Annual Report: Operations

Sheila McGuinness
Chief Operations Officer
The RCSI Hospital Group provides a full range of clinical services for a population of over 800,000 people. Demand for these services is increasing with both an ageing and growing population. Subsequent clinical activity has increased within the Hospital Group 2016 / 2015 and all activity projections identified within the National Service Plan 2016 were exceeded (FIGURE 5)

During 2016 the Hospital Group’s key priority was to improve access to emergency assessment, care, treatment and where required.

Figure 6. Average number of patients waiting in ED @ 8am awaiting ward bed accommodation 2016/2015

  • 42% reduction in average number of patients waiting in ED 2016 / 2015 (total patient count reduction n = 5025)
    • RCSI Hospital Group performance compared favourably with national performance which conversely experienced a 23% increase in number waiting.
Access – Emergency Care Wait Times

RCSI Hospital Group also secured wait time reductions for both patients discharged home from ED and those requiring ward bed accommodation (FIGURE 7).

Figure 7. Average wait times experienced for non-admitted patients and admitted patients 2016 /2015

  • average time spent in ED (non-admitted patients) has reduced by 17% from 2015 (6 hours) to 2016 (5 hours)
  • average time spent in ED (admitted patients) has reduced by 15% from 2015 (13 hours) to 2016 (11 hours)
Inpatient / Day Care

The RCSI Hospital Group through (1) increased overall productivity (2) internal migration of patients to sites with underutilised capacity and (3) more effective chronological scheduling, secured a reduction in the length of time patients waiting for their elective treatment / surgery (FIGURE 8)

Figure 8. RCSI IP.DC Patient waiting <8mths

  • National Service Plan target (70%) exceeded
Endoscopy – Urgent Colonoscopy (FIGURE 9)

Figure 9. % of patients triaged as urgent who received a colonoscopy within 28 days

  • with the exception of January (98.2% n=9 non-compliance) there was 100% compliance within the RCSI Hospital Group for this target
Endoscopy – GI Endoscopy (FIGURE 10)

Figure 10. % wait times for GI Endoscopy <13 weeks

  • significant internal insourcing commenced in June with the migration of patients to sites within available capacity particularly Connolly, Louth, Cavan and Monaghan resulting in 84% of routine GI Endoscopy patients waiting < 6 months at year end
Access – OPD

Figure 11. RCSI Hospital Group OPD Wait List – 2016 – % of patients <52 weeks

  • limited progress made in terms of reducing wait times within the Hospital Group
Access – Patient specific delayed discharge to Home / Nursing Home

Figure 12. RCSI Hospitals Group Monthly Average Delayed Discharges 2016 vs 2015

  • target of <143 patients experiencing delayed discharge was only achieved in November and December
    • 13% decrease 2016 / 2015 in the average number of patients experiencing a “delayed discharge”
      • monthly average of 4760 bed days were inappropriately utilised for accommodation of patients experiencing a “delayed discharge”