Manager, Midland Regional Hospital Portlaoise

Reporter:

Michael Knowles, General Manager, Midland Regional Hospital Portlaoise

 New Year Message from the Midland Regional Hospital Portlaoise

On behalf of all the staff in the Midland Regional Hospital Portlaoise, I would like to sincerely thank the community for their support in this last year.

I would like to take this opportunity to highlight some of the great work that has been achieved throughout 2019.

The hospital has continued to make significant improvements across all aspects of service delivery in 2019.  Patient experience times have improved with compliance of 99% for the 24 hour and 83.6 % compliance with 9hr for patients aged 75 years and over.

In addition, the hospital has achieved a reduction of 24.05% in the number of patients waiting on trolleys at 8 am in 2019 when compared with the same period in 2018.

This improvement has been achieved against a backdrop of a 4.85% increase in new Emergency Department attendances to 38,513. In addition, we had 1,490 babies born in the Hospital which is an increase of 74 on the 2018 births.

The hospital has introduced a range of measures which have contributed to the improved performance. These improvements include the establishment of an Acute Medical Assessment Unit in January 2019, the commencement of daily board rounds, the targeted development of Community Intervention Team and an overall integrated approach with community colleagues to support improved patient flow. As part of the hospital's winter strategy, an acute surgical assessment unit is also operational since December 2019. MORE BELOW PICTURE.

A number of patient-centred service developments for maternity services have commenced at the hospital this year. These include the establishment of a perinatal psychiatry service and maternity bereavement service. The hospital has also signed a memorandum of understanding with Trinity College, Dublin to commence preparation for midwifery training for the hospital. Anatomy scanning is now offered to all maternity patients and Anti D prophylaxis was introduced.

A range of other general services developments have also commenced. These include the provision of MRI onsite, introduction of dementia-friendly initiative, the commencement of a paediatric diabetic pump service and the commencement of paediatric allergy testing service.

The commencement of a dermatology service at the hospital is at an advanced stage and expected to deliver an Outpatient and Day service. A COPD Collaborative Working Group is in place to develop Quality Improvement Plans for COPD patients and ensure that all COPD patients have a self-management plan to reduce unnecessary admissions. As part of the development of sexual health services nationally, the hospital has been designated as one of 4 centres for the provision of PREP service.

The hospital has made considerable infrastructural improvements in the past year to improve the service user experience which includes the development of a maternity bereavement suite, the refurbishment of the end-of-life family room. The development of a hospital street in 2019 also provides direct access from the emergency department to the acute medical assessment unit. This development provides for improved patient flow and better infection control management.

As part of a recent presentation to the Irish Hospice Foundation, the hospital has received funding to reconfigure and upgrade the mortuary viewing facility at the hospital. This project will afford bereaved families dignity, privacy and respect when visiting the hospital.

As part of the Sláintecare Integration programme, the hospital have obtained funding to progress 2 key projects. 

1.      The introduction of an Advanced Nurse Practitioner (ANP) Cardiology – Heart Failure to improve patient access to Heart Failure clinic and service. The ANP will provide an assessment, diagnostic and screening role in relation to Heart Failure, helping to reduce wait times and a faster throughput of patients/clients.  The ANP will assess, admit, treat and discharge patients, assisting in achieving goals of the National Clinical Programme for Heart Failure (NCPHF).  This service will incorporate a ‘Virtual Clinic’; where the ANP in cardiology who would work with the Consultant Cardiologist in providing ambulatory care.  A key component of which would be a telemedicine service (Virtual clinic) providing diagnostic and management support for GPs. The scope of patients would be prevention, low risk chest pain, palpitations and assessment of patients with heart failure and at risk of heart failure. 

2.      The development of a COPD outreach service (which incorporates a Clinical Nurse Specialist and a Senior Physiotherapist under the clinical governance of a Respiratory Consultant). This is a nationally recognized scalable project.  It has been implemented successfully throughout the country and forms part of the clinical care programmes.  However, to date this has not occurred in the Laois catchment area and as evident by the demographics there is significant capacity and scope to warrant the introduction of such a post in Laois. The effective and efficient management of people with COPD, using an integrated approach to prevent disease, slow disease progression, optimise quality and quantity of life and provide care in the most appropriate setting.  COPD Outreach programmes can provide easily accessible support, education, health promotion and guidance to COPD sufferers which impacts greatly on their rates of exacerbation and hospital admissions but more importantly their own governance.

The hospital recognises the importance of nutrition and food quality as a central element in supporting a patients recovery. The catering department at the hospital have been recognised nationally by various bodies for their role in the provision of high quality healthy and nutritional food. In 2018 the Catering Department at the hospital were the Overall National Winners of the EIQA (Excellence Ireland Quality association) Hygiene and Food Safety , National Q Mark Award 2018. This is a very significant and prestigious award for the department and the hospital as a whole. There were in excess of 140 companies competing for this award  from both the private and public sector and the Midland Regional Hospital, Portlaoise were the first acute hospital to have ever won this award.  In May 2019 the catering department received a Gold Award  from the Irish Heart Foundation.

While the hospital awaits the conclusion of the consultation on the future of service provision, there exists many and varied challenges which include challenges to service development, recruitment and infrastructural development. However, we continue to deliver and build on our services for our patients and embrace 2020 with a focus on the future and acknowledging the dedication and commitment of our workforce who come to work every day and give everything to the service.

We look forward to continuing our work through the SláinteCare Programme and embracing new ways of working and to developing our hospital campus with two developments including the approval to increase clinical accommodation by changing the use of existing administrative accommodation and new a new hospital entrance/foyer. The hospital intend to seek approval to proceed with the design stage of this project at the beginning of 2020.

Finally, we would like to acknowledge the commitment and dedication of staff and reiterate our thanks to all our patients and the wider community for your continued support.