Patient safety dangers of Emergency Department overcrowding continue to be played down and ignored
The Irish Association for Emergency Medicine continues to be very concerned about the high levels of Emergency Department (ED) overcrowding nationwide. Although the recent focus has been on Tallaght Hospital, the reality is that for many EDs around the country, ongoing overcrowding with admitted inpatients is a daily occurrence.
The attitude of certain managers within the Health System who seem to regard overcrowded EDs as ‘safe’ is also a cause for concern. In this regard, the comments last week of Tallaght Hospital CEO, David Slevin, on RTE News in which he claimed that the situation was ‘safe’ notwithstanding the high level of ED overcrowding in Tallaght was hugely disappointing. It confirms, yet again, that many of those who make strategic decisions within the Health Service lack understanding of the risks to patients that ED overcrowding causes.
There is very little evidence that the proven increased risks of patients dying or having poorer medical outcomes as a direct consequence of ED overcrowding has motivated administrators and managers to take the matter as seriously as they should. Instead of resolving the problem there have been a succession of self congratulatory statements pointing to ‘improvements’ in the extent of ED overcrowding, even though the current position is both unsafe and unacceptable. Indeed the concern now must be that the Department of Health, Special Delivery Unit, HSE and individual hospital managers tacitly regard a certain level of ED overcrowding as acceptable The reality is that there is no such thing as a safe level of ED overcrowding and this fact must be openly acknowledged by everybody with responsibility for the provision of healthcare in this country.
IAEM is strongly of the view that the recommendations of the HIQA Tallaght Report must be implemented in full and immediately. The ‘zero tolerance’ policy that was adopted by the Government as long ago as 2006 must also be applied without obfuscation. The responsibility for the avoidable deaths and worsened medical outcomes that result from ED overcrowding clearly must rest with those who fail to act.