Concern about ED care in the future

Doctors working in Emergency Departments (EDs) have made a number of recommendations about how ED care should be provided now and in the post-COVID era.

According to the Irish Association for Emergency Medicine (IAEM), a lot of what passed for as 'normal' in the time before COVID-19 "was clearly unacceptable, even then".

"In the light of the social distancing requirements for both patients and staff, these 'norms' are all the more unacceptable and cannot be allowed to recur," it said.

However, it expressed concern that as time passes, the healthcare system "will just passively return" to these unacceptable 'norms'. Prior to COVID-19, several hundred patients were left waiting on trolleys in EDs every day.

"This series of recommendations is intended to ensure that steps are taken now, as a matter of urgency, to lessen the chance of a return to these dark days which now, more than ever, will place patients and staff at considerable and wholly avoidable risk," the IAEM said.

The recommendations include:
-Ireland must achieve the necessary bed capacity in acute hospitals. This includes retaining all beds that were opened during the COVID-19 pandemic

- The principle that ‘the right patient is seen at the right time by the right clinician so the patient gets the right care' is adopted and applied in Irish healthcare. Only patients in need of emergency medicine expertise should attend or be referred, and EDs should not be "a replacement or surrogate for a variety of non-emergency outpatient and diagnostic services"

-The length of time patients spend in EDs must be minimised. The HSE's own target is that 95% of patients should spend less than six hours in an ED until the time that they leave or are admitted to a hospital bed.

The IAEM acknowledged that COVID-19 has been, and will continue to be, a "huge challenge" for this country, and this will be made "all the more difficult by longstanding and well-flagged deficits in Irish healthcare".

"However, hopefully it has also brought some focus onto the importance of public healthcare, accessible to all when they need it," it added.

The recommendations have been forwarded to senior management in the HSE and the Department of Health.

 

[Posted: Mon 08/06/2020]

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