Beaumont Hospital Annual Report 2010
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Beaumont Hospital Annual Report 2010 www.beaumont.ie CONTENTS Annual Report 2010 Chairman’s Statement ............................................................................................................... 1 Chief Executive’s Review ............................................................................................................ 7 Director of Nursing Report ...................................................................................................... 19 Beaumont Hospital Finance Report ......................................................................................................................... 27 Organisational Development .................................................................................................... 37 Integrated Quality and Safety ................................................................................................... 45 Human Resources .................................................................................................................... 51 Information and Communications Technology ....................................................................... 57 Clinical Directorates ...........................................................................................................59 Medical Directorate .................................................................................................................. 61 Surgical Directorate ................................................................................................................. 79 Neuroscience, ENT and Cochlear Implant Directorate .......................................................... 85 Transplant, Urology and Nephrology Directorate ................................................................... 91 Anaesthetics/Critical Care Directorate ................................................................................... 97 Imaging and Interventional Radiology Directorate ................................................................101 Clinical Directorate of Laboratory Medicine ..........................................................................105 Clinical Services Division .................................................................................................113 Operations ........................................................................................................................129 Projects and Estate Management ....................................................................................137 St Joseph’s Hospital, Raheny ...........................................................................................143 Royal College of Surgeons in Ireland ...............................................................................149 Publications ......................................................................................................................157 CHAIRMAN’S tatement S Statement Chairman’s Annual Report 2010 Beaumont Hospital 1 CHAIRMAN’S Statement tatement S Chairman’s Chairman’s Ireland’s health service is facing a crisis of a scale never seen before. The country’s extreme financial difficulties are clearly a major Mr. Donal 0 Shea, contributor to this, but there are others and it is important to consider Chairman these influences in context. Annual Report 2010 The huge improvements which have taken place in Emergency Department are over 85 years of age. These are healthcare in Ireland are unquestionably a significant factor typically people with complex conditions and comorbidities. and have important implications for future service demand But unfortunately this growing challenge has not been and delivery. These improvements have contributed to rising fully acknowledged in the tangible way one might wish, expectations in respect of healthcare and to rising costs. through provision of additional funding. Just three years Beaumont Hospital Furthermore, the pace of change for the better continues ago Beaumont received funding under its service level to accelerate. The unprecedented improvement in life agreement in excess of €280 million. In 2011, although there expectancy in Ireland is one of the most obvious examples has been no decline in demand for services, the hospital will of this. receive approximately €60 million less than this and further budget cuts could even see the hospital trying to cope with Over the last 60 years average life expectancy for men has an allocation not significantly in excess of €200 million in increased by more than 12 years to approximately 77 years years to come. today. For women the improvement has been even greater, increasing by some 15 years over the same period to close to Beaumont Hospital has worked extremely hard over recent 82 years now. years to try to bridge the gap between the cost of meeting the growing demands of an ageing population and the Obviously reductions in infant mortality, better nutrition significant and continuing reductions in funding. In addition and improved living standards generally, not just to cost containment drives under all headings, the hospital improvements in medical care, have all contributed to this. has been in the vanguard of introducing new approaches But it is particularly notable that the dramatic improvement to drive efficiencies and to improve processes. For example, in life expectancy which occurred over the past decade has Beaumont pioneered the development of the clinical been almost exclusively attributable to improvements in directorate model as a means of engaging experienced healthcare services, for example in tackling major causes of clinicians more directly in the day-to-day provision of death such as circulatory system diseases. hospital services and to bring decision-making closer to the Research recently published by the Department of Health bedside. (Health in Ireland: Key Trends 2010) shows that between Similarly, Beaumont has pioneered a number of hospital 2000 and 2010, a period in which average life expectancy outreach services, such as the one for patients with COPD, within the EU as a whole continued to rise, Ireland went as a means of bringing the hospital’s expertise out to the from a position of nearly one year below EU average life patient and thereby helping to reduce the frequency and expectancy to almost one year above. As a result, in the duration of repeat admissions. Such approaches have space of just ten years Ireland has jumped from 16th to 8th healthcare benefits for patients and financial ones for the place in the European life expectancy league table. hospital. Partly as a consequence, Ireland is also beginning to catch Various factors, to which I have referred in recent annual up with other European countries in terms of having an reports, have made it particularly difficult for hospitals in ageing population. Approximately 20,000 more people are north Dublin to ensure that sufficient inpatient capacity is currently joining the 65+ age group each year. Over the next retained within Beaumont to ensure timely admissions for 20 years the number of people in this category is expected all patients through the Emergency Department. Addressing to double to over one million, with the greatest proportional this remains a top priority for our hospital and Beaumont increase in the 85+ age group. It is also noteworthy that, is enthusiastically participating in the HSE’s national acute while women live longer than men, as might be expected medicine programme. The development of a new acute they have greater health problems in their later years. medical unit will provide assessment and specialist care This has huge implications for the provision of all kinds for adult patients with a wide range of medical conditions, of care and supports for the elderly, including the acute helping to reduce significantly the pressure on the already hospital sector. For example, the average length of stay in overburdened Emergency Department. We are confident an acute setting is strongly associated with age. Nationally that it will play a significant role in our ability to meet our it rises from around three days for people under the age of commitments in respect of admission waiting times. 35 to nearly two weeks for those over 85. It is a startling fact Beaumont is similarly active in respect of the national that over half the people admitted to Beaumont through its programme for elective surgery, one element of which 2 is The Productive Operating Theatre (TPOT) programme. Hospital’s board and of its management and staff, to This involves the provision of pre-assessment clinics for maintain both the quality and range of services we provide inpatients, improved use of the theatre IT system, adoption and to find ways of doing that with fewer resources. We tatement of the World Health Organisation’s safe surgery checklist know that we are not alone in facing such a challenge, it is S and various other measures. The objective is to improve one which confronts service organisations and businesses utilisation of all resources related to theatre activity and to throughout the land every day. As a large tertiary referral improve patient access, care and safety. Anticipated future centre, however, we have to accept that the nation is relying Chairman’s Chairman’s benefits will include a reduction in cancellations, reductions on us to rise to this seemingly impossible challenge. in length-of-stay and increases in the proportion of same- In light of the enormous pressures Beaumont has been day admissions, with consequent