HIQA carried out an unannounced inspection of the Rotunda Hospital on 7th December 2017. The inspection involved an assessment of facilities and practices in two clinical areas of the hospital. The hospital appreciates the strong endorsement of HIQA of its infection prevention and control governance strategies, which underpins the hospital’s commitment to a culture of patient safety and excellence. The hospital also acknowledges the issues raised in the report and its recommendations as part of its continued efforts to improve the quality of facilities and practices.
The Rotunda Hospital recognises and accepts that the limited physical infrastructure is challenging, and that the infrastructure of its Neonatal Unit and Post-natal Ward are outdated and do not meet modern standards. With building infrastructure that is over 260 years old, the most effective long-term solution is to complete the planned relocation of the hospital to the grounds of the Connolly Hospital Campus in Blanchardstown. Unfortunately, it is unrealistic to expect the completion of this relocation in the near future. In the absence of any indication to the contrary, it is likely that it will take at least ten years to realise the Connolly relocation, which means that over 100,000 mothers and their babies will need to be safely managed on the existing campus before a potential relocation to Connolly.
The Master of the Rotunda Hospital, Prof Fergal Malone said: “In our opinion, and now supported by this latest HIQA report, we cannot wait such a long period without taking action to protect patients from serious adverse outcomes related to infection. The Rotunda Hospital is currently embarking on a minor capital works programme to upgrade infrastructure in its existing campus, including the development of a modular operating theatre, upgrading of the Labour Ward and upgrading and refurbishment of the Neonatal Intensive Care Unit. These upgrade works are being funded directly by the Rotunda Hospital, with some financial support committed from the HSE Acute Hospitals Division in 2019.”
He continued by saying that modifications will not adequately address the major risks identified during the HIQA inspection, associated with overcrowding and infection that currently exist at the hospital due to its dated infrastructure. “To address these risks, the Rotunda Hospital is currently finalising an interim capital/service optimisation plan for its existing city centre campus, and is in the process of engaging with relevant stakeholders in this regard,” Professor Malone pointed out.
It was also outlined in the HIQA report that less than desirable staffing numbers likely contribute to challenges in infection outbreak management in the hospital. The hospital acknowledges this finding and has been very proactive in trying to source additional nursing and midwifery staff, in particular for the neonatal intensive care unit. This has included a major effort to recruit nurses from outside the EU.
The hospital has placed great emphasis on achieving the highest possible standards of hygiene not only at the level of frontline patient care, but just as importantly in ensuring a culture of optimising hygiene standards is evident from senior management level down throughout all sections of the organisation. The hospital has consistently achieved the required HSE hand hygiene compliance target which is commendable.