Irish health system

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elacsaplau

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Over the few days, following an A&E admission, I have been (too) up close and personal with the public health service - and it's an absolute shocker. It was really, really bad - no single outrageous occurrence - just multiple inaccuracies and poor diagnosis and prescribed treatment, coupled with outlandish delays. What struck me also was how really awful the communication was generally.
 
I've had mixed experiences over the years. When my dad died 3 years ago after a sudden illness, I can't fault the hospital for the care and consideration, the staff were brilliant but totally overworked. As an operations manager by trade I'd be looking around and thinking "how can I improve this". The sheer amount of paperwork is staggering and the delays in getting patients historical files out of storage and to the front line in this day and age needs to be seriously tackled. Likewise, I've had one of my kids in 2 different hospitals over the years for various treatments and again superb.

Having said that, I'll never forgive the Coombe for putting my wife in a ward with expectant mums after a miscarriage. She had to lie there and listen to some young one giving out about how she couldn't go out and get a few cans. Likewise and on another occasion (and in a different hospital) I'll never forgive a so-called nurse who didn't know that a beeping alarm meant an epidural bag had run out until I said to her (I could see the bag was empty). Having said that a public consultant at that self same hospital came back in a few hours after he had gone home to finish off the birth even though there was no need for him to do so but he said afterwards he was worrying at home over us. Hospitals are staffed by people for better or worse.
 
In my experience as someone with a background in manufacturing, quality and process development (5S and LEAN) the systems and processes run in the healthcare system are grossly inefficient. If you are working in an inefficient system you will be inefficient, no matter how hard you work.
It seems that any criticism of the system is taken as a criticism of the people who work there an so the discussion becomes emotional and emotive. At the same time if you ask a doctor or nurse or administrator they can ream off inefficient practices. The employees in the healthcare industry are only part of the problem when they resist change for selfish reasons, i.e. looking for pay increases for changes which increase organisational efficiency without increasing the work load of the individual; "less of my time will be wasted each day so I want a pay rise".
Local empowerment and much better information gathering and analysis so that successes can be measured and replicated would mean many small improvement could result in a large overall improvement.
I like the new set-up that Simon Harris is putting in place and I think Róisín Shortall will be good as Chair of the new Committee on Healthcare Planning. It should mean that the vested interest groups (Pharma Companies, Consultants Unions, Nurses Unions, Porters Unions etc) cannot just wait out the serving minister.
 
Thanks thedaddyman and Purple

I justed needed to rant!

Possibly unfair to highlight just one comment from your posts but
Purple said:
.....many small improvements could result in a large overall improvement.
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that's nail smack on head stuff.

(It's kind of what I was trying to say with my "no single outrageous occurrence" reference.)
 
We've thrashed out the ineptitude of our Health Service on this forum and elsewhere for years. There is no great push from government, consultants, the medical profession, the unions and the people to worthwhile resolve anything. And so it remains; removing all the sand from Dollymount using a thimble only comes to mind.
 
Did anyone see the program on RTE last night - Keeping Ireland Alive? I didn't (hence the question) but just wondering, did they show people on trolleys in A&E?
 
Firefly said:
Did anyone see the program on RTE last night - Keeping Ireland Alive? I didn't (hence the question) but just wondering, did they show people on trolleys in A&E?
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I watched the programme which I thought was quite good but it was the usual following individual patients and their operations etc. It was similar to the 24 hours in A&E in St. George's in London from Channel 4. As far as I can recall they didn't show anyone on trolleys in A&E.
 
Purple said:
In my experience as someone with a background in manufacturing, quality and process development (5S and LEAN) the systems and processes run in the healthcare system are grossly inefficient. If you are working in an inefficient system you will be inefficient, no matter how hard you work.
It seems that any criticism of the system is taken as a criticism of the people who work there an so the discussion becomes emotional and emotive. At the same time if you ask a doctor or nurse or administrator they can ream off inefficient practices. The employees in the healthcare industry are only part of the problem when they resist change for selfish reasons, i.e. looking for pay increases for changes which increase organisational efficiency without increasing the work load of the individual; "less of my time will be wasted each day so I want a pay rise".
Local empowerment and much better information gathering and analysis so that successes can be measured and replicated would mean many small improvement could result in a large overall improvement.
I like the new set-up that Simon Harris is putting in place and I think Róisín Shortall will be good as Chair of the new Committee on Healthcare Planning. It should mean that the vested interest groups (Pharma Companies, Consultants Unions, Nurses Unions, Porters Unions etc) cannot just wait out the serving minister.
Click to expand...

Interestingly when my Dad was in hospital the last time there was a bunch of students from UCC recording times and actions as part of a Lean initiative. In fairness they were not interfering but I'd wonder if anything every happened it
 
thedaddyman said:
Interestingly when my Dad was in hospital the last time there was a bunch of students from UCC recording times and actions as part of a Lean initiative. In fairness they were not interfering but I'd wonder if anything every happened it
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I very much doubt it. The essence of such a project would be to identify wasteful activities and reallocate or remove the resource. In simple terms that means getting rid of wasteful activities (duplication of actions, unnecessary data entry, better flows which reduce meters travelled by patients and employees, that sort of thing) and either getting the person who was doing that to do something else which is necessary and adds value or, if there’s nothing else they can do or are needed to do, getting rid of that person.

I can’t ever see a Union allowing that to happen; their members changing activity and many of them losing their jobs. Unions are not there to act in the national interest or in the interest of anyone who is not their member. The Consultants Unions, the Nurses Unions, the Porters Unions, the Admin Unions etc; they will all act to stymie any improvements and the rest of us be damned.

Of course for the conversation to even start there would have to be an effective senior management in place and I see no evidence of that either.
 
Purple said:
I very much doubt it. The essence of such a project would be to identify wasteful activities and reallocate or remove the resource. In simple terms that means getting rid of wasteful activities (duplication of actions, unnecessary data entry, better flows which reduce meters travelled by patients and employees, that sort of thing) and either getting the person who was doing that to do something else which is necessary and adds value or, if there’s nothing else they can do or are needed to do, getting rid of that person.

I can’t ever see a Union allowing that to happen; their members changing activity and many of them losing their jobs. Unions are not there to act in the national interest or in the interest of anyone who is not their member. The Consultants Unions, the Nurses Unions, the Porters Unions, the Admin Unions etc; they will all act to stymie any improvements and the rest of us be damned.

Of course for the conversation to even start there would have to be an effective senior management in place and I see no evidence of that either.
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They probably have their own union too!
 
They are all members of the same unions, IMO,Nurses & Midwives Unions, Clerical & Professional Unions, etc.
 
Gerry Canning said:
Why are Unions blamed for poor management?
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Most of the management are in Unions?
Unions resist change that doesn't involve pay increases for their members?
Unions protect the inept and inefficient?
Unions set the bar as low as possible and try to keep it there?
 
Purple said:
Most of the management are in Unions?
Click to expand...

My head genuinely hurts when I think about that, in the same sort of way when I try to think about infinities like what's at the end of space, or the largest number in the world.
 
On the issue of the lab in Waterford Hospital; it seems that if it opened for loner then it could meet all required capacity. At the moment it opens from 9 to 5. If it opened from 8-6 or 8-8 there would be no need for the new lab.
If that is the case then it is amazing that a group of doctors think it is reasonable to expect to state to build another lab instead of just getting better use out of the existing one.
 
A bit like Gerry Robinson and the NHS 9/10 years ago. In one hospital Gerry found that queues for operations were growing and noone could understand why until he discovered that one theatre was closed every Friday for unknown reasons. Opening an expensive facility to work at full capacity fixed the problem at zero cost to the NHS.
 
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