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IAEM welcomes HSE memorandum regarding delayed transfers of care

The Irish Association for Emergency Medicine welcomes an important Memorandum issued by Mr. Bernard Gloster, CEO of HSE and Dr Colm Henry, Chief Clinical Officer, which can improve bed availability at our acute hospitals and reduce the duration of time patients spend on trollies in Emergency Departments, awaiting an inpatient bed.

At issue is patients who have completed hospital treatment for their acute illness and are deemed ready to be discharged from the Acute Hospital to a Transitional Care or Long Term Care bed in a Nursing Home. Often these are older adults who cannot safely be discharged directly to their own home. Problems can arise when the Long Term Care facility preferred by the patient or the family of the patient is not immediately available. Mr. Gloster and Dr Henry emphasise that at all times the HSE wants to respect patient and public choice and self-determination, however they state, what is available may have to be accepted while a patient’s choice is awaited.

We know that for every 82 patients who are delayed more than 6 hours in an Emergency Department to get to an inpatient bed, there is an excess death. It is unconscionable that a patient who needs an inpatient bed for acute treatment is unable to go to one because the bed in the acute hospital is being used for a patient who could have their care needs met elsewhere. Given the shortage of acute hospital beds in Ireland it is simply not feasible to allow these beds be used for patients who do not need the services of an acute hospital and who could be managed safely in a Nursing Home or Community Hospital facility.

We hope patients and their families will understand the vital importance of maintaining acute hospital beds for sick patients who need to be admitted to the hospital and tolerate what may at times be an inconvenient temporary arrangement while the nursing home or community supports of their choice is awaited. It goes without saying that investment in extra bed capacity in our hospitals and in the community healthcare setting is vital and every effort must be made by our Government to increase our bed base to align with OECD bed numbers.


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