McEntee: ‘Reconfiguration needs to happen now to ensure patient safety’
A STARK warning that any delay in the reconfiguration of services at Our Lady's Hospital, Navan will compromise the health and safety, and possibly lives, of critically ill patients, has been made by the hospital's Clinical Lead, Gerry McEntee.
“Any delay, either political or otherwise, will compromise safety. This change needs to happen in the interests of critically ill patients.”
Mr McEntee warned that bringing critically ill patients to Navan wasn't giving them the best opportunity for survival.
“National and international data highlight the fact that hospitals dealing with small volumes of critically ill patients are associated with poorer outcomes.”
The HSE is proposing the Emergency Department in Navan be replaced with a 24 hour Medical Assessment Unit and a 12 hour Local Injuries Unit, with critically ill patients taken by ambulance to their nearest Level 3 or 4 hospital. Navan is designated a Level 2 hospital.
“Id like to say to the politicians who are fighting this, if it was one of their own family members who was critically ill, would they prefer they were brought directly to a Model 3 or 4 hospital that has critical care services to treat them on arrival or to Our Lady's Hospital, Navan where they don't have those critical care services.”
He said it was the view of the nurses and physicians who look after the critically ill medical patients and of the surgeons that look after acute surgical patients, the anaesthetists who look after critically ill patients and intensive care, the management of the hospital and local GPs that Navan doesn't offer the best chance of survival.
Mr McEntee said that immediate transfer to a Level 3 or 4 hospital was best for the ten per cent of acute medical presentations who would bypass Navan under the proposed new arrangements.
“There will be no delays. The patient will be brought directly to a level three or four hospital from their home or a GP surgery. An advanced paramedic will meet them at the scene and commence first line treatment and bring them to the nearest Level 3or 4 hospital.
“Patients will be better managed. There will be no delay in starting initial treatment and no delay in providing critical care services in the hospital.
“We have been assured by Robert Morton of the National Ambulance Service that the Rapid Response Vehicle and Advanced Paramedic Service is ready to go when reconfiguration takes place.”
“We are talking about five to six critically ill patients per day bypassing Navan. Emergency surgical transfers to Drogheda already make up two of those five to six patients.” He pointed out that Navan is already bypassed in cases of heart attack, stroke, major trauma, paediatrics and obstetrics.
“It is also bypassed for emergency surgical patients. When assessed in Navan, if they need hospital admission, they are transferred to the nearest model three or four hospital.”
Responding to comments by the North East Doctor on Call service regarding stroke and cardiac patients he said those patients already bypass Navan.
Mr McEntee said Model 3 and 4 hospitals have essential critical care services available at arrival and because those hospitals have larger numbers of critically ill patients, such as heart attacks, strokes and major trauma, the patient is more likely to have a better outcome.
“The cohort of critically ill patients that are taken to Navan at the moment are the only such patients in the country who are not brought directly to a Model 3 or 4 hospitals and therefore are not provided with the best opportunity for survival at the outset,” he said.
“The consequences of the reconfiguration are that Our Lady's Hospital, Navan will be safer, but also busier and more efficient.
“There has already been significant investment in areas where Navan can provide a safer and more effective service including a new lab, an upgraded radiology department, a new operating theatre, a surgical day ward.
“Our Lady's Hospital has developed closer links with the Mater Hospital's surgical services in general surgery, urology, vascular surgery, plastics and gynaecology.
“There have also been joint consultant appointments between Navan and the Mater, which improves access for Navan patients to the services delivered in the Mater that aren't delivered in Navan," he said.