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Presentation on Reconfiguration of Hospital Services from Dr Dominic O’Brannagain & Dr Colm Quigley to Regional Health Forum – Dublin North East 25 th January 2010. “Disconnecting from change does not recapture the past. It loses the future.”
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Presentation on Reconfiguration of Hospital Services fromDr Dominic O’Brannagain & Dr Colm Quigley to Regional Health Forum – Dublin North East 25th January 2010
“Disconnecting from change does not recapture the past. It loses the future.” - Kathleen Norris
Transformation Objectives • NE Transformation is committed to addressing quality and risk issues identified in the Teamwork Report 2006 by: • Making the best use of our available resources. • Raising services to safe levels of practice and beyond • Introducing key work practice changes which benefit patients and staff • Integrating PCCC and Hospital services • Allowing more patients to be cared for at home or close to home • Expanding day and outpatient procedures and services in Dundalk, Monaghan & Navan hospitals • Reconfiguring acute and complex care onto the Cavan and Drogheda sites
Rationale for Change • Changing Expectations & expertise in medicine • Volume of patients • Recruitment & retention of staff • Accreditation by training bodies • Inspection by external agencies ie HIQA • Resources
Overview of intended service changes • New ED in Drogheda • Medical Assessment unit • Development of short stay & observation wards • Enhanced Ambulance service • Home care packages • Opening of two new inpatient ward over the new ED • Expansion of ICU & CCU • Improved discharge planning & reducing length of stay • Dundalk ED will revert to 12 hour service • Ambulance trauma will transfer from Navan to Drogheda • Stroke, Rehab and Step-down beds will be developed in Dundalk
New ED • New ED in OLOL Scheduled to open in Q1 2010* • Increase capacity from 19 to 25 bays • Separate Paediatric area (6 bays) • Dedicated x-ray facilities • With the opening on the new ED it planned to initially convert the ED in LCH to a 12 hour service • On the transfer of Acute Medical inpatient services to OLOL the 12 ED will convert to a MIU * Target Date
Medical Assessment Unit • To be established in old ED • Will be an 8 bay unit • Focus on rapid ambulatory assessment, expedited workup and treatment initiation with expected low rate of inpatient admission • MAU’s already established in Navan and Cavan.
Short stay & Observation Wards • An Observation Ward will accommodate patients who require observation for a period specific period of time will open in conjunction with a Short stay ward for patients who care needs only require an identified short stay in hospital.
Ambulance Services • Additional ambulance vehicles and personnel will be in place to support the service changes • Direct access primary angioplasty service is also being developed in conjunction with the Mater Hospital
Home Care Packages/ Discharge Planning and ALOS • Packages of care have been identified to support hospital avoidance and early discharge. • More detailed work is underway to see how these can be put in to PCCC and what additional disciplines are need to provide these. • Discharge planning will also be improved and factors that delay discharge and result in a patient having a longer length of stay will be addressed.
Additional inpatient Wards • 2nd and 3rd floor of new ED building is being commissioned as inpatient accommodation. • This will be single and double room accommodation – all rooms are ensuite. • This will see an additional 40 beds over these two floors
ICU and CCU • The 4th floor of the new ED building will be the new Coronary Care Unit • The capacity of the ICU will enhanced by the transfer of the CCU to the new location • The expansion of the current ICU
Non Acute Beds in Dundalk • Day medical beds • Day surgical beds • Stroke rehabilitation beds • General rehabilitation beds • Step down beds
Phase 1 • Open new ED • Open new MAU • Develop Short Stay and Observation Wards in OLOL • Commence development of non acute services in LCH • Progress Integrated Discharge Planning to reduce ALOS across the hospital sites
Phase 2 • Completion of the new wards over the new ED • Completion of the new CCU • Expansion of the ICU • Continue the development of non acute services • Transfer of acute inpatient care from LCH to OLOL • Develop, in conjunction with PCCC, packages of care • to enable hospital avoidance, • reduce ALOS and • allow for early safe discharge
Vital Role of Louth County Hospital and Our Lady’s Hospital Navan • Acute care will transfer to Drogheda and Dundalk and Navan will provide local services to the community. • Future Services in Louth County Hospital and Our Lady’s Hospital, Navan will include: • Day medical servicesOutpatient Services • Laboratory & radiology • Stroke Rehab • ENT • CT Scanning • Care of Elderly Assessment • Day surgical Services • Elective Endoscopy • 12 hour ED (then 12hr MIU) • Step Down Unit • Rehab Unit
Next Steps • Continue to engage with staff and representatives • Set up project groups for the service changes • Develop staffing profiles to support the service changes • Continue to progress the infrastructural needs