39TH ANNUAL REPORT 2019 Moving Forward Together 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 2019 Inpatient Discharges Day Cases Outpatient Attendances Service No. patients Service Clinics Spinal Cord System Consultant Led Clinics of Care Programme 126 0 Spinal Cord System of Care Programme 733 Brain Injury Programme 129 0 Stroke Specialty Programme 87 0 Brain Injury Programme (including Stroke) 816 Prosthetic Orthotic and Prosthetic Orthotic and Limb Limb Absence Rehabilitation Absence Rehabilitation (POLAR) Programme 391 (POLAR) Programme 68 42 Paediatrics Programme 47 Paediatrics Programme 80 11 Total Consultant Led Clinics 1,987 TOTAL 490 53 Therapy Led Clinics Spinal Cord System of Care Programme 2,397 Brain Injury Programme (including Stroke) 4,971 Prosthetic Orthotic and Limb Absence Rehabilitation (POLAR) Programme 932 Paediatrics Programme 71 Total Therapy Led Clinics 8,371 TOTAL 10,358 VISIT US AT: www.nrh.ie Contents SECTION 1 SECTION 2 YEAR IN REVIEW NRH REHABILITATION PROGRAMMES 02 Chairman’s Report 22 Brain Injury Programme and 04 Chief Executive’s Report Stroke Specialty Programme Reports 08 A Tribute to Sr Aileen McCarthy 32 Spinal Cord System of Care (SCSC) Programme Report 10 NRH Board of Management 38 Prosthetic, Orthotic and Limb 11 NRH Committees Absence Rehabilitation (POLAR) 12 Financial Statement Programme Report 14 Clinical Director’s Report 44 Paediatric Family-Centred (PAEDS) 16 Medical Board Report Rehabilitation Programme Report SECTION 3 SECTION 4 CLINICAL SERVICES PROVIDED CORPORATE & ACROSS ALL PROGRAMMES SUPPORT SERVICES 53 Outpatients Services – 83 Academic Department Consultant and Therapy Led Clinics 85 Catering 55 Department of Nursing 85 Clinics for Disabled Drivers 57 Nursing Education Department Medical Board of Appeal 59 Infection Prevention & Control 86 Central Supplies Department 87 Chaplaincy 60 Sexual Wellbeing Service 88 Communications 61 Spinal Nurse Liaison Service 92 Health Planning Team 62 Urology Service 93 Human Resources 63 Dental Service 96 Information Management 64 Nutrition & Dietetics & Technology (IM&T) 65 Occupational Therapy 97 Occupational Health 68 Pharmacy 99 Risk Management Department 70 Physiotherapy 101 School Report 73 Psychiatry – Liaison Service 102 Stakeholder and 74 Radiology Corporate Data Management 76 Rehabilitative Training Unit 104 Technical Services Department 78 Social Work 80 Speech and Language Therapy National Rehabilitation Hospital Annual Report 2019 1 SECTION 1 | YEAR IN REVIEW Chairman’s Report responsibilities. This includes having an effective Board structure; evaluation of the Board and its meetings; review of duties and liabilities of Board members; review of the Terms of Reference of Board sub-committees; compliance with legal and regulatory frameworks, GDPR compliance, and Corporate Governance training. The Board’s knowledge and understanding of hospital matters is enhanced by membership of staff and patient representatives on the Board. Hospital Activity and Performance Data Reporting Monthly reports are circulated to the Board to ensure its members are fully informed in relation to all key issues and milestones on an ongoing basis. Challenges for the NRH in 2019 Kieran Fleck Chairman The hospital awaits the outcome of the submission to the HSE of a detailed workforce planning document which identified the necessary staffing resources to enable the hospital provide a safe and appropriate level of care to our The New Hospital Development – Phase One patients within its current bed capacity (and also in respect of the move to 120 beds in the new hospital); and to ensure In 2019, the New Hospital Project at the NRH achieved that NRH beds, given their scarcity, are made fully available further momentous progress with the main structure of the at all times. Four beds remain closed in the hospital and building completed and the fit-out works underway. The new discussions are ongoing with the HSE. Sports and Exercise Therapy facility was formally opened for patients’ use in January. This is the exciting first stage of the transformation into a world class rehabilitation facility. This Sr Aileen McCarthy major capital project will reshape the delivery of specialist Board members were sad to learn of the passing of Sr Aileen rehabilitation services for the national population. In 2020, McCarthy, former Board member in May. Sr Aileen was the patients and staff of the hospital will finally move into instrumental in the establishment of the NRH, with particular the new, long awaited state of the art facilities. The Board interest in spinal injury patients and outreach services. receives continuous updates of the Project Team’s ongoing The Board greatly appreciates the dedication, care and work and is involved in all decision making processes. compassion shown by Sr Aileen to NRH patients for over 50 years. We encourage you to read the tribute to Sr Aileen on Launch of HSE Capital Plan at the NRH pages 8 and 9. In September, the NRH hosted the launch of the HSE Capital Plan and we were delighted to welcome An Taoiseach, NRH Board of Management Leo Varadkar, Simon Harris, Minister for Health; Paschal In December, Ms Aine Cornally resigned from the Board after Donohoe, Minister for Finance and Public Expenditure and many years of voluntary service. On behalf of the patients Reform; Catherine Byrne, Minister for Health Promotion, we serve, the Sisters of Mercy, the Board, Management and and Paul Reid, Chief Executive, HSE. The event gave us the staff, I thank Aine for her hard work and commitment during opportunity to showcase part of the new hospital building her tenure as Board member. We wish her well for the future. as a successful capital project in which the Government has invested. There is a commitment to provide the funding We warmly welcomed new Board member, Mr Robert for Phase Two of this capital project in the National Costello. Development Plan 2018 – 2027. I thank each Board Member for your ongoing work and Corporate Governance commitment to the NRH. We greatly appreciate the contribution made by each Member of the Board in sharing During 2019 the Board continued to incorporate your expertise and experience towards achieving the the principles of good corporate governance into its hospital’s strategic objectives. 2 National Rehabilitation Hospital Annual Report 2019 Clinical Directorship at the NRH Key Appointments and Retirement in 2019 The Board is very appreciative of the work undertaken by In January, we were delighted to welcome Ms June Stanley Professor Mark Delargy in this vital role which involves as Director of Operational Services / Deputy CEO. We strategic matters as well as managing all medical resources warmly welcome Ms Stanley to this role, particularly at such and service delivery planning across NRH Clinical a crucial time in the development of the new hospital and its Programmes. services. We also welcomed Ms Elayne Taylor as Quality and Risk Manager and wish her every success in this role. NRH Medical Board We bade farewell to Ms Bernie Lee, Clinical Risk The Board thanks Dr Jacinta McElligott for her immense Manager who retired in September after over 30 years’ work and steadfast commitment during her tenure as Chair service to the NRH. Bernie reported on Risk Management of the Medical Board up to May 2019. The Board welcomed matters at the Board and during her career worked as staff Professor Áine Carroll as Chair of the Medical Board in June nurse, CNM, Assistant Director of Nursing and most recently and looks forward to continuing to work closely with the as Clinical Risk Manager. The Board greatly appreciated Medical Board as we transition to new ways of delivering Bernie’s professionalism and dedication to the NRH and wish specialist rehabilitation services to our patients. her well for the future. Quality Improvement and CARF Accreditation A Note of Appreciation The hospital staff, management and Board continue to work We extend our grateful appreciation to Sr Peggy Collins, collaboratively with the HSE Quality Improvement Division Provincial Leader, for the enormous contribution of the (QID), and we strive to continually improve our services Sisters of Mercy over the years and welcomed Sr Brenda through implementing the ‘Framework for Improving Quality Dolphin as Provincial Leader in early 2019. at the NRH’. In addition, the Board operates within the CARF Leadership and Governance Standards. The Commission We also thank the HSE for its ongoing support and look for Accreditation of Rehabilitation Facilities (CARF) is an forward to working constructively together to maintain and independent, international accrediting body for Rehabilitation improve the invaluable services provided by the NRH. Services. We are grateful for the continued assistance