Community bed shortages delaying discharge of medically fit patients from Cork hospital, inspection report finds

EFFORTS are underway by the HSE to provide new public beds in the community in Cork.

It comes as a Health Information and Quality Authority (Hiqa) inspection report revealed that patients, who were admitted through Cork University Hospital’s (CUH) emergency department, faced a wait of up to 16 hours to be sent to a ward.

The inspection found that, on July 25 and 26, triaged patients faced a wait of up to nine hours before being treated by a doctor and an average wait time of nine hours for a bed.

While this was an improvement on Hiqa’s previous inspection findings, inspectors noted that CUH remains particularly challenged with the limited availability of suitable beds in the community — which impacted on the ability to transfer patients from the hospital.

Speaking to The Echo, a spokesperson for Cork Kerry Community Healthcare (CKCH) said: “All staff in CKCH are very aware of the importance of timely and appropriate discharge from all acute hospitals.

“CKCH staff constantly work closely with colleagues across the entire health system, including acute hospitals. Intensive work is underway to facilitate discharge, to provide new public beds, to provide quality Home Support, and to help people to avoid hospital admission.”

There were 29 delayed discharges and the report stated “it was clear that the shortage of community rehabilitation, transitional, and step-down beds, and shortfalls in home care services in the community impacted on the timely transfer of patients who were medically fit for discharge from CUH”.

DELAYED DISCHARGES

Inspectors found the limited availability of suitable community rehabilitation, transitional and step-down beds, shortfalls in home care services in the community, and the inability to transfer patients, resulted in a number of patients experiencing a delay in their transfer of care.

Closed inpatient areas, delayed discharges, along with an admission rate of 24.8% from the CUH’s emergency department and a reported higher average length of stay for medical and surgical patients impacted on the flow of patients through CUH’s emergency department.

This resulted in increased patient experience times and contributed to the boarding of admitted patients in the emergency department.

The report found that plans were progressing to increase the bed stock in CUH, but the mismatch between demand for healthcare services and bed availability did impact on the flow of patients through CUH on days of inspection.

Inspectors found, however, that there were systems in place to support the safe discharge and transfer of patients within and from CUH.

Nursing documentation reviewed by inspectors contained a very comprehensive discharge planning section, which included requirements for complex discharge and there was collaboration and integration with community services in Cork Kerry Community Healthcare.

Due to a number of infection outbreaks, four clinical areas were closed to new admissions during the inspection.