Review of acute hospital services in the Mid - Health Service Executive

Integrating PCCC services with the acute services
Review of acute hospital services in HSE Mid-West
An action plan for acute and community services
To complement the regional and local ‘centres of excellence’, there needs to be a
comprehensive range of primary and community services, which can support the changes in
acute hospital care. Most importantly will be health promotion and the prevention of ill
health, the avoidance of hospital admissions and supporting earlier discharge from
the acute care setting.
Most of this support will be provided by the development of:
• Self care, promoted through education of patients and carers and telemedicine;
• Home care packages, PCTs and PSCNs to support patient management in the home;
• Community chronic disease management programmes;
• More PCCC services to cover out-of-hours and week-end requirements;
• An Advanced Paramedic service; and
• Community facilities to provide an Urgent Care Centre, nurse and therapy managed beds
for rehabilitation, access to enhanced diagnostics and a base for staff.
The recent national Acute Hospital Bed Review 32 identified a significant proportion of
inpatients who could have been cared for in more appropriate care settings, both at
admission and during their stay in hospital. At a national level the review found that 13% of
patients were unnecessarily admitted to hospital and that 39% of patients in hospital could
have been treated in an alternative setting on the day of care, if appropriate alternatives were
available.
The national review also identifies the appropriate alternatives to acute hospital care that
would be required, and the proportion of patients occupying an inpatient bed that would
satisfy these alternatives. For the Mid-West, these alternatives and their proportions are
shown in Table 7.
Table 7: Proportion of patients for alternative care settings in the Mid-West
Alternative Care Setting
Proportion of inappropriate
admissions
42
Proportion of patients
whose length of stay could
have been reduced
32 HSE: Acute Hospital Bed Review: A review of acute hospital bed use in hospitals in the Republic of Ireland with Emergency
Departments, PA Consulting and Balance of Care, 4 May 2007 (available from the HSE website at www.hse.ie).