31st Annual Report 2011 Commission for Accreditation of Rehabilitation Facilities Details of NRH Accreditation on www.nrh.ie OUR MISSION The National Rehabilitation Hospital espouses the values established by the Sisters of Mercy to provide high quality care and treatment to patients irrespective of background or status, but on the basis of need. The hospital, in partnership with the patients and families, endeavours to achieve health and social gain through effective treatment and education of patients who, following illness or injury, require dedicated interdisciplinary rehabilitation services. The hospital aims to achieve this in a manner that is equitable and transparent in its service delivery, sensitive and responsive to those availing of its services and supportive of the staff entrusted with its delivery. PATIENT ACTIVITY FOR 2011 CONTENTS Day Inpatient Admissions Cases Brain Injury Non-Traumatic 127 76 Brain Injury Traumatic 133 139 Section 1 Section 2 Year in Review NRH Rehabilitation Stroke Service 129 3 02 Chairman’s Report Programmes Other Neurological 37 11 04 Chief Executive’s Report 20 Brain Injury Programme Spinal Injury 193 53 08 NRH Board of Management 28 Spinal Cord System of 09 NRH Committees Care (Scsc) Programme Prosthetic Service 127 67 10 Looking Back – Photo Diary 36 Prosthetic, Orthotic and Limb Absence 14 Financial Statement TOTAL 746 349 (Polar) Programme 16 Medical Board Report 44 Paediatric Family-Centred Rehabilitation (Paeds) Programme . Outpatient service Attendances Brain Injury Programme 739 SCSC Programme 640 Section 3 Section 4 Clinical Services Corporate & POLAR Programme: Provided Across Support Services Prosthetics 3,371 All Programmes 79 Catering Orthotics 812 55 Department of Nursing 79 Central Supplies Nurse Led Clinic 704 60 Clinical Neuropsychology 80 Chaplaincy 62 Dental Service 81 Communications Orthoptics 109 62 Nutrition & Dietetics 83 Disabled Drivers Xray 1,549 63 Occupational Therapy Medical Board of Appeal 64 Pharmacy 84 Human Resources TOTAL 7,924 66 Physiotherapy 86 Information Management and Technology (IM&T) 67 Radiology 88 Occupational Health 69 Rehabilitative Training Unit 89 Health Planning Team 71 Social Work 91 Patient Services 72 Speech & Language Therapy 92 Risk Management 73 Education and Training Delivered by NRH 94 School Report Healthcare Professionals 95 Technical Services 96 Volunteering at NRH National Rehabilitation Hospital Annual Report 2011 1 Section 1 Year in Review CHAIRMAN’S REPORT A new hospital – at last !! What welcome news – we are to get a new hospital. It will not be exactly the hospital we were planning – which And it is great news for our patients and staff, coming as was a 235 bed unit, to be built in one phase. The new it does after we celebrated our 50th Anniversary in 2011. hospital will be a replacement hospital with 120 beds, with And what a year of celebration we had, involving patients the possibility of 235 beds, and built in three phases. and staff, both present and past. The year of celebration commenced with a grand formal opening by the President Phase 1 will be a 3 storey 120 bedded ward block of Ireland, Mary McAlesse, on 2nd February 2011. There with some integral therapy space. Phase 2 will provide followed a whole series of events to celebrate 50 years of therapy spaces, located vertically above each other, service at NRH, including a major national conference on and horizontally adjacent to the new wards. And specialist rehabilitation services in Ireland, and an inter-faith Phase 3 will deliver the final 235 bed hospital. service of thanksgiving which recognised the many different The good news is that we have been given approval by nationalities represented by our patients and staff. All those the Health Service Executive to proceed to completion who organised these events, deserve our heartfelt thanks. of Phase 1. Unlike the original plans to have 50% of The hospital did not stand still during 2011. For the 30th year beds in single rooms, all beds in the new development in succession we came in on financial budget – a deficit of will be in single rooms to comply with the latest SARI* €5,000 on an expenditure budget of €24.5m or 0.02% has requirements. Also because the horizontally adjacent been a major achievement. However, we face a challenging therapy areas will not be available until Phase 2, time in 2012 with reduced funding and reduced staffing. provision has been made in Phase 1 for increased integral therapy space over that in the original design. During 2011 we continued our “war” against hospital acquired infections. In that connection, the current building The cost of Phase 1 will be funded (a) by the sale of project taking place in Our Lady’s and St Patrick’s Wards will land which is not required by the hospital, (b) by the NRH greatly improve the conditions for patients in those wards. Foundation from the proceeds of previous land sales, and (c) by the HSE from its capital allocation. It is expected that The hospital co-operated in 2011 with RTE in the production professional advisors will be appointed, planning approval of two TV programmes which followed the progress of received and, building works commenced by mid-2013. some patients through the hospital. The series gave a very good demonstration of the value of medical rehabilitation. The HSE is committed to support Phases 2 and 3 but this will be dependent on the financial position of the country There was slow progress made on the establishment of the improving in the years ahead. However, the fact that Phase new trust which will oversee the governance of the hospital 1 has been approved, despite the current perilous financial and will ensure its continuation as an independent voluntary state of the country, is a credit to all those, who over the hospital into the future, when the Sisters of Mercy will no years, believed that a new hospital was achievable. longer be involved. Also the other charitable trust, the National 2 National Rehabilitation Hospital Annual Report 2011 Medical Rehabilitation Trust, which collects and distributes for the support over the years of David Cox, Solicitor, who funds for the benefit of the hospital, changed its name in retired from Mason Hayes + Curran in 2011. And also the 2011 to the NRH Foundation, to enhance the link with the contribution of our auditors Robert J. Kidney & Company. hospital. We thank Mr David Plunkett for that initiative. The members of the Board of Management and of its We welcomed in November 2011 the publication by sub-committees also deserve our thanks (Medical – Kathleen Lynch TD, Minister for Disability, Equality, Mental Dr Jacinta McElligot who replaced Dr Aine Carroll in 2011 Health and Older People, of the long awaited National at the end of her term; Audit – Barry Dunlea; Nominations Policy and Strategy for the Provision of Neuro-Rehabilitation – Sr Maura Hanley; Ethics – Kieran Fleck SC). They put in Services in Ireland 2011 – 2015. We are pleased that the considerable time, voluntarily and without remuneration, in report strongly endorses the “hub and spoke” structure of the interests of the hospital. We congratulate Dr Aine Carroll medical rehabilitation as advocated and practised by the on her appointment in 2011 as Clinical Lead of the National NRH over the years eg the developments already in place Rehabilitation Medicine Programme. in HSE South and those proposed for HSE West. However, We received recently, with regret, the resignation of we have reservations about the recommendation that the Sister Aileen from the Board of Management after many medical rehabilitation of children should be provided “within many years of dedicated service. We will miss her incisive a children’s framework” as such rehabilitation may not get contributions at the Board which were always made with the priority it requires in an acute children’s framework. the objective of improving services for our patients. We regret the death which has taken place recently of two And our final thanks must go to you, the staff of the persons who gave dedicated service over many years on hospital, ably led by Derek Greene as CEO. You all deserve the Board of Management – Dr Claire Carney, who was great praise for your dedicated service during the year. the first woman to be appointed to the position of Faculty Dean in the history of UCD, and Mr Michael Slattery who as Manager of the Laboratory, for many years represented staff on the Board of Management. We are indebted to them both and extend sincere sympathy to their families. The hospital could not survive without the support of many people, particularly the unstinting support of the Sisters of Mercy over the years, and in particular in 2011 by Sister Henry Murdoch Peggy Collins, Provincial Leader. We also thank the HSE Chairman for its support, particularly Mr Gerry O’Dwyer, Regional Director of Operations (Dublin Mid-Leinster). We are grateful *Strategy for the control of Antimicrobial Resistance in Ireland National Rehabilitation Hospital Annual Report 2011 3 Section 1 Year in Review CHIEF EXECUTIVE’S REPORT Delivering & Developing Specialist New Hospital Project Rehabilitation Services Since 1961 The Board continued in 2011 to do everything possible to 2011 was a special year for the National Rehabilitation ensure that a new hospital is delivered and that this vitally Hospital as we celebrated the hospital’s 50th year as National important national project is realised, at the earliest possible provider of Specialist Rehabilitation Services. A Programme of opportunity. events was planned and took take place throughout the year. Patients – current and past, and their families; Staff – current CAPITAL PROJECT and retired; the Sisters of Mercy, the Board of Management, In the interim period, remedial building works were approved colleagues from the wider healthcare sector, and invited in order to address ongoing challenges faced by patients guests attended these events.