1. 1 Presentation on Reconfiguration of Hospital Services from Dr Dominic O’Brannagain & Dr Colm Quigley to Regional Health Forum – Dublin North East 25 th January 2010

2. 2 “Disconnecting from change does not recapture the past. It loses the future.” - Kathleen Norris

3. 3 Transformation Objectives NE Transformation is committed to addressing quality and risk issues identified in the Teamwork Report 2006 by: Making the best use of our available resources. Raising services to safe levels of practice and beyond Introducing key work practice changes which benefit patients and staff Integrating PCCC and Hospital services Allowing more patients to be cared for at home or close to home Expanding day and outpatient procedures and services in Dundalk, Monaghan & Navan hospitals Reconfiguring acute and complex care onto the Cavan and Drogheda sites

4. 4 Rationale for Change Changing Expectations & expertise in medicine Volume of patients Recruitment & retention of staff Accreditation by training bodies Inspection by external agencies ie HIQA Resources

5. 5

6. 6 Overview of intended service changes New ED in Drogheda Medical Assessment unit Development of short stay & observation wards Enhanced Ambulance service Home care packages Opening of two new inpatient ward over the new ED Expansion of ICU & CCU Improved discharge planning & reducing length of stay Dundalk ED will revert to 12 hour service Ambulance trauma will transfer from Navan to Drogheda Stroke, Rehab and Step-down beds will be developed in Dundalk

7. 7 New ED New ED in OLOL Scheduled to open in Q1 2010* Increase capacity from 19 to 25 bays Separate Paediatric area (6 bays) Dedicated x-ray facilities With the opening on the new ED it planned to initially convert the ED in LCH to a 12 hour service On the transfer of Acute Medical inpatient services to OLOL the 12 ED will convert to a MIU * Target Date

8. 8 Medical Assessment Unit To be established in old ED Will be an 8 bay unit Focus on rapid ambulatory assessment, expedited workup and treatment initiation with expected low rate of inpatient admission MAU’s already established in Navan and Cavan.

9. 9 Short stay & Observation Wards An Observation Ward will accommodate patients who require observation for a period specific period of time will open in conjunction with a Short stay ward for patients who care needs only require an identified short stay in hospital.

10. 10 Ambulance Services Additional ambulance vehicles and personnel will be in place to support the service changes Direct access primary angioplasty service is also being developed in conjunction with the Mater Hospital

11. 11 Home Care Packages/ Discharge Planning and ALOS Packages of care have been identified to support hospital avoidance and early discharge. More detailed work is underway to see how these can be put in to PCCC and what additional disciplines are need to provide these. Discharge planning will also be improved and factors that delay discharge and result in a patient having a longer length of stay will be addressed.

12. 12 Additional inpatient Wards 2 nd and 3 rd floor of new ED building is being commissioned as inpatient accommodation. This will be single and double room accommodation – all rooms are ensuite. This will see an additional 40 beds over these two floors

13. 13 ICU and CCU The 4 th floor of the new ED building will be the new Coronary Care Unit The capacity of the ICU will enhanced by the transfer of the CCU to the new location The expansion of the current ICU

14. 14 Non Acute Beds in Dundalk Day medical beds Day surgical beds Stroke rehabilitation beds General rehabilitation beds Step down beds

15. 15 Phase 1 Open new ED Open new MAU Develop Short Stay and Observation Wards in OLOL Commence development of non acute services in LCH Progress Integrated Discharge Planning to reduce ALOS across the hospital sites

16. 16 Phase 2 Completion of the new wards over the new ED Completion of the new CCU Expansion of the ICU Continue the development of non acute services Transfer of acute inpatient care from LCH to OLOL Develop, in conjunction with PCCC, packages of care  to enable hospital avoidance,  reduce ALOS and  allow for early safe discharge

17. 17 Vital Role of Louth County Hospital and Our Lady’s Hospital Navan Acute care will transfer to Drogheda and Dundalk and Navan will provide local services to the community. Future Services in Louth County Hospital and Our Lady’s Hospital, Navan will include:  Day medical servicesOutpatient Services  Laboratory & radiology  Stroke Rehab  ENT  CT Scanning  Care of Elderly Assessment  Day surgical Services  Elective Endoscopy  12 hour ED (then 12hr MIU)  Step Down Unit  Rehab Unit

18. 18 Next Steps Continue to engage with staff and representatives Set up project groups for the service changes Develop staffing profiles to support the service changes Continue to progress the infrastructural needs

19. 19 Questions?