Every chance, Every chance that I take, I take it on the road

It has been an interesting few days as the hospital I work in has been in the news for overcrowding. There sometimes feels like there’s a disconnect between overcrowding and patient safety. On one hand, the international evidence repeatedly shows that ED overcrowding has a negative effect on patient outcome, with increased morbidity and mortality. On the other hand, we are all working in busy EDs, and many patients are getting timely, appropriate care from hard-working staff in spite of these pressures. We are hanging on, doing our best, etc, etc.

The disconnect is because while overcrowding does increase patient risk, it doesn’t change the outcome for every patient. The best way to explain this is by the speed limit analogy.

Continue reading

Gonna go where the bright lights and big city meet…

Since I started this blog a few weeks ago, I’ve tried to write a piece about the so-called “inappropriate attenders” that turn up in A&Es all over Ireland & the UK. If the politicians are to believed, they are ruining everything for everyone.

I think “inappropriate attenders” is another one of those phrases like “admission avoidance” which are weighted with an odd kind of patient-blame. Anyway, I was trying to write something but Dr Malcolm McKenzie (@fourhourtarget) managed to say most of what was on my mind in his recent blog post.

I wanted to add three things:

Continue reading