Hospital Trolleys

[Purple]

We keep hearing about the long lists of people waiting on trolleys in A&E departments for days and weeks.

Every time I am in a hospital with kids and other relatives who are in-patients we seem to spend the last day to day and a half waiting to be discharged. Why don’t the HSE measure that? If discharge decisions can be made every few hours instead of every day of two we could probably sort out a large chunk of the problem. How come this is never mentioned?

 

[Purple]

RTE sent me a notification to say that the INMO total for patients on Trollies is 612.
Why do they keep publicising this meaningless BS without backing it up with any analysis into the causes? Why do journalists not do their job any more? Why do media outlets report press releases from biased self-interest groups as if it is news?

 

[Delboy]

They report it because it saves them having to pay for real journalism. And then they'll have an Opinion piece or Primetime special on fake news!

 

[Firefly]

RTE publishing figures from a trade union. Well, I never

 

[ashambles]

It's an easy first week in January story for RTE. Just copy and paste the 2015 report in.

What's more interesting is why is there an increase in numbers on trolleys every single January. Just as a sneak preview It'll happen in Jan 2018 as well.

The answer is partly to due seasonal factors such as flu, but what's more important and the unions or HSE won't tell you is that hospitals are surprisingly expert at reducing capacity over Christmas. Wards start being cleared out in early December - they get cleared out by having no elective or non-emergency patients being treated.

I've been in hospitals around Christmas and you'll see a lot of empty wards or one or two patients per ward. Partly it's patients don't want to get a non-emergency treatment around then, partly it's to allow staff time off.

So on January of every year you're dealing with the patients you'd expect and 3-4 weeks worth of backlog. So you're guaranteed to have around double the trolley number.

 

[Purple]

So on January of every year you're dealing with the patients you'd expect and 3-4 weeks worth of backlog. So you're guaranteed to have around double the trolley number.

Yes, but as the wards are empty post-Christmas why are they not being transferred? And back to my original point; where's the list of people sitting around waiting for a Consultant to bother their backside to do a Ward round and discharge them?
Every hour someone spends waiting to be discharged is an hour someone else spends on a trolley. Why is that never focused on? Well we know why; we cannot criticise so-called "Front Line" staff and anyway, it doesn't suit the INMO's narrative, parroted by RTE, that the problem is lack of beds and lack of "Front Line" staff.

 

[jjm]

Why do you never focus on getting the people you support/ elect to do there job, Time to stop sitting on your back side criticising the wrong people.Do you not realize the minister already knows what is going on.Discharge all the Dail Eireann Deputies/Ministers at the next General Election no need to change parties just replace them with there running mates.They need to fear the people when the don't do there job .Right now the Minister fears change more than he fears the people.Don't blame INMO / RTE /MEDIA/JOURNALISTS/ FRONT LINE STAFF.Look.You ought to look in the mirror and face reality. Consider self Examination before continuing to criticising front line staff.Change will only come when people stop voting for the same Ministers/Parties who do not stand up to pressure groups/special Intrest groups on behalf of the people.We need to start voting on there record in office/oppisition and stop voting on there promises.They need to know that there will be an extra 157 people waiting on trolleys to be discharged after the next general election going by there record so far.

 

[Purple]

Why do you never focus on getting the people you support/ elect to do there job, Time to stop sitting on your back side criticising the wrong people.Do you not realize the minister already knows what is going on.Discharge all the Dail Eireann Deputies/Ministers at the next General Election no need to change parties just replace them with there running mates.They need to fear the people when the don't do there job .Right now the Minister fears change more than he fears the people.Don't blame INMO / RTE /MEDIA/JOURNALISTS/ FRONT LINE STAFF.Look.You ought to look in the mirror and face reality. Consider self Examination before continuing to criticising front line staff.Change will only come when people stop voting for the same Ministers/Parties who do not stand up to pressure groups/special Intrest groups on behalf of the people.We need to start voting on there record in office/oppisition and stop voting on there promises.They need to know that there will be an extra 157 people waiting on trolleys to be discharged after the next general election going by there record so far.

So it's the fault of TD's that the HSE, Hospital Management, Doctors and Nurses etc can't manage to run the health service at anything like the same levels of efficiency as just about every other health service in the OECD? It's the fault of TD's that RTE and Newstalk and other media outlets refer to the INMO figures as being compiled by "officials"? It's the fault of TD's that no journalist asks for the "why" after reporting the "what"? You think we should replace the people we have now with the populist far left ideologues whose economic policies are based on Trotsky and Marx? Give me a break! Do you think those clowns are going to stand up to the Public Sector Unions, the strongest and most damaging vested interest groups in the country?

 

[Firefly]

The answer is partly to due seasonal factors such as flu, but what's more important and the unions or HSE won't tell you is that hospitals are surprisingly expert at reducing capacity over Christmas. Wards start being cleared out in early December - they get cleared out by having no elective or non-emergency patients being treated.

I've been in hospitals around Christmas and you'll see a lot of empty wards or one or two patients per ward. Partly it's patients don't want to get a non-emergency treatment around then, partly it's to allow staff time off.

So on January of every year you're dealing with the patients you'd expect and 3-4 weeks worth of backlog. So you're guaranteed to have around double the trolley number.

I never thought about this before. Would be interesting to hear Liam Doran offer his opinion on this.

 

[Leo]

Why do you never focus on getting the people you support/ elect to do there job

So which elected official decides the work practices, detailed budget allocation across departments/ cost centres, staffing levels, rostering, etc. at my local public hospital?

 

[ashambles]

I never thought about this before. Would be interesting to hear Liam Doran offer his opinion on this.

Doran's own INMO figures for trolley watch show why we've an annual January crisis.

https://www.inmo.ie/trolley_ward_watch

Pick any year and look at the December trolley numbers and watch how they nosedive for Christmas as the nation suddenly become healthy.

Illustrative are the 2015 numbers as they go to the 24th of Dec with a mere 50 people waiting on trolleys. Chances are this 50 number is the base average figure for patients in A&E who are emergencies opposed to patients who've no option but to use A&E as the method to get into a ward for diabetes treatment or whatever.

It is impossible to not have a dramatic trolley increase in January with the way the Irish system works.

 

[Purple]

Doran's own INMO figures for trolley watch show why we've an annual January crisis.

https://www.inmo.ie/trolley_ward_watch

Pick any year and look at the December trolley numbers and watch how they nosedive for Christmas as the nation suddenly become healthy.

Illustrative are the 2015 numbers as they go to the 24th of Dec with a mere 50 people waiting on trolleys. Chances are this 50 number is the base average figure for patients in A&E who are emergencies opposed to patients who've no option but to use A&E as the method to get into a ward for diabetes treatment or whatever.

It is impossible to not have a dramatic trolley increase in January with the way the Irish system works.

It looks like our multi billion Euro hospital system is grossly under utilised for one twelfth of the year. That equates to a waste of hundreds of millions of Euro. A large part of the solution is to keep the hospitals busy over Christmas with elective procedures. If you don't want to be in hospital over that period then you can go to the back of the queue.

 

[Delboy]

I don't think its the Patients now wanting to be in the hospitals during xmas, more likely the Consultants and Nurses.

And it's not just 1/12th of the year thats wasted. How much work is done at weekends, evenings,nights throughout the years. Hospitals seem to operate at most for about 1/3 of the year at a max

 

[Leo]

I don't think its the Patients now wanting to be in the hospitals during xmas, more likely the Consultants and Nurses.

Anecdotal evidence from family in the health service says there's a significantly higher volume of no-shows for elective procedures in the run up to Christmas, even for serious cases, with a lot of them walking in early in the new year claiming to have forgotten about the appointment or not having received the notice.

 

[PMU]

The answer is partly to due seasonal factors such as flu,

Why is influenza an issue? It's a virus so flu vaccination is the preventative measure. It's free to those with a medical or GP visit card, so why don't people take it, and if they don't surely it's reasonable to charge them the marginal costs of taking up a trolley and subsequent costs? Also is it actually correct to say that flu is responsible for the 'trolley' issue? Flu can be detected by influenza diagnostic tests, so why are 'flu patients' not so tested and shifted out if the results are negative? Why are they taking up trollies? If positive, why are they not prescribed antivirals and then shifted out? What else can you do?
I don't want to turn this into a rant, but having put my late mother, my late aunt and family members through the Irish public hospital system - it is a disaster (and I'm being charitable here). It's not that the health services staff in it are competent and hard workers etc. and are screwed by the system. IMHO they are not that good - if they worked really hard they could become second rate, but they have a long way to go; going into a public hospital is like going into a monkey house but I've seen better managed zoos. If you are a professional, can talk to doctors etc., in my experience you have a reasonable chance of survival but if you kowtow you will end up dead.

 

[Delboy]

Docs on the radio over the day all seemed to be saying that the free GP care for under 6's has contributed to the mess. More kids now showing at their GP's, no extra GP's. So some patients not getting appointments on tiem and ending up in hospital.
2.1m with medical cards, nearly half the population. Castro, Chavez would be proud of a stat like that

 

[Purple]

I don't want to turn this into a rant, but having put my late mother, my late aunt and family members through the Irish public hospital system - it is a disaster (and I'm being charitable here). It's not that the health services staff in it are competent and hard workers etc. and are screwed by the system. IMHO they are not that good - if they worked really hard they could become second rate, but they have a long way to go; going into a public hospital is like going into a monkey house but I've seen better managed zoos. If you are a professional, can talk to doctors etc., in my experience you have a reasonable chance of survival but if you kowtow you will end up dead.

I agree with the thrust of your post but why would a solicitor or a doctor have a better chance of surviving than an engineer, an IT consultant or a business owner (or anyone else who was reasonably confident, intelligent and a good communicator)?


I don’t think our doctors and nurses are particularly bad but I certainly don’t think that they are particularly good either. Having dealt with doctors and nurses in the USA and Britain I would certainly rate ours behind both but not by much.

 

[Firefly]

It looks like our multi billion Euro hospital system is grossly under utilised for one twelfth of the year. That equates to a waste of hundreds of millions of Euro.

Doran's own INMO figures for trolley watch show why we've an annual January crisis.
https://www.inmo.ie/trolley_ward_watch

Pick any year and look at the December trolley numbers and watch how they nosedive for Christmas as the nation suddenly become healthy.

This is shocking and given the state of things deserves an investigation by the HSE in its own right. If the HSE hired more agency staff I am guessing this would be less of an issue..

Anecdotal evidence from family in the health service says there's a significantly higher volume of no-shows for elective procedures in the run up to Christmas, even for serious cases, with a lot of them walking in early in the new year claiming to have forgotten about the appointment or not having received the notice.

If this is true (and it sounds plausable to me) I would think the HSE, in its defense, should publish this information. At least it might give the honourable Liam Doran something to chew on.

 

[Purple]

If this is true (and it sounds plausable to me) I would think the HSE, in its defense, should publish this information. At least it might give the honourable Liam Doran something to chew on.

Yes, and he knows the solution; hire more nurses and pay them more. That will also sort out global warming and that bother in Aleppo.

 

[mathepac]

It looks like our multi billion Euro hospital system is grossly under utilised for one twelfth of the year.

When investigating a NHS hospital some years ago, Gerry Robinson, former TESCO boss from Mayo, drilled down to find out why there were excessive delays for certain operations. He discovered that an operating theatre was closed every Friday. No-one knew why, but it was "custom and practice". Re-opening the theatre solved the problem permanently.

God only knows what wasteful customs and practices obtain within the HSEs. An hour off to cash a cheque anyone? But you're paid by credit transfer now. Ah yes sisters, but custom and practice dontcha know.