New Complex Discharge Unit at St. Mary’s Hospital

Mary Harney, T.D, Minister for Health and Children today officially opened the new Complex Discharge Unit at St. Mary’s Hospital, Phoenix Park.
The Complex Discharge Unit provides care for persons over 65 years whose acute care has been completed in the Mater Hospital but whose final discharge is delayed for varying reasons, such as the need for further rehabilitation, palliative care or the arrangements of home care packages or adaptation to their homes. The patients are, in the main, frail and need the services of a well qualified multi disciplinary clinical team. The maximum stay is twelve weeks.

A feature of this project is the strong relationships between the multidisciplinary teams of St. Mary’s Hospital, the Mater Hospital and St. Francis’s Hospice in Raheny. The patients’ interests have been paramount in the whole process and good communication has been forged that has impacted positively on the efficiency of the transfer and treatment processes. There is also sufficient flexibility in the system to change and adapt as the patient’s needs becomes clearer.
Since the unit opened on the 15th January there have been 30 admissions to the Complex Discharge Unit and 11 discharges. There have been 6 Palliative Care admissions. The average length of stay of the eleven discharges has been 20 days.
Mary Harney, T.D. Minister for Health and Children said ‘The important developments being celebrated today have one purpose, that is, to improve the quality of the physical environment and care strategies for patients’.
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‘The total investment in St. Mary’s campus over the period 2008/2009 will be in the order of €26 million.
h4. Advocacy Project
The HSE launched a National Advocacy Project in 2008, and have chosen St Mary’s Hospital as a pilot site in partnership with Age Action. The involvement of a diverse group of stakeholders in the initiative strengthens the approach through a strong system of volunteer selection, education of the volunteers and education of the hospital workforce to value themselves primarily and in so doing value the innate humanity of the residents for whom they care
Anne O Connor, HSE Local Health Manager said ‘St. Mary’s Hospital has long recognised that older people who reside at the hospital should have the opportunity to have formal advocacy services to ensure that their needs are met and that their voices are heard despite the undoubted quality of the nursing and other services in the hospital. The first initiative in this area took place in 1998 when, in collaboration with Age Action Ireland, a system of volunteer advocacy began where a volunteer worked on behalf of individual patients.’
She said ‘These advocacy efforts continued with the establishment of a Residents Forum in cooperation with Age Action Ireland, where a group of residents met with a facilitator and discussed there needs and concerns. Other initiatives included an Essence of Care Project, systematic residents/family satisfaction surveys, and team based performance management projects focused on improvement in processes for resident well being. The initiation of Hospital Open Days, the third of which is taking place today, is another example of openness to residents and their families.
h4. Community Nursing Unit
A new 100 bed Community Nursing Unit at St Mary’s has been operational since May 2008. It has added increased long-stay capacity for older persons within north Dublin. The new unit has been welcomed widely by patients and staff, as it marks a new beginning in terms of providing modern accommodation. In most instances residents have the privacy and dignity afforded by a single room. Staff have more modern facilities to be able to assist residents in their daily care needs.
A new Day Hospital was built along with this facility. St Mary’s has an active connection with the geriatric specialist service provided by consultants in the acute hospitals in the area, as well as with community practitioners. The new Day Hospital, and its improved therapeutic facilities, has enhanced the service St Mary’s provides to older persons living at home.
h4. Evaluation of Standards
In 2008 an Evaluation of Standards in St Mary’s Hospital was commissioned by the HSE. This evaluation was benchmarked against the HIQA Draft National Quality Standards for Residential Care settings for Older People in Ireland. Joe Wolfe and Associates conducted this assessment, and found the Hospital to be compliant with 90% of the sub-criteria. The reviewers from Joe Wolfe and Associates identified many aspects of good practice within St Mary’s and noted that the practice in relation to care planning, documentation, policy development, system implementation and audit is of exceptional standard. The reviewers also noted that many initiatives within the hospital are innovative and of a very high quality. The report informed plans and ongoing developments to improve infrastructure and patient care.
The report by Joe Wolfe and Associates, as well as other assessments by the HSE, highlighted the challenges facing the Hospital in meeting the physical standards required for long-term care. Consequently, a decision was made in 2008 to build an additional 50 bed Community Nursing Unit to replace beds in the least suitable wards of the older building. This unit is due for completion by the summer.