1. Listening forum 2017 Model 2 development Unscheduled care forum
Ennis Hospital September 2018
Listening forum
Model 2 Development

2. Development of UL Hospitals Group
Higgins’ Report 2013
Counties - Limerick, Clare and North Tipperary
Population – 473,269
Clare population 139,000
Academic Partner: University of Limerick

3. UL Hospitals – Our Hospitals
University Hospital Limerick (Model 4)
438 Inpatient Beds
117 Day Case Beds
Nenagh Hospital (Model 2)
49 Inpatient Beds
26 Day Case Beds
Croom Orthopaedic Hospital
43 Inpatient Beds
15 Day Case Beds
Ennis Hospital (Model 2)
50 Inpatient Beds
19 Day Case Beds
Say what you see
St. John’s Hospital
(Voluntary Model 2S)
89 Inpatient Beds
10 Day Case Beds
Maternity Hospital
89 Obstetric Beds
19 Neonatal Cots

4. Ennis Hospital Services
Model 2 hospital part of the ULHG
50 In-Patient Medical Beds (single on-suite rooms)
Medical Assessment Unit ( 7 days a week)
Local Injuries Unit (7 days per week)
Timely access
Patient experience and quality care
Appropriate setting , cost effective and strong emphasis on prevention
Integrated care
Slainte care

5. What works well MAU LIU 8 bay unit with 2 isolation cubicles
Sees 16 new patients daily (GP referrals/ED Team)
Bed Bureau / Direct referrals / Bookings from ED to MAU
Separate Review area with 10 to 15 reviews per day
Weekend – sees 10 new patients and 5 reviews
Dedicated Senior decision maker in MAU- registrar with GP background
Medical admission average is 10-15% per day
Diagnostics Supports
OPAT/CIT
LIU
LIU- sees an average 46 patients per day
ED consultant on site one day a week
ANP x 3 days per week
Good patient experience ,
access to senior decision maker, reduced admission
Appropriate daily access and treatment
patient flow
Works with LIU/UHL

6. What works well cont.
A Target of 5 transfers from the Model 4 site per day
Daily group Huddle-communication.
OPAT/CIT services and extension to CNH
Discharge process and collaboration with PHN service
Collaboration and engagement with the GPs , CNH and CHO
Discharge planner on medical wards
Projects- Falls collaborative , WMTU, medication management

7. Attendances In Patients (overnight) 1956
Local Injury Unit attendances (news and reviews)
New 10631
Medical Assessment Unit attendances (news and reviews)
Inpatient Admissions: 3491
Review: 1445
Conversation rate for MAU daily
10-15%
Transfers from UHL daily
Average 6 up to 17 per day
Number:
Inpatient Admissions: 3491
New: 5 Review: 1445
New: 464 Review: 5

8. Challenges
Staff are deskilled in the model 2 when the framework is limiting and confined.
Diagnostic access
MAU weekend slots increased-critical to reduce ED numbers on Monday morning
Medical resources for the site – difficult to fill vacant Consultant posts.

9. Site Priorities
Develop the MAU service .
Expand the MAU service to see 20 new GP referrals per day and expand the weekend slots and opening times. Will require additional resources.
LIU build commencement for the Ennis site
Capital funding agreed
OPD development
Integration with CHO, integrated care collaboration with GP, PHN,&Primary care services
Should Ennis focus on Medicine