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Lodgers, Boarders, Trolley Patients; A Growing Challenge in Emergency Departments (ED). Zero Tolerance for Trolleys or Zero Tolerance for Zero Trolleys; A Crude Examination of Progressive Capacity Issues in an Irish Emergency Department.

Published online by Cambridge University Press:  13 July 2023

Maria Conradie
Affiliation:
Wexford General Hospital, Wexford, Ireland
Marco Smit
Affiliation:
Wexford General Hospital, Wexford, Ireland
Ria Abraham
Affiliation:
Wexford General Hospital, Wexford, Ireland
Andrea van der Vegte
Affiliation:
Wexford General Hospital, Wexford, Ireland University of South Wales, Caerleon, United Kingdom
Muhammad Bilal
Affiliation:
Wexford General Hospital, Wexford, Ireland
Brendan Orsmond
Affiliation:
Wexford General Hospital, Wexford, Ireland
Robin Andrews
Affiliation:
Wexford General Hospital, Wexford, Ireland
Rochelle Janse van Rensburg
Affiliation:
Wexford General Hospital, Wexford, Ireland
Sayed Yousuf Raza Taqvi
Affiliation:
Wexford General Hospital, Wexford, Ireland
Phillip Jordaan
Affiliation:
Wexford General Hospital, Wexford, Ireland
Aishleigh Dowle
Affiliation:
Wexford General Hospital, Wexford, Ireland
Darshini Vythilingam
Affiliation:
Wexford General Hospital, Wexford, Ireland
Bryce Wickham
Affiliation:
Wexford General Hospital, Wexford, Ireland
Thomas Kelly
Affiliation:
Wexford General Hospital, Wexford, Ireland
Michael Molloy
Affiliation:
Wexford General Hospital, Wexford, Ireland School of Medicine, UCD, Dublin, Ireland Beth Israel Deaconess Medical Center - Fellowship in Disaster Medicine, Boston, USA
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Abstract

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Introduction:

The Health Information and Quality Authority (HIQA) Tallaght Report of 2012 found care of lodged admitted patients on ED trolleys was undermined in terms of quality and safety. HIQA advised the practice of lodging in ED adjacent hospital corridors should be discontinued entirely. This message was reiterated during the pandemic. Some lodged patients may spend the total duration of their admission on an ED trolley. ED has 15 Adult rooms, seven pediatric rooms, two minor injury rooms, one procedure room and two resus bays. The aim was to calculate the annual number of days when no admitted patients were lodged on trolleys in ED.

Method:

A descriptive study using data available from nationally issued reports on patients allocated to trolleys to the ED of Wexford General Hospital from January 2019-September 2022. Data was collected from national HSE daily SBAR reports. “Lodged patients” were those present in ED admitted but for whom no ward bed existed at 0745 daily.

Results:

Data was collected for 1,369 days, 90 days were excluded due to missing data sets, and data were included for 1,279 days. 290 days were recorded in 2019 with no lodged patients, 126 in 2020, 55 in 2021, and only 11 days in 2022 with no lodged patients. In 2022 the average number of lodged patients was six (Range 0-19). A total of 47 days had a lodged count of ten or greater.

Conclusion:

Despite a strong recommendation from HIQA to terminate the practice of ED patient lodging, this has not been implemented. During the COVID-19 pandemic, there had been a reduction in the overall number of patients visiting the ED. This contributed to the reduction in trolley-lodged patients however post-COVID pandemic there has been a surge in attendance with a clear deficit in bed capacity.

Type
Poster Presentations
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine