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MINISTER FOR HEALTH Simon Harris has said the wording was “a bit off” on hospital posters offering cash prizes to wards that discharged their patients early in the day.
The Irish Independent reported today that St James’s Hospital has been offering staff members cash prizes of up to €500 as part of a competition to discharge patients from wards before 11am.
The contest has allegedly been underway in the hospital since October and it is aimed at improving patient flow to free up beds in the facility. The posters have since been removed by the hospital.
“I think the wording on the poster was a bit off, to put it mildly,” Harris said today.
“I think the fundamental purpose of wards and clinicians on wards working as efficiently as they can to get patients out of wards… they should be looking at a way of encouraging that spirit within a hospital.”
The minister said it was “not [his] understanding” that the prizes were for staff as individuals.
“My understanding is these were financial incentives to individual wards rather than individual staff,” he said.
“I’m pleased that St James’s has withdrawn those posters and I think a rewording and looking at a better way of achieving the same name, which is discharging patients quicker from a hospital.”
Simon Harris was speaking today before the launch of the National Standards for Adult Safeguarding.
A statement from the Irish Hospital Consultants Association said the move was “ill-judged” but pointed to the lack of beds and overcrowding as a cause for such an incentive to be introduced.
“While the method, encouraging prompt discharge of patients at Saint James’ Hospital through incentives for individual hospital wards, was ill-judged, it does not take away from the underlying issue faced by the hospital professionals and all acute hospitals across the country. Namely, the severe shortage of acute hospital beds,” it said.
“This lack of bed capacity is placing huge pressures on all hospital staff to ensure that patients requiring treatment can access timely care, including through freeing up hospital beds and getting patients off trolleys.
“This lack of capacity translates in practice into significant numbers of patients waiting on chairs or being treated on trolleys, and intensifies pressures on staff, such as at St. James’ Hospital, to discharge patients as quickly as medically appropriate.”
The poster has the word ‘Win!’ on it and offers a prize of €500 to the ward that sends the most patients to the hospital discharge lounge before 11am.”
It says the competition will run from October to January this year. “The battle is on – don’t miss out,” the poster says.
A spokesperson for St James’s Hospital told the Irish Independent that they “apologise for any offence caused”.
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Total joke. Remove FFG…
@Willy Mc Bride: so you think the other half of the dail has the balls to sort this mess out ?
unfortunately we seem to be between a rock and a hard place with our politicians not one of them appear competent.
which is what’s really worrying
@ed w: so that’s your logic? Stick with ffg because at least we can expect the misery?
@Euro McPúnty: Nothing will change in our lifetime. Until our young people stops politics in this country in its track altogether, then nothing will change. We will have to wait until the hardcore supporters of FF and FG are dead and buried. It could take generations for them to be completely filtered from our society.
@Euro McPúnty: Exactly, its just mental logic…
@ed w: have the other side of the Dail ever been in power?
@David Corrigan: People have no education in politics. They don’t know the differences between parties, who is in which party, How elections work, the proportional representation operates in voting, nothing much about local Government or its role, how a mayor is elected, how senators are elected and what their role is. They think TDS are supposed to be getting medical cards for people and treat them as social workers. On the other side, the politicians cash in on the ignorance of the electorate and people are voting for the best actor/TD on telly and this is aided and abetted by the presenters of the shows/news, who should be apolitical & should never ever allow their own views be used or even known when doing their job. The media is supposed to be balanced, fair and professional.
@Matthew Handibode: Not a bit. FF and FG have spent 100 years managing this country to suit themselves and their cronies. They do not represent the people of this country. Name one thing that they have done in your lifetime that actually benefited the people of Ireland?
Nothing will change in this kip until the political system changes. The best thing one can do is keep the head down and pay as little as possible to the system. It is as simple and as black and white as that.
@Julie G Graham: Spot on. Politicians do not work for the people who elect them. Look at the character who resigned today from the Dail. What has he ever done for the people in north Cork? He only became a politician to further his own “career” or whatever he calls it. The man couldn’t even finish college first time of asking.
@Willy Mc Bride: Yes bcause they wrote the poster…..
I am sure the 90 year old lady who was dumped in a hallway for two days would be thrilled to know she could have been part of this competition. The Irish health system simply can’t go any lower.
@David Corrigan: Wait until all the obese kids grow up in 20 odd years and we as a population have aged…..you ain’t seen nothing yet it will totally collapse.
@David Corrigan: She might have got a bed sooner if a patient was discharged more efficiently
@David Corrigan: she’s on a trolly waiting for patients to be discharged.
@David Corrigan: That’s the sort of thing the HSE would regard as a challenge… They can demand more money and give it all to pen-pushers like they’ve been doing for years.
@Aoife Mac Cana: And firing cash at the already overworked nurses and doctors is going to speed it up Aoife? The system is broke and the budget is increasing year on year but things are getting worse. When will be the time to say STOP!
@David Corrigan: Where did you read that I suggested that a cash bonus to the ward staff would speed up the process of moving patients out of wards? The system needs to be stripped back to the very basics.
@Aoife Mac Cana: I didn’t read it anywhere Aoife. I was just asking the question and I fully agree with you.
Is it april 1st? This can’t be real?
@Brian Dunne: Roll up Roll up we’re giving away €550 for a cancer patient, €800 for a blind cancer patient in a wheelchair ….. this is shocking stuff!!
@Tony Henry: its like “carry on health service” starring simon harris! Be funny if it wasn’t true
@Brian Dunne: We should hold a charity white collar boxing night to fight against sitting ministers, you need to bid to fight…. highest bidder wins the right to fight…. I’d pay thousands to get a couple of minutes in a ring with Harris…. no more mr smug with no place to run!!
@Brian Dunne: Perhaps the saddest or craziest part of all this is that taxpayers money was used to design and post these ‘Win’ posters which will now be replaced by reworded redesigned posters leaving unchanged the financial reward incentive again at taxpayers expense. Money that could be used to provide more beds etc.
Who ever approved these posters should resign or be fired , patients need to be treated with integrity, the HSE is a joke, too many pen pushers not enough spent on frontline staff.
@Paul O’Sullivan:
Like something Ryanair would do.
Harris probably consulted Michael O’Leary for ideas as he has FA to himself.
@Paul O’Sullivan: Totally agree but nobody will answer for introducing this morally bankrupt idea to our hospital wards.
@Paul O’Sullivan: also dignity and respect
@Paul O’Sullivan: The HSE is a very difficult work environment, and of course requires administrative staff to function, Its unfair to lump them all as pen pushers.
That being said, this was a crazy scheme, and whoever pushed it down the line, or more likely bulldozed it, should be held to account.
One thing after another for Harris, totally out of his depth here.
Maybe if there was enough staff to actually discharge the patients. It’s a lengthy process depending on how long the patient has been in for. Also the nurse probably have 8 or 9 other patients to get up, washed, fed, drug round to do, iv medication, vital signs, drips, feeds, drains, preparing patients for theatre and bringing them there and dealing with whatever else crops up in between. Personally as a nurse these things are more of a priority than getting massive loads of discharge paperwork done before 11am so another patient can be landed in the bed before you even have your morning work done. It’s a disgrace and to be honest it’s so disrespectful to nurses. Oh throw them €500 to make them work faster. Joke of a system
@clairebear: Don’t think the nurses do the washing of patients or change the sheets and they certainly don’t feed them. These jobs are done by nurses aid. My 98 year old aunt was in a major teaching hospital and no one came to help her eat – she lost so much weight. It is an absolute disgrace. Simon Harris should be fired. Roll on the election it can’t come quick enough.
@Orla Cosgrave: Orla I have worked in two major teaching hospitals in Dublin and yes the nurses do wash and feed patients. There is often only one or if lucky two care assistants for the whole ward which has 30+ patients so nurses also have to do these jobs. I’m sorry to hear about your aunt not getting fed. Unfortunately it’s so short staffed that nurses often are reliant on patients families to help which is wrong but that’s the reality of public hospitals
@clairebear: This poster was probably approved by Nurse Managers,who now should claim ownership for implementing it.
I thought these were places to treat sick people not a bus station
How much was the prize for moving them from the corridor that might be a better offer where is this prize money coming from and is it taxed ???
If they introduce the same scheme for FG ministers like anybody called Murphy, Harris, Bruton (what a waster), Madigan-Bailey and other FG TDs leaving the Dail you can put me down for a contribution to the prize fund. WIN!
Example:
Patient has had a hip op with 2-4 days in hospital depending on age and recovery.
Day 4 patient ready and able for discharge.
Consultant approves discharge. Nurse takes over to discharge the patient.
Patient decides they want to have breakfast, a shower and then pack there bags, then informs the nurse their relative cant pick them up till mid afternoon.
Patient continues to occupy the bed. Patient finally discharged at 4pm.
The bed now needs to be cleaned. Meanwhile there is a staff changeover.
Someone else’s relative is waiting hours in ED and was assigned that bed at 11am but doesn’t get it till 7pm that eve.
Discharge before 11 is one of the most important aspects in achieving efficiency in a hospital and should be incentivised where the patient is fit for discharge.
@Clark Griswold: Ye, you’re right. On the morning of discharge, assist the patient to get their belongings together and escort them to the discharge lounge in a timely and efficient manner or escort yourself out the door with your P45 under your arm. Is that incentive enough?
@Michael Evans: yes you would imagine it would be. Just because you are a nurse doesn’t mean you cant be incompetent or lazy. Just like any other job there is different levels of competency.
To discharge a patent, the consultant has to be liaised with, social workers in some cases, the hospital pharmacy, cleaners, relatives, nevermind the patient themselves who thinks they paid their taxes and wants to get their moneys worth and won’t vacate the bed or go the discharge lounge if their is one.
If your a nurse working day to day incentives do help!
@Clark Griswold: even worse I was ready for discharge was all packed. waited till 5pm for a prescription which was for iron tablets which cheaper off prescription so i was sitting there waiting all day for a prescription i didnt need. I could have been out at 9am. to Thomas day I dont know wht it took so long.
@Clark Griswold:
Example
Patient has a knee replacement, days later told they are discharged on following morning at 9.30am
On morning of discharge , patient is up from 6am,breakfast over, showered, shaved and bag packed, wife waiting beside him.
Told he can not leave until seen by doctor and prescriptions and follow up appointments made, won’t be long, within the hour.
Bed is taken, sitting on hard plastic chairs, waiting, waiting, waiting, call to nurses station to check, ” any time now…….more waiting
Past lunch time, still waiting, no lunch as this patient is discharged, go to hospital canteen, back to ward, still waiting, check with nurse again, “any time now……
Around 2.30 ward is closed, two other patients transferred to other wards, still sitting on plastic chairs worn out
Around 3.30pm two assistants arrive and clean out ward,they are not allowed to clean his bed as he is still here, he asks if he can lie down so and she says ” why not”, he is exhausted and in discomfort.
Finally around 5pm and more visits to nurses station, young house doctor arrives , sorry, sorry, sorry, you can go now, paperwork in hand,
Can’t wait to go, hope never to return.
Parking charges in excess of 20 euro, crazy.
@Clark Griswold: no one should be given incentives to do their jobs, that’s what they get paid for. If a patient is fit to be discharged, discharging them on time should be a given. There should be a shift manager/ supervisor who ensures this is done on time. The incentive is a higher wage that the individual who is promoted to this position.
@Clark Griswold: Imagine the patient actually wanted to have breakie, get washed & dressed. Planning is the one thing missing in discharge planning. There’s no reason why discharges cannot be planned with everything in place on d/c day. Some families arent able to just drop everything to do a pick-up. Prior notice & arranging a time instead of last minute decision making can help.
@Clark Griswold: Exactly, if they are due to be discharged and are ok to do so get them out… plenty of people waiting to get in. So many people up in arms over logical efficiency.
@Honeybee: As for your example above, said young doctor arrives to work at 6.00am (after finishing at 8.30pm the evening before).
Young doctor prepares for rounds and begins a round with consultant 1, then does the round with consultant 2 and finally finishes off with consultant 3′s round.
Young doctor now learns he is covering a colleague who is on night duty.
Young doctor is now covering 40+ patients.
There is an endless stream of jobs to be done: scans to be organised, IV lines to be done (as nurses refuse to do them), specialist consults to be gotten, notes to be written.
15 patients are being discharged – so detailed discharge letters, prescriptions etc needs to be done on a computer programme from the 90′s where if you make a mistake you have to start all over again.
Most of patients can only go if their bloods come back normal as per the consultant but the phlebotomy service is understaffed and the bloods haven’t been taken so now young doctor has to go and take the bloods himself as no one else will (even though he hasn’t recieved 1 iota of formal training in phlebotomy).
Then you are paged, Mr X is very unwell and needs to be reviewed immediately. And now Ms Y has chest pains and her BP is low. Oops a last minute theater slot has opened for Mr P and his clotting bloods need to be taken now or the slot will be cancelled.
Now Mr Q’s family is complaining that his discharge paperwork isn’t done, just as you go to do it you hear Mr R has passed away and needs to be pronounced RIP and family spoken to.
Mr Q’s family is now very angry and threatening to leave, the ward are demanding the paperwork be done immediately. Its 3pm, you’ve been working since 6am flat out and are starving and dehydrated.
You get the paper work done (instead of eating), take it to Mr Q, who’s family promptly tells how long they’ve been waiting and threaten to report you for not coming sooner.
As you go to the canteen at 4.45pm for your first bit of food of the day, you notice the stream of staff leaving the admin section of the building (on their way out home of course), meanwhile you know you’ll be there til 8-9pm AGAIN.
As you chew on you prepackaged chicken and stuffing sandwich (as that’s all thats left) you get a call from the ward Mr X’s family have turned up and are irate as Mr. X’s scan has been cancelled again. The ward manager says you need to come to speak with them (i.e get shouted at for something not within your control) right now! so much for the sandwich! – and this is “good” day!
Its the “young doctors” who keep the system afloat!
Its the system that’s the problem
That’s disgraceful. Personally i discharged from hospital when I was not well enough, as was my husband. I ended up vomiting at home for 24 hours non stop and my husband was readmitted within 36 hours.
Imagine there was a competition to get people into the morgue….or is there?
@Madra: I really hope the person who came up with the first idea doesn’t read your comment.
@Madra: Tried it.. wouldn’t work…found that patients were very unpredictable in their dying habits
What is missing in this whole charade is dignity and respect. When they closed all the hospitals ,Baggot st, Adelaide, Dr Stephens, The Meath etc and just dumped patients in to overcrowded facilities, what did they expect? patients being treated in corridors and dying in storage rooms. Maybe we should open the equivalent of a ‘lepers valley’ where our loved ones could go and die quietly out of sight, no need for competitions for hospitals to rid themselves of patients by offering cash prizes, a new low even by government standards.
You’re a bit off Simon .. off the pace.
I totally agree with encouraging discharges by 11am. If you are fit to go home and are being discharged there is no benefit to the patient in being kept waiting around all day and discharged at a time of rush hour traffic.The people commenting in opposition to an 11am discharge have obviously never been in the situation.
@Ray Martin: the issue here is Cash Prizes on offer… I have no problem with hospital policy aiming for a 11.AM discharge, but offering prizes??? Cmon!
Everyone knows how much Nurses and hospital staff work so hard, I’m certainly not targeting them… my issue is with the pen pusher who came up with this idea.
@Ray Martin: Who mentioned anything about being fit to go home, the emphasis was to get people out by 11.00am, nothing more. And I have been in most of the hospitals mentioned, I’ll be in one again next week, all going well.
We’ve moved to a Healthcare model, endorsed by the Minister of Health, where the system can’t cope and the staff are bribed to discharge them. It’s not unusual for patients to die on corridors waiting to be seen or admitted, some are now even assaulted. If you’re not sick enough going into a hospital, give it time. It’s almost like a Monty Python sketch.
@Ray Martin: This is not encouraging discharges by 11 am. Problem just gets shifted to another unit called the discharge suite. It might free up a bed, but patients are left waiting for their discharge prescription, letters etc.
James’s hospital pushed my 81 year old dad out the door after 1 week of treatment for pneumonia. Nurses were Great, bed manager and doctors constantly telling him he should be at home not in the hospital. Bed manager admitted that they fast tracked him as they needed the bed. We knew something was wrong at the time and now it appears they received a financial incentive to do this. Shame on this shambles of a government and this health service middle managent that thought this was an OK solution.
Dad died 9 weeks later in Vincent’s hospital of the same bout of pneumonia, he refused to be readmitted to James’s. I often wondered why, not anymore
@JMcB: Really sorry to hear your Dad died,Ican so understand why elderly people are afraid of hospitals,they know how they will be treated and that they are not wanted there. My Dad is terrified of going to hospital in case he ends up in a corridor and after seeing the picture of the 90 year old woman on a trolly for days in the corridor, I just hope he stays well.Imagine that we are fearful of going near hospitals, imagine they pay prizes to staff to get people out.
The whole premise of the discharge lounge is to facilitate the discharge of medically fit patients, freeing up beds for those waiting in ED, etc. Someone who is still sick or unstable is not going to shipped off and out the door. The competition is to purely increase the rate at which the service is used by medical teams!
@Alberto Mcevoy: is one way of looking at it….the other is that as taxpayers we spend billions for a health service that has been in ‘ trolley crisis’ mode for years and the health professionals we employ should be able to do the job they are paid for without BS hamper competitions in hospital wards – pathetic
The wording of good response to this seems a bit off
Unbelievable…goes against every moral and ethical concept that you are trained with as a health professional!! Eoghan Murphy’s incompetence is bad but this is staggering!!
The only criteria for discharging a patient from hospital should be whether the patient is well enough to be discharged, not whether nurses or doctors “win” bonus payments for getting patients out. That is a blatant conflict of interest and shows the contempt hospital management have for the patients.
On that premise why not raffle hospital beds!
Why not go the whole hog and start a tote among the hospital staff on whether or not a particular patient will be discharged on time? The process could be outsourced to Paddy Powers or some other bookmaker’s to manage. At this point, nothing would surprise me anymore.
At this stage the government needs stop spending anymore money on PR people as they get it wrong time after time.
I once waited for three hours in the Discharge Lounge in a Hospital for a Nurse to give me a letter for my GP. Why they could not email or post it to the GP is beyond me.
The loney left will table a motion of no confidence. Feeling Failed will abstain (as usual). FG will rally the troops and all will go on as normal. Such is the cycle!
@John Tierney: Sadly John, that is the truth as we witnessed with the Dail vote on Murphy and homelessness,our politicians have no moral compass,long live animal farm (sic). People need to shake themselves up and stop voting for parties of incompetence,we are worth so much more.
Wording is a bit off or are these guys really human or living in the real world
Appalling idea, revolting idea. Also any monies paid to staff who engaged with this idea should be declared for tax purposes .
I thought this was a Waterford Whispers story,madness!
They were offered money to do their job to the best of their ability. I always thought that was what wages were for. Silly me.
Waste of space
Discharged ,to where?
If I’m in a que waiting to be seen should I flash some cash to get seen quicker?
Simon Harris is absolutely Useless
Wild concept I know – but how about don’t discharge patients before they are ready to return home and look at providing efficient hospital services instead; ensuring patients have received the care they need and deserve, by nurses and doctors who arent stretched beyond belief.
have your say