University Hospital Limerick- what can be done?

thomas 123

https://www.boards.ie/discussion/comment/122054881#Comment_122054881

And a high profile court case costing the state millions that results in:

cnocbui

https://www.boards.ie/discussion/comment/122054881#Comment_122054881

Just call them road deaths and suddenly all the stops will be pulled out in an attempt to assuage the public's fears and to convince them that they are on it. Guards can man ER departments with their speed gun lasers, issuing patients on trolleys tickets if they are caught dying too quickly.

Igotadose

https://www.boards.ie/discussion/comment/122055102#Comment_122055102

Imagine if there were a really obvious widespread emergency, like a plant explosion in a crowded area or a fire in a rumored asylum seeker centre that spreads to the local populace. What then? This poor woman's case was because, well, it was rainy that night and there were a lot of people in the ER, so she got to lay on a couple of seats for 12 hours - 12 hours! - before seeing the doctor, who prescribe medication but was so busy with 190(!) other patients she couldn't see to its administration, left it to the nurses who took 1:15 to administer it.

Why not scramble a dozen doctors in the area to come in? Or in the County? The State? Most places the drive to limerick's only a few hours, if it meant this woman would "only" have had to wait, oh, 3 hours to see a doctor, she might be alive today.

And what's even more regrettable - it'll happen again, at the same hospital. Plus no consequences for anyone involved on the HSE side, no reassignments, reduction in pay grades, nothing. There'll be a lawsuit and the taxpayers will foot the bill, again (and again…and again) and it will neither bring this woman back, nor improve things in the short or long term.

Interesting read on how a medical system responds to an acute crisis, the Boston Marathon bombing. https://www.hmpgloballearningnetwork.com/site/emsworld/article/12079966/boston-marathon-bombing-after-action-report

When the bombs went off, it was 3p.m. and the various local hospitals were doing shift change. Tweets went out to all doctors to scramble, and those driving from work, turned around and went back to work. 118 patients, most survived, having been spread to many local hospitals. Also, Boston does have a lot of medical resources lots of hospitals, medical schools, etc.

There was no 1 doctor with 190 patients like in UHL on a rainy night. Insanity.

JP Liz V1

If you are a doctor on call and refuse to attend, are you liable for a civil case?

On probably huge wages all, administrator working from home and doctors refusing to attend even though on call

That poor family

https://www.limerickpost.ie/2024/04/24/manager-powerless-as-aoife-lay-dying-inquest-hears/

Igotadose

https://www.boards.ie/discussion/comment/122074639#Comment_122074639

Pretty sad there's no doctor in charge of the ED. Never the case in the US. Notice how good the admin in charge is at CYA. Gets you to be high level in the HSE.

Nothing will change as a result. Unqualified administrators who can't compel consultants to attend in dire circumstances, will continue to be in charge of EDs in Ireland.

ProfessorPlum

https://www.boards.ie/discussion/comment/122074639#Comment_122074639

Going after the 'doctor on call' (who was covering foe 48 hours straight, worked 2 day shifts over the weekend in additions, and was never informed about this particular case, just that the ED was overcrowded) will do nothing to improve the situation at UHL or anywhere else. In fact, it wold completely deflect attention from the real issue - management at senior HSE level.

JP Liz V1

Interesting that Fiona Steed now works for Department of Health

In February 2021 Fiona was the first HSCP to be appointed as directorate General Manager in ULHG.

As the General Manager for the Medicine Directorate, Fiona continued to collaborate with colleagues across all disciplines within both the acute sector and the community health organisation

Igotadose

https://www.boards.ie/discussion/comment/122075481#Comment_122075481

I think her 'vitae' is that she was a physiotherapist prior to her administrative roles. So, no medical degree and a limited background. Somehow I think that's typical of HSE administrators. Wasn't one of the heads of the HSE a former installer for Eir?

Maybe only senior doctors should be in positions of authority for the HSE. Then decisions will be made based on medical reasoning, not just numbers.

Podge_irl

https://www.boards.ie/discussion/comment/122075794#Comment_122075794

HSE administration and medical practice abilities are not massively overlapping areas. Companies the world over are led by people who haven't the slightest idea how to do the jobs their frontline staff do.

I'm not sure pulling senior doctors off the frontline to do jobs they aren't trained for is necessarily a winning strategy.

cnocbui

https://www.boards.ie/discussion/comment/121832932#Comment_121832932

https://www.boards.ie/discussion/comment/121834471#Comment_121834471

'It's a terrible suggestion.'

That is the sort of knee jerk, defensive rubbish I would expect out of the HSE management layers.

So, let’s look at the figures. It was stated at the time, UHL would need
672 beds to cope with the increased patient numbers in the region. It
currently has 530 beds, and needs another 200 to cope with the current
demand.

So more than 200 additional beds required if you take into account any projection for population growth. And that was more than a year ago, Re-do that exercise for current conditions and the recommendation would no doubt be a far larger number. That's new hospital time, not trying to tack on yet another band aid fix to the existing cramped rabbit warren.

We had a €10 billion surplus last year, so a new, properly sized and properly resourced replacement for UHL is easily affordable. I'd suggest inviting an Australian construction company in to build it, given the 135% cost differential between Perth Children's Hospital and the NCH.

karlitob

https://www.boards.ie/discussion/comment/122076651#Comment_122076651

No. You’re still incorrect.

You said to replace UHL. It’s a terrible suggestion to replace the hospital. We need more beds. It takes a long time and is very expensive to build a hospital. The notion that you could improve the situation by knocking a hospital, and rebuilding it is hare brained.

You’re gonna close down 530 beds to build a new hospital of 637 beds. If there’s not enough beds for patients now, where will they all go when your Australian building company comes over to build it.

karlitob

https://www.boards.ie/discussion/comment/122076607#Comment_122076607

Well make your allegation of malpractice to Coru since you know exactly what the job description is and exactly what the person may or may not have done in her job.

Only doctors can prescribe here.

GPs have no more competence in how to run an ED than anyone else.

This really is disgraceful commentary.

cnocbui

https://www.boards.ie/discussion/comment/122078514#Comment_122078514

FFS! You really do sound like the HSE functions.

I did not say knock, nor did I suggest closing UHL in the interim, and nor would I repeat the mistakes of the past in terms of bed numbers. I'd build an 850 bed facility, at a minimum, in a different location. You build the new hopital and keep UHL functioning until it's complete, then you repurpose or demolish UHL after you transfer it's functions to the new hospital.

Perth WA had a children's hospital, Princess Margaret. The state and city outgrew it, so they built a new and larger hospital, Perth Childrens Hospital, a near equivalent to the NCH, except with a 33% better population to bed ratio. When it was complete, PM was closed and PCH took over it's former function.