Annual Report 2010
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Beaumont Hospital ANNUAL REPORT 2009 Beaumont Hospital Annual Report 2009 | zzContents Corporate Reports 3 Chairman’s Statement 5 Beaumont Hospital Board Members 2009 – 2012 7 Chief Executive’s Review 9 Nursing Administration 19 Finance Report 25 Organisation Development 35 Human Resources 41 Information and Communications Technology 47 Clinical Directorates 49 Medical Directorate 51 Surgical Directorate 65 Neuroscience, ENT and Cochlear Implant Directorate 69 Nephrology/Urology/Transplantation Directorate 75 Anaesthetics/Critical Care Directorate 81 Radiology Directorate 85 Laboratory Medicine Directorate 89 Clinical Services Division 95 Operations 111 Projects and Estate Management 117 St Joseph’s Hospital, Raheny 121 Royal College of Surgeons in Ireland 127 Publications 137 1 Beaumont Hospital Annual Report 2009 | 2 Corporate Reports 3 Chairman’s Statement 4 Beaumont Hospital Annual Report 2009 | Chairman’s Statement zzChairman’s Statement It is evident to everyone in Ireland, I the linkage between State funding and the needs of individual believe, that we are now embarked patients. Such a development might at least have the benefit of on what is likely to be a prolonged ensuring that funding for hospital transfers, including funds for period of financial retrenchment. The expensive drugs for example, would accompany the patient. This challenges that this will present will is not the case at present. be immense. Yet even in such difficult The ongoing transformation programme for Irish health services times it is important to keep things in is wide ranging and frequently complex. On the one hand the perspective. intention is clearly to develop greater linkages between primary For us in Beaumont Hospital it is and tertiary healthcare, on the other to centralise the increasingly Mr. Donal 0 Shea, vitally important that we recognise the specialised expertise needed to address a range of specific Chairman achievements which we have already diseases and conditions. made and that we seek to maintain For an acute hospital such as Beaumont this presents both the quality and volume of services we provide. More than both challenges and opportunities. Beaumont provides a this, we must also remain firmly committed to continuing to comprehensive range of diverse acute hospital services to the achieve improvements in these services, despite the many local community it serves of some 250,000 people, specialised challenges that we face in common with everyone else in the services at a regional level and highly specialised national healthcare sector and the wider community. services. This can only be achieved through innovation, finding better ways Reorganisation at a regional level will see the development of a of doing what we do now and achieving efficiencies throughout better integrated network of service providers, including primary the organisation. As Chairman of Beaumont I am proud to report care teams and hospitals, working closely together to ensure that this positive approach is becoming an embedded part of that patients have timely access to the services they need. More the culture of the hospital. Reconfiguration of our management hospital outreach services and co-ordinated delivery of services at structures into business units, or Clinical Directorates as we refer multiple locations will ensure that the specialist clinical expertise to them, represents a major change in the way we administer and residing within an acute setting becomes accessible outside that manage our resources. setting. One of the important objectives will be the removal of Although we are still in the relatively early stages of this major unnecessary duplication of effort by different service providers. transition in the way we manage our business, the value of this Meanwhile, at a national level new directorates are being approach is already being seen. established to develop critical mass in selected centres of Paradoxically, perhaps, the quality of management at Beaumont expertise. The model for this is in the delivery of cancer care. has in some ways masked the extent to which resources have Beaumont is one of eight hospitals selected to provide specialist been curtailed, not just in the year under review but over a services to cancer patients under the National Cancer Control number of years, in fact. Programme. Work is progressing on the construction on the Beaumont site of the new radiotherapy unit and Beaumont has Last year we suffered a 10% cut in resources in real terms. a high quality breast care service up and running, operating well This has been followed by a corresponding reduction of 14% in within the targets set. Working with the National Cancer Control the current year. I regret that it has simply not been possible to Programme, Beaumont will play a significant role in the delivery of respond to this pressure without some impact on staff numbers a range of oncology services in the future. and on our overall ability to deliver timely services in the manner we would wish and that our patients expect. Beaumont’s commitment to the development of an Academic Health Centre is set to make a major contribution to this evolution It should be borne in mind that reconfiguration of health services in the delivery of Irish health services. Working with existing in the North East Region has also played a role in this. Changes in partners, initially the Royal College of Surgeons in Ireland and the types of services provided in some hospitals within the region, Connolly Hospital in Blanchardstown, the new AHC will provide including restrictions on their surgical activity and centralisation the axis for the development of an integrated approach to the of cancer services into eight centres nationally, have put pressure delivery of acute healthcare in the North East. on larger tertiary hospitals in the region, most particularly on Beaumont. Starting with the merging of Beaumont and Connolly hospitals, it is envisaged that the AHC will quickly embrace new partners, There has been some discussion in recent times of ways in which providing a model for patient-centred care, the training and the funding model for hospitals might be developed to increase teaching of staff and for clinical and healthcare related research. 5 Beaumont Hospital Annual Report 2009 | Chairman’s Statement Ambitious targets will be an essential element in ensuring that HIQA has also been involved in monitoring of such important the AHC realises its potential. For example, we believe that in the aspects of healthcare as hygiene. In the past this has been an specialist area of neurosciences the new AHC should become area of significant concern, particularly amongst the public, and it recognised as one of the best places to train in Europe – if not the does have an important part to play in the continuing fight against best place. the spread of infections acquired in healthcare settings. This is an issue in which the hospital board has taken a close interest and I With the involvement of additional academic partners, including am pleased to report that weekly internal audits are consistently Dublin City University, there will be a strong move away from confirming that Beaumont’s hard work in this area is continuing to what could be regarded as an “opportunistic” approach to the deliver excellent results. development of core specialties, education and research into far more structured one. With the support of the Minister and Clinical governance and risk management is another aspect of Department of Health, as well as the HSE, we are currently our work in which the hospital board has shown considerable working closely with the HSE to ensure a good fit with the interest and leadership. As the first hospital in Ireland to establish Executive’s own transformation programme. a specific board subcommittee and internal structures to address this issue, Beaumont is gratified by the progress being made. It should be noted that the management and control of the flow Here, too, we have worked closely with HIQA where appropriate. of data of all kinds, especially clinical information on patients, has This is crucially about how we can ensure patient safety through become an increasingly important component in the effective and the adoption of best practice in all aspects of our services. It is a efficient delivery of healthcare. The rapid provision of information hospital-wide issue and I am pleased that all staff recognise that contributes at two levels: most importantly to the quality of patient they have a role to play in achieving our objectives in this area. outcomes but also to optimise the use of expensive resources. Beaumont is currently engaged in an ambitious programme to In concluding this report I would like to thank the members of upgrade its IT services with additional support for this coming the board for their commitment and generosity. These are unpaid from the HSE. positions and we indeed are fortunate that our high-calibre board members feel a huge sense of loyalty to the hospital. They Taken together, these events represent radical changes in our have done sterling work both as main board members and on organisation, with the underlying aim being the development of the Services and Governance Committee, Finance Committee, an organisation well able to adapt to changing circumstances and Strategy and Planning Committee, and Audit Committee. opportunities in order to deliver high quality services to patients. On behalf of the Board, I also wish to thank the management In so doing we reflect the new national agenda being driven by and staff of Beaumont Hospital for their loyalty and commitment. the Health Information and Quality Authority. This Authority is Regardless of the present difficult economic situation, they establishing new standards for healthcare providers of all types continue to show a genuine concern for the care and treatment of from acute hospitals to nursing homes – and Beaumont has been our patients.