An unannounced HIQA inspection at Letterkenny University Hospital found emergency wait times well below national targets and the highest absenteeism rate of all Saolta hospitals.
The inspection on 7th and 8th of November found patients “being seen relatively quickly in triage” but left waiting for long periods of up to 12 hours to see a doctor or wait for an x-ray or scan.
Two patients who spoke with inspectors were in the emergency department were waiting for 17 and 19 hours.
Another patient was in the emergency department for more than 24 hours after registration. This is in compliance with the national target that 97% of all attendees at ED are discharged or admitted within 24 hours of registration.
The inspectors visited the emergency department, Medical 3 ward and Surgical 2 ward.
Staff were described as ‘kind’ and ‘helpful’ although ‘they were very busy’.
Inspectors observed that the privacy and dignity of patients was promoted and protected by staff when providing care.
Patients told inspectors that they ‘get very good care’ and ‘nurses are powerful’.
The inspection took place in the same week that HSE specialists started a review at Letterkenny University Hospital on the back of serious warnings from consultants and GPs. In open letters to the government, medics said they feared for patient safety as the hospital ED faces relentless overcrowding.
There were 64 patients in the emergency on the first day of the inspection.
The average waiting time from registration to triage at 11am was 36 minutes, which was not in line with the 15 minutes triage time recommended by the HSE’s emergency medicine programme. The average time from triage to medical assessment was 6.6 hours. The average waiting time from medical assessment to admission was 6.9 hours.
The report noted that the hospital was not compliant with all the HSE’s key performance indicators for patient experience times. For the week prior to the inspection, the percentage of patients admitted or discharged from the ED within six hours was 42%, well below the national target of 70%, within nine hours was 78.5%, still below target of 85%. The percentage of patients admitted or discharged from the ED within 24 hours was 99.7%, compliant with the national target of 97%.
Regarding discharge, hospital management outlined that patients complex discharge needs and shortage of community carers posed challenges to transferring patients to safe appropriate care in the community.
Absenteeism among staff was found to be above the national target. Current absence figures for LUH as of January 2024 is 8.76%, which is acknowledged is above national target of 4%. This is up from the hospital’s reported absenteeism rate for September 2023 which was 7.8%. This absence rate was the highest of all Saolta University Health Care Group hospitals.
Inspectors were informed that return-to-work interviews were held with staff, and staff’s sick leave records were escalated to the relevant assistant directors of nursing following three consecutive sick leave episodes.
By January, it was reported that LUH had held information sessions with Heads of Departments in relation to absence management and monitoring and in particular in line with the new changes under the public service sick leave scheme.
