The HSE is planning for an acceptable maximum level of overcrowding of 236 trolleys a day over the coming winter, internal documents reveal.
Across all hospitals a “national threshold” has been set which says no more than 236 people should be waiting on a trolley at 8am on a given day, according to the document drawn up by the hospitals division of the HSE.
The document, seen by The Irish Times, sets out the targets individual hospitals must aim to achieve in order to conform to the threshold. For larger hospitals, this would mean ensuring no more than 12 patients are on trolleys daily.
“Ideally, there should be zero trolley waits,” according to the winter resilience planning documents, “but clearly the system is not at this level of performance.”
The plan provides for the aggressive management of patient admission and discharge in order to ease the pressure on beds. Almost half of patients being discharged on a particular day will leave before 11am, it is planned.
A focus on “admission avoidance”, the presence of senior decision-making staff and pathways for frail elderly patients can yield “productive gains”, according to the document.
Health managers are being advised to “focus aggressively” on patients who are in hospital for more than two weeks, as these take up the majority of beds. Ten per cent of patients account for 60 per cent of bed days.
Managers are being advised to communicate actively with staff, patients, the public and the media “in a candid and transparent manner” about hospital performance. “Do not ‘spin’ performance; patients know and tell family and relatives what they experience.”
