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

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Review of acute hospital services in HSE Mid-West An action plan for acute and community services • Taking urgent steps upfront to reduce clinical risk and improve patient safety in areas of the current services where the present quality of care needs to be addressed; • Maintaining the current service configuration and reducing deficiencies in capacity to meet today’s demands, pending implementation of the new service configuration; • Developing integrated locality working between NHO and PCCC services; • Ensuring that all the pre-conditions to delivering the optimal configuration for acute care are in place; and • Ensuring that appropriate contingency plans are in place to manage the risks to success. The over-riding principle is that no acute service will be withdrawn from the current general hospitals until the regional ‘centre of excellence’ is resourced and ready to deliver that service with reference to international quality standards. In turn, these assumptions for acute care are based on the following assumptions for prehospital services: • The PCCC service has been resourced, developed, and is working to recognised international best practice standards for the management of the anticipated future demand across the Mid-West, both during working hours and out-of-hours, for admissions avoidance and earlier discharge; • The ambulance service has fully developed its mobile emergency response capabilities, by developing its ‘Advanced Paramedic’ workforce and by deploying them to all areas of the Mid-West; • The Helicopter Emergency Medical Service is fully integrated into the emergency care system for Mid-West; • There is an ‘Advanced Nurse Practitioner’ and ‘Clinical Nurse Specialist’ workforce in place, leading the delivery of a Mid-West network of local nurse led Urgent Care Centres, integrated with local Advanced Paramedic and duty GP teams and the single central A&E service; and • There is effective partnership working across all elements of the pre-hospital and hospital systems. The future clinical model of acute care is designed around a robust infrastructure. Creating the circumstances for the provision of an assured quality of care is based upon the presence of: • Formal clinical teams/networks, responsible for managing and coordinating care for that specialty or category of acute care across the region (emergency care, planned care, cancer, critical care, obstetrics, paediatrics, radiology, etc); 71
Review of acute hospital services in HSE Mid-West An action plan for acute and community services • An integrated network programme for education, teaching, training and research, developed in partnership with all local stakeholders, including the University of Limerick, the ‘regional centre of excellence’ and the local ‘centres of excellence’ as part of the academic network; and • Clinically relevant information technology and communications (unique patient identification, electronic records, real time/store and forward transfer of clinical images, tele-consultation, etc). The action plan below sets out the major steps to achieving the necessary changes in service reconfiguration. We estimate, excluding the timescales for new builds and refurbishment, that the programme should be deliverable within 3-4 years, following completion of the detailed project planning stage. Actions have been identified in relation to the project management arrangements, improvements in operational efficiency, the regional ‘centre of excellence’, localities, and workforce development. The actions also identify the transitional arrangements necessary to make clinical services safer in the immediate future, pending the full transformation of services. Managing the implementation programme In order to oversee the implementation of the changes and actions identified below, it is essential that effective project management arrangements are put in place promptly, as presented in Figure 5. 72
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Key messages Review of acute hospit
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educe the length of stay in hospita
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What is ‘International Best Pract
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Table 43: A comparison of specialis
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Critical care network Review of acu
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Tele-medicine Review of acute hospi
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• Picture archiving and communica
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Review of acute hospital services in the Mid - Health Service Executive

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