Surge in illness placing increased pressure on Emergency Departments

The HSE confirmed today, Tuesday 3rd January 2017, that many hospitals are now reporting a significant surge in demand as the number of reported cases of winter related illnesses such as influenza, respiratory illness and norovirus (Winter Vomiting Bug) continue to increase.  

21 respiratory infection and influenza outbreaks have been reported this season to date in healthcare settings, including hospitals and residential centres, and nursing homes. There has been a significant increase in the numbers of persons aged 75 years and older presenting for treatment and care. These patients are typically twice as likely to be admitted to hospital, and in turn, are likely to have a length of stay that is twice that of the general population. Due to the rise in winter related illnesses hospitals are also reporting bed closures due to necessary infection control measures and staff illness.

All hospitals are implementing the ED National Escalation Framework and have contingency measures in place to manage the increased number of patients presenting to their Emergency Departments. These measures include:

  • The use of surge capacity i.e. opening additional beds
  • Cancellation of scheduled admissions
  • Prioritisation of diagnostics
  • A special focus on those patients aged 75 years and older that have been admitted in recent days that could be discharged home or to other services with supports. Hospital staff are working closely with colleagues in the community to effect same.

While the HSE expects this spike in demand for ED care to continue in the coming weeks, the situation will continue to be carefully monitored. Three times daily, at 8am, 2pm and 8pm, Acute Hospitals record the number of patients awaiting admission to an inpatient hospital bed. This system,TrolleyGAR (Green, Amber, Red) enables daily monitoring of EDs and helps trigger the hospitals overall actions and response during busy periods. The number of patients recorded at 8am this morning was 487 and had reduced significantly by 2pm.The latest updated figures are available here.

As part of the key measures of the Winter Initiative to address increased demand for health services, the number of patients waiting to be discharged from hospitals has reduced to 436 by end December down from 659 in September and exceeding the Winter Initiatives target of 500 by year end 2016. An additional €10 million in funding has been provided for homecare measures to help patients to leave hospital or to avoid hospital admission.

The plan is delivering an additional 950 Home Care Packages (HCPs) targeting 10 specific hospitals from September 2016 to February 2017 including Our Lady of Lourdes Hospital Drogheda, Mullingar Hospital, Cork University Hospital, South Tipperary Hospital, Waterford University Hospital, University Hospital Limerick, Galway University Hospital, Tallaght Hospital & St.James’s Hospital and Beaumont Hospital.

An additional 55 acute beds are being provided in hospitals. To date, beds have opened in Beaumont Hospital and in the Midlands Regional Hospital, Mullingar. In addition, 18 step down beds are open in the Mercy University Hospital Cork

Community Intervention Teams have been developed and expanded across the country. There are now 13 teams in place in to provide rapid and integrated care to patients. Additional funding has been provided to address orthopaedic and scoliosis waiting lists in Cappagh National Orthopaedic Hospital, Our Lady’s Hospital for Sick Children, Crumlin and Tallaght Hospital.

€5m has been spent in on aids and appliances, with over 3,400 patients benefiting from provision of these aids and appliances to facilitate hospital avoidance/ hospital discharge since the beginning of October.

The HSE is urging at-risk people, who have not yet received the flu vaccination, to do so as soon as possible. They can get the vaccine from their local GP or pharmacist. The HSE also requests patients and visitors suffering with symptoms of norovirus (winter vomiting bug) not to visit or attend hospitals or other healthcare facilities. This bug, while often unpleasant, rarely causes serious problems for otherwise healthy children and adults.  Norovirus can, however, be a serious problem in hospitals and residential facilities where it can lead to ward closures, postponed operations, and, worryingly, can result in very serious illness for patients in hospital who are already weakened by other medical conditions.

Last updated on: 04 / 01 / 2017