Microsoft word - infomation for oirechtas members 8th nov 201

Services available at Roscommon County Hospital INTRODUCTION
This paper has been prepared following a request from the Oireachtas members for a briefing regarding the on going service changes at Roscommon County Hospital due to the reconfiguration of the Emergency Department at the hospital on the 11th July 2011. CONTEXT OF RECENT CHANGES TO SERVICES:
The changes to service delivery in Roscommon County Hospital took place so as to ensure that patient care, patient safety and patient outcomes are optimised. Roscommon County Hospital will continue to provide acute hospital care for the population of Roscommon area. It will do this as part of a wider network of acute hospitals across HSE West and it will be supported by the other hospitals in the region. SUMMARY OF SERVICES AVAILABLE:
Urgent Care Centre
Open 7 days per week – 8:00 a.m. to 8:00 p.m. Adults 16 years or over can self present or be referred by a
GP with minor injuries only
Medical Assessment Unit
Open 5 days Monday to Friday – 9:00 a.m. to 5:00 p.m. GP contacts Consultant on-call by phone directly to arrange referral in. Medical In-patients
Medical Day Services
Open 5 days Monday to Friday – 9:00 a.m. to 5:00 p.m. Cardiac Rehabilitation and Pulmonary
Open 5 days Monday to Friday – 9:00 a.m. to 5:00 p.m. Rehabilitation Service
Surgical In-patient Service
Surgical Day Case (Elective Surgery only)
Open 5 days Monday to Friday – 9:00 a.m. to 5:00 p.m. – facilitates routine elective minor surgical day case procedures and Endoscopy. Radiology Services
Monday to Friday Walk-in service for GP referrals 2:00 to 4:00 p.m. Direct GP Access for GP Referrals for CT scans of Brain or Sinus CT Service operates 5 days per week providing In-patient and Out patient service Ultrasound Service provided for in-patients and out patients from GP referrals to the Radiology Department. ___________________________________________________________________________________________ Oireachtas Members Briefing 09/11/11 Therapy Services include
Laboratory – 24/7 including on-call service Clinical Nurse Specialists also provide support and participate in Multi-disciplinary teams – Respiratory, Diabetes, Palliative Care, Infection Control DETAILS OF SERVICES CURRENTLY AVAILABE AT ROSCOMMON COUNTY HOSPITAL

1. Urgent Care Centre: (Minor Injuries Unit) 8:00 a.m. to 8:00 p.m. 7 days a week.
The Urgent Care Centre is a walk-in service available to treat patients over sixteen years old who present with non–emergency conditions. The Urgent Care Centre will treat minor injuries from shoulder to fingers and knee to toes. (Note: Plans are being put in place to treat children of 5 years and over with minor injuries. Details will be announced when the necessary training and governance are in place.) 2. Surgical Services:
Direct access for surgical conditions is still available at Roscommon County Hospital between 08.00am
and 17.00pm Monday to Friday, however, it is essential that the GP communicates directly with the hospital.
The GP can contact the Registrar or Consultant via main hospital telephone number (090 6626200) – the
Switchboard Operator will bleep the relevant doctor so you can then discuss the possible admission of non-acute
surgical problems. However, we cannot treat the following:
Urgent /major / or complex surgery; Surgery that would require post operative ventilation or surgical ICU; Surgical conditions that are likely to deteriorate rapidly and require urgent night-time operation. Surgical Out-Patient Service – 2 clinics held weekly, with a short waiting time to be seen and treated.
The GP sends a referral letter addressed to Consultant Surgeon. Letters are triaged by Consultants and patients seen in the appropriate clinic. Elective Surgical Services:
Roscommon County Hospital can treat patient requiring surgical procedures such as Laparoscopic Cholecystectomies, Hernia Repair, Varicose Veins, etc., It has the facility to overnight patients as necessary. This service will expand considerably, with patients on Galway waiting lists operated on in Roscommon County Hospital. Specialist Surgical Services
A Plastic Surgery Service commenced in Roscommon County Hospital in September 2011 as an out reach service from Galway University Hospitals. Both an out patient service including a “See & Treat” option and elective day case surgery is available. GP referrals are to the Plastic Surgery Team at GUH and not Roscommon County Hospital. ___________________________________________________________________________________________ Oireachtas Members Briefing 09/11/11 Day case Dental Surgery is performed and referrals are to the Community Principal Dental Surgeon at Roscommon County Hospital. Note: There is no walk-in service for Surgical patients. All patients accessing any of the services outlined
above must be referred by their GP.

3. Endoscopy Services
GPs can refer patients to the Roscommon County Hospital Consultant Surgeons. Waiting list less than 3 months. 4. Medical Services
Medical Assessment Unit (located adjacent to Urgent Care Centre)
(9:00 a.m. to 5:00 p.m. Monday to Friday) GP-referred, low-risk patients requiring a low level of inpatient medical treatment who can be safely managed in the hospital without intensive care. The GP contacts the Medical Consultant on-call by telephoning the main Switchboard Number - (090 6626200) The GP will be put directly through to the Consultant on call and can discuss the patient’s details. If the patient fulfils the criteria then the patient comes to Medical Assessment Unit for assessment and may be admitted if required. Rapid Assessment Clinic (situated in Medical Day Services – Urgent care Centre Entrance)
Medical Patients who don’t need admission but cannot wait for routine out-patient review. Specialities offered include General Internal Medicine, Endocrinology/Diabetes, Respiratory Medicine and Geriatric Medicine The GP can fax a letter to the Medical Day Services Unit (Fax 090 6627346) or contact the relevant Consultant by phone (090 6626200). The service will provide a Consultant-delivered assessment /investigation unit. Same day investigation and diagnosis will be offered where possible. Medical Day Services (MDS)
A broad outline of services available through our Medical Day Services Unit includes the following types of Medical Day Cases – most of such patients are either newly diagnosed or require an ongoing maintenance care programme for infusions or treatment such as Blood Transfusions, Venesections, Haemachromotosis. Some of these infusions are for palliative care patients also. Blood Transfusions; Cosmofor Transfusion; Synactin Test; Dexamethasone Suppression Test; Methalpred Infusion; Intract Infusion; Zola Injection; Zometa Injection. There are 20-30 New/Review patients per week reviewed at the Venesection clinic. Services are also provided to: Urology OPD by way of carrying out trial catheterisations; Nursing home patients requiring peg tube insertions; Bone Marrow and Lumbar Puncture Day Case procedures; Parasynthesis intervention (removing fluid of lung); Patients requiring radiological interventions such as Prostate biopsy are treated within the MDS treatment area; Patients requiring Portacath insertions; CT Heart, Hysterosalphinograms are admitted via MDS and with the assistance of M Nursing Staff the Consultant Radiologist carries out these procedures. ___________________________________________________________________________________________ Oireachtas Members Briefing 09/11/11 Fine needle aspirations are also carried out. The Consultant Physician also carries out 2-3 Tilt Tests per week; Speech and Language Therapy patients requiring Videofluroscopy under the care of the Radiology Department and S&LT are also admitted via the MAU for same. The Medical Day Services also provides a daily IV cannulation service for any patient requiring CT Scan on campus as an out patient. Doppler tests are also scheduled as Day Cases for the MDS. Medical Outpatient service. (in the Out Patients’ Department)
Patients suitable for routine outpatient review. Specialities offered include General Internal Medicine, Endocrinology/Diabetes, Respiratory Medicine and Geriatric Medicine The GP sends a letter addressed “Consultant Physician”. Letters are triaged by Consultants and patients are seen in the appropriate clinic. Note: There is no walk-in service for medical patients. All patients accessing any of the services outlined
above must be referred by their GP

5. Acute Psychiatric Services
There have been no changes to the Psychiatric Services at Roscommon County Hospital. Full services are available 24 hours per day – The Acute Psychiatric Unit can be accessed directly via the front door of the General Hospital from 8.00am – 8.00pm. After 8.00pm the Psychiatric Unit can be accessed via the Security Office which is based at The Urgent Care Centre and the Security Officer will direct or bring the person to the Acute Psychiatric Unit. All patients presenting with Mental Health problems will be assessed at the Acute Psychiatric Unit over 24
hour period which includes the following:- Patients presenting with/without a GP referral letter Patients self referral/self presenting to the Acute Unit Referral from the Urgent Care Centre, following referral from Medical Registrar UCC (Urgent Care Centre). Patients with Psychiatric Disorder who have a co-morbid, alcohol or drug problem will be assessed on the Acute Psychiatric Unit 24/7. i.e. depression, schizophrenia, suicidal thoughts, mood disorder and addiction problems. Following assessment of the patient he/she may be:
1) Admitted to the Acute Psychiatric Unit because of co-morbid psychiatric problems e.g. depression, 2) Patients may be sent home with family member and undergo a community detoxification programme Phone numbers for the Acute Psychiatric Unit are as follows: (090) 663 2324/ (090) 663 32325
___________________________________________________________________________________________ Oireachtas Members Briefing 09/11/11 6. Out-Reach Services from Galway University Hospital
The following out-reach services are available at Roscommon County Hospital in the Out patients Department: Service Developments at Roscommon County Hospital
There are 2 projects being perused in relation to Endoscopy Services at Roscommon County Hospital. Project 1
Endoscopy Suite – Capital project
This capital project will provide a self contained Endoscopy suite which will include: 2 procedure rooms and decontamination facilities Pre and post patient care areas and wc facilties This suite will meet all of the new Endoscopy standards and will allow Roscommon County Hospital to apply to the National Cancer Screening Service to be one of the bowel cancer screening centres in Ireland. Funding of €2m is assigned to this project and will commence in 2012. Project 2
Interim Endoscopy Decontamination Facility
A minor capital project is due to commence to locate new Endoscopy decontamination equipment into an area in the theatre until such time as the Endoscopy Suite is completed. This equipment will then move to the new suite. Funding is assigned to this project and will commence on the 18th November 2011. This will necessitate the closure of 1 theatre for 6 weeks. The new facility and both theatres will be operational again in January 2012. Sterile Services (CSSD)
Discussions are underway with regard to another hospital within the Network sterilising surgical equipment on behalf of Roscommon County Hospital. This solution is operating very successfully in other hospitals around the country. Medical Rehabilitation (National Rehabilitation Hospital, Dublin)
Roscommon County Hospital has been considered as a site suitable for the location of a HSE West Medical Rehabilitation Service under the remit of the National Rehabilitation Hospital in Dublin. The hospital is at an early stage of discussion regarding this service. ___________________________________________________________________________________________ Oireachtas Members Briefing 09/11/11 Palliative Care
The Mayo Roscommon Hospice has commenced discussion with HSE West regarding the location of a hospice facility on the grounds of Roscommon County Hospital. Services from GUH
Elective day case surgical patients on GUH waiting lists will be treated in Roscommon County Hospital. The numbers treated at Roscommon County Hospital will increase over 2012. Theses patient will be treated by Roscommon County Hospital consultants in the first instance. Ongoing discussion with GUH regarding the provision of other service at Roscommon County Hospital. More details will be announced. Rheumatology Telemedicine Outpatient Clinic
The first Rheumatology Telemedicine Outpatient Clinic was held in Roscommon County Hospital October 7th 2011. The clinic involved a computer link-up between patients in Roscommon County Hospital and Dr Robert Coughlan, Consultant Rheumatologist in Merlin Park University Hospital, Galway. This is initially being done on a pilot basis and allows the consultant to discuss and review a patients condition with them via a computer link, this also means they do not have travel to Galway. The telemedicine service is for patients who are currently under the GUH Rhumatology service and whose condition is stable. Recruitment of Consultant Physician with special interest in Respiratory Medicine
This process is completed and a start date for the permanent appointment is awaited. ___________________________________________________________________________________________ Oireachtas Members Briefing 09/11/11


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