HSE Chief Executive Prof Brendan Drumm has said the Executive plans to reduce the number of patients who enter hospitals through EDs to get a consultant opinion or access to diagnostics.
Almost 20 per cent of patients admitted through EDs in 2009 spent less than 24 hours in hospital, and 30 per cent were there for less than 48 hours.
“Many of these admissions could clearly have been avoided,” said Prof Drumm. “We owe it to patients to reduce these figures considerably by making it easier for them to see senior clinical decision makers in Medical Assessment Units, and improving access to diagnostics and other ambulatory care services.”
Several Medical Assessment Units – which provide a comprehensive day case medical review for urgent GP referrals within 24 hours – are now open, but many more hospitals, especially in cities, still need to be able to provide this type of care, Prof Drumm told the Joint Oireachtas Committee on Health yesterday.
A significant number of people who visit EDs do so for treatment associated with a chronic illness that requires interventions such as intravenous antibiotics, or simply monitoring and observation. With more active chronic-illness management at primary care level, supported by fast track and direct access to a consultant opinion when it is needed, these ED visits, which often lead to admission, can be avoided, said Prof Drumm.
During the year, the HSE will be implementing a number of projects, led by Dr Barry White, National Director of Quality and Clinical Care, to develop these alternatives. The initial focus will be on diabetes, heart failure, acute coronary syndrome, stroke, asthma and chronic obstructive pulmonary disease (COPD).
The aim is to provide a bridge between community care and hospital care and take pressure off EDs. Chronic illnesses absorb substantial resources, and while this new approach will not necessarily impact on budgets immediately, it will improve access and quality of care in the short term, Prof Drumm pledged.
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