This unannounced risk-based inspection took place at Cork University Hospital’s emergency department in June 2022. This inspection was carried out to ensure the hospital were implementing adequate measures to mitigate potential safety risks, the impact of overcrowding and to ensure continuous and effective patient flow. 

HIQA found the hospital to be partially compliant with three standards and non-compliant with one standard assessed on the day of inspection in the Emergency Department.

Inspectors found, at the time of this inspection, that despite management efforts to mitigate risks, the emergency department remained overcrowded. The demand for emergency care exceeded the department’s capacity and was a major contributing factor to the boarding of admitted patients. There was a reliance on agency nursing staff to support and maintain nursing rostering in the hospital, which raised concerns for HIQA’s inspectors in terms of ensuring sustainable and safe staffing levels. HIQA found that a more sustainable approach was needed to enhance patient flow, in particular, a further need to focus on progressing clinical leadership arrangements across the hospital to strengthen interdisciplinary planning and patient flow. 

Overall, the hospital was challenged to manage surge capacity, support effective patient flow and ensure care supports the timely review and medical assessment of patients. 

On this inspection, HIQA found St. Columcille’s Hospital to be compliant with two standards, substantially compliant with five standards and partially compliant with four standards. 

HIQA found that there were governance structures and monitoring systems in place to identify and act on opportunities to improve the quality and safety of services, but was evolving to reconfigure and rationalise governance arrangements. The hospital had implemented quality improvement initiatives to support vulnerable patients, and had systems and processes in place to respond promptly, openly and effectively to complaints and concerns raised by people using the service. Areas for improvement noted by inspectors included the need to address aspects of the hospital’s physical environment, which did not adequately support the delivery of high-quality care, and mechanisms to deliver and record mandatory and essential training for staff.  

Following this inspection, HIQA will continue to monitor the progress in implementing actions to enhance and strengthen the governance arrangements, monitoring and physical environment at the hospital.

An announced inspection of Cavan and Monaghan Hospital, confined to the Cavan Hospital site, took place in July 2022. HIQA found the hospital to be compliant with five standards, substantially compliant with eight standards, and partially compliant with one standard on the day of inspection.

Inspectors found that the emergency department was challenged by the lack of space and effective flow of patients admitted to an inpatient bed. However, inspectors acknowledged that there were further medium and long-term plans in place to improve patient flow, such as the use of the surgical assessment unit and a new building for the emergency department. The hospital had implemented an electronic Irish National Early Warning System which provided the opportunity to identify and respond to potential deteriorating patients. Overall, HIQA found that the hospital needed to improve monitoring arrangements to identify and act on opportunities to improve the quality of the healthcare services provided.