'Significant improvements' to patient experience arising from pandemic, says CUH operations manager

Breda Graham hears of the reorganisation and co-operation that was needed on a grand scale in the last 12 months as Cork University Hospital adapted to deal with the challenges presented by Covid-19
'Significant improvements' to patient experience arising from pandemic, says CUH operations manager

Staff at CUH. Hospital operations manager Brendan O’Reilly described it as a “very rewarding year in a strange way” for the hospital, thanks to its “outstanding” staff. Pic Daragh Mc Sweeney/Provision

CORK University Hospital (CUH) operations manager Brendan O’Reilly has spoken of the role that the hospital played in the battle against the Covid-19 pandemic over the past year.

Mr O’Reilly described it as a “very rewarding year in a strange way” for the hospital, thanks to its “outstanding” staff.

Mr O’Reilly said that much of his role over the past year has been “being part of teams that decided how we would approach certain situations, supporting people who know what they’re doing — clinical people who inform us and fill in the gaps that all of us have as leaders and managers — and then making collective decisions”.

He said that the three major stakeholders kept in mind when making such decisions were patients, staff and organisations, and a priority was ensuring the safety and protection of those stakeholders.

Mr O’Reilly said that, although training and donning and doffing was not new to the health system because of many outbreaks and epidemics in the past, the Covid-19 pandemic was “a whole other plane”.

One of the hospital’s earliest cases was detected when an ICU patient with undifferentiated pneumonia was subsequently tested, after one of the hospital’s infectious disease doctors suggested it best to test.

Mr O’Reilly said that it was a “huge learning exercise for us, it was a huge learning exercise for the country” and informed the subsequent testing algorithm for hospitals, as the patient’s close contacts who nursed him in ICU had to self-isolate for two weeks.

He said that the hospital was not prepared to lose whole teams and that they learned early on to step up use of PPE to protect staff and patients, much of which was sourced through local businesses due to worldwide shortages and tested to ensure suitability and safety.

Ventilators and pumps needed for ICU patients were also purchased in a competitive market when the whole world was in need of such equipment at the same time.

Certain areas of the 42-year-old hospital also had to be rearranged and regenerated to control the spread of infection.

The hospital’s fifth-floor high-dependency unit (HDU) was cleared out and prepared for additional critical care patients, the emergency department was refurbished, and all the shared spaces were divided into single rooms or separated areas. The medical short-stay ward was ripped out and replaced with single-room spaces on the foot of an outbreak and has since had no issues in relation to spreading of the virus.

The whole disused underfloor of the hospital, which Mr O’Reilly said was “a construction site”, was regenerated by the estates department into a Covid-19 ward.

St Catherine’s Convent was also refurbished by the estates department and turned into a custom-made state-of-the-art outpatient department (OPD), from where both the physical and virtual OPD operated .

Mr O’Reilly said that rotas were reorganised so doctors carried out ward-based work, as opposed to team-based, which saw doctors stay on a ward.

The strict visiting measures that were introduced “were not always pleasant” but were in place to protect staff and patients.

The IT department also developed the use of iPads to keep families and loved ones connected during their stay in the hospital.

He said that the 50% drop in presentations to the emergency department when community cases rose in Cork worried staff because “there were people with a genuine disease that probably weren’t presenting” due to concerns about Covid.

Mr O’Reilly said it was important to acknowledge that, although cases have dropped in Cork, CUH still nurses “some really sick patients”.

“The ICU is a lagging trend. It follows behind community activity because patients, when they go into ICU, often take quite a while in there to come right or some of them sadly pass away,” he said.

He said that one of the “significant improvements” to come out of the pandemic is that there are no more trolleys in corridors.

“While we have patients in a trolley in a space in the emergency department, who might be delayed going up to a ward, they are no longer on a corridor. The dignity of the patient is protected; it’s a much better patient experience and one of the significant improvements of the whole process,” he said.

He said that the last year has highlighted the importance of interdisciplinary working, where people of all grades — the professional, non-professional, clinical, non-clinical — all had input in the running of things, which made for a more horizontal approach, which he said “is a healthy thing”.

He acknowledged all those who have had such input in the workings of the hospital throughout the pandemic including the estates department; local businesses and companies; the South/Southwest Hospital Group and the HSE; consultants; doctors; GPs; nurses; social care professionals; and support services including cleaners, porters, caterers, and security staff.

He also thanked the National Ambulance Service and University College Cork (UCC) for their use of spaces not being used for educational purposes.

Mr O’Reilly was speaking during the last session of a week-long Covid-19 conference hosted by five UCC societies: the biomedical science society, the science society, the pharmacy society, the medical society, and the medical research and technology society.

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