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New Era for Unscheduled Care as UHL Emergency Department Opens

New Era for Unscheduled Care as UHL Emergency Department Opens. Pictured are UHL CEO Colette Cowan (right), nurses Ingrid O’Brien and Petra Petrovic. Photo: Alan Place

Ireland’s largest and most advanced UHL Emergency Department has opened this Monday, May 29th, at University Hospital Limerick.

A €24 million project (development and equipment costs), the ED spans 3,850 square metres of floor space, over three times the size of the old department. In 2016, UHL had the busiest ED in the country, with over 64,000 attendances.

Almost 100 additional staff have been recruited to work in the ED, which has increased capacity for patients and has been designed with the input of senior clinicians to improve patient flow, reduce patient experience times (PET) and improve outcomes for the sickest patients.




The new ED features the most advanced diagnostic equipment of any such facility in Ireland or the UK, including a c. €1 million, 128-slice CT scanner which is mounted on a track to minimise the movement of the sickest patients in Resuscitation, allowing for earlier diagnosis and treatment of stroke, trauma patients etc.

UHL Emergency Department

Addressing the new UHL Emergency Department team before it opened its doors was Dr. Fergal Cummins, Consultant in Emergency Medicine. Photo: Alan Place

The facility is separated into different pods and zones, allowing for paediatric patients, major cases, minor cases etc to be treated separately, matched to the most appropriate clinical expertise and moved to the next stage of their care in the most efficient manner.

Each separate area has its own isolation facilities that offer a gold standard in infection prevention and control. The number of triage areas has increased from one to four, including a separate room for paediatric triage. There is an advanced pharmacy dispensing system next to staff bases throughout the department and the pneumatic chute system for sending specimens to the laboratories is now available throughout the ED as opposed to a single point of access previously. Other features include a decontamination suite; two family rooms attached to a viewing room and garden for bereaved relatives; an internal courtyard which can be accessed by patients; a dedicated space for patients presenting with a mental health crisis; significantly improved staff facilities and a simulation room and education/training facilities that will significantly enhance the attractiveness of UHL as a major teaching hospital.

Speaking as the new ED opened this Monday, Prof Colette Cowan, CEO, UL Hospitals Group, said: “We are delighted to open the most modern ED in Europe. It is something our patients and our staff have been waiting a long time for and we thank the HSE and the Department of Health for their support in delivering an ED the whole country can be proud of.

“We know from our patients that many of the problems associated with the old ED were environmental. The department was simply too small to treat patients with the dignity and privacy they deserve at such a vulnerable time. The new department will return that dignity and privacy to them; it will help us minimise the risk of infection for our patients; it will allow for more prompt investigations, earlier treatments and better outcomes and it is designed very much with patient comfort in mind. Small design details stand out everywhere you look, for example with non-slip floors, better signage and handrails to allow elderly patients better navigate the department,” said Prof Cowan.

“The new environment will allow us to introduce new ways of working and the latest thinking on patient flow has been integrated into every joint and contour of this department. Our ED consultants have adapted concepts from industry from all over the world and brought that thinking back to Limerick for the benefit of our patients, to make their journey through the ED as smooth as possible and their experience as pleasant as possible. You move progressively from triage to the x-ray department, for example, and on to the appropriate treatment zone in a unidirectional way, with no doubling back, which reduces the wait times for patients,” she said.

Prof Paul Burke, Chief Clinical Director, UL Hospitals Group, said:

“We are really excited to be opening a new state-of-the-art UHL Emergency Department, which we know will greatly enhance the patient experience of ED and of UHL overall. We are confident of improved patient outcomes, which is something the region can celebrate. We are also delighted for all our staff. Many of them have been working under extremely difficult circumstances over many years in a department that was no longer fit to serve the needs of the region. This modern facility will come as a great morale boost for them and for the whole of the UL Hospitals Group.”

Dr Cormac Mehigan, Consultant in Emergency Medicine, UL Hospitals Group added:

“As soon as they walk in the door, patients will see a huge difference between the facility we have now compared to what they have been used to. You don’t have to be a clinician to realise our ability to deal with any sort of situation is significantly enhanced.

“There is increased capacity for every category of a patient; increasing cubicle space for minor cases from three to 10; from six to eight paediatric rooms; from seven to 12 majors and from nine to 12 in the Clinical Decision Unit. But it is not just about the increased capacity. We are changing our processes and how we work. The combination of both the space and how we use the space is what will enhance the experience of the patient and help them to flow more efficiently through the department.

“Given that there is a body of international evidence that suggests numbers will increase when you open a facility such as this, it is important that people in the MidWest continue to use our Injury Units in St John’s, Ennis and Nenagh for appropriate unscheduled care and to keep the UHL Emergency Department for emergencies. Ennis and Nenagh are open from 8 am to 8 pm seven days a week and St John’s from 8 am to 6 pm Monday to Friday where people with minor injuries to limbs, sprains, cuts, grazes and so on can be appropriately and quickly seen.”

UHL Emergency Department

Pictured in the new Resonation unit at the UHL Emergency Department are nurses, Ingrid Byrnes and Siobhan O’Grady. Photo: Alan Place

The new ED has been funded by the HSE and occupies the Ground Floor of both the €40m Critical Care Block which opened in late 2014 and the more recently constructed extension to it which also includes a new dialysis unit at first-floor level.

Contracts for the fit-out and completion of the new UHL Emergency Department and adjoining 25-bed dialysis unit at University Hospital Limerick were signed in August 2015. Works also involved the demolition of the old dialysis department, the provision of a separate roadway for ambulance access and alterations to the internal road layout at UHL.

The delivery of the capital element was managed by the local Estates office of the HSE and the design team appointed included O’Connell Mahon Architects, Punch Consulting Engineers, JV Tierney & Co Consulting Engineers and O’Reilly Hyland Tierney Quantity Surveyors. The successful building contractor was John Sisk & Son Holdings Ltd. The capital budget included almost €4m for equipping the new ED including circa €1.5m for the provision of both the CT equipment provided by Siemens Healthcare and also two modern digital X-Ray Rooms equipped by Medray Imaging Systems.

Approximately 400,000 man hours went into completing the building works element of the project along with materials used including almost 25,000 square metres of plasterboard; almost 6,500 ceiling tiles; over 1,500 light fittings; almost 2,900 electrical points; over 600 information signs; 244 doors; over 2,200 litres of paint and 12km of mastic.

“This was a hugely complex project to deliver with construction ongoing in close proximity to our ICU, HDU and cardiology patients in the Critical Care Block. We needed to maintain power and services to these critically ill patients in the middle of one of the most significant infrastructural developments ever undertaken in this region. The contractors also managed to deliver the project while maintaining access to the public, ambulance services and staff and it is an enormous credit to them that they have delivered the project successfully,” said Prof Cowan.

“We would also not be here today were it not for the support of the HSE and the Director General Tony O’Brien, in particular, the Acute Hospitals Division, its National Director Liam Woods, and of the Department of Health, Minister Simon Harris and his predecessors,” Prof Cowan said.

She also paid tribute to the tremendous effort of staff across all disciplines that ensured the delivery of this state-of-the-art facility for people of the Midwest.

For more information on UHL Emergency Department click here

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Richard is a presenter, producer, songwriter and actor. He was named the Limerick Person of the Year (2011) and won an online award at the Metro Éireann Media and Multicultural Awards (2011) for promoting multi-culturalism online. Richard says that the concept is very much a community driven project that aims to document life in Limerick. So, that in 20 years time people can look back and remember the events that were making the headlines.