Theatre department to be redeveloped after HIQA report

The HSE has approved a plan to redevelop the theatre space at the Coombe Women and Infants University Hospital and the hospital is awaiting details on when the funding will be released.

News that the operating theatres at the Coombe are to be redeveloped comes after HIQA described them as “not fit for purpose” in a recent inspection report.

HIQA conducted an unannounced inspection visit to the Coombe in August and found that the Operating Theatre Department’s (OTD) infrastructure did not comply with international standards, HIQA standards, or basic best practice guidelines for surgical facilities.

HIQA noted that the design of the OTD, which includes two theatres dating back to 1967, was “outdated and neither meets the desirable standards of a modern surgical facility nor facilitates the implementation of effective infection prevention and control measures”.

Coupled with concerns surrounding infrastructure and design, the inspection also identified a number of high-risk findings in relation to endoscope decontamination facilities and the separation of functional activities within the Department.

Staff facilities were “insufficient” for the number of people working there, the report also found.

According to the report: “The operating theatre ventilation system did not meet recommended specifications for healthcare premises. During the inspection, windows and doors in ancillary rooms were open, as were doors to an operating room, which meant that unfiltered air from outside was circulating in an operating room during surgery.”

HIQA acknowledged that the provision of an OTD in line with current infrastructural guidelines would require “significant capital investment”.

“There is a proposed national plan that the Coombe will move to a new site in the grounds of St James’s Hospital in the future, but this could take several years to complete. Risks identified in this report will need to be addressed in the interim,” HIQA added.

The Coombe stated that it accepted HIQA’s conclusions and welcomed the Authority’s finding that there was good ownership and teamwork in relation to hygiene in general, and that the hospital had an effective system in place in relation to cleaning in the OTD.

The Coombe endorsed HIQA’s key finding that risks in respect of operating theatre infrastructure could not be addressed without major capital investment, and acknowledged that the implementation of a major re-development would contribute to the quality and standards of service delivered in the Theatre Department.

“Patient safety is central to the care provided at the Coombe. For some considerable time, senior management has had extensive, ongoing engagement with the HSE concerning essential upgrading of the Theatre Department and a detailed business case for this work was submitted to the HSE earlier this year,” the Coombe stated.

Since HIQA’s visit, the Coombe has received notification that the business case has been approved by the HSE, and the hospital is currently awaiting details of the timeline for the necessary funding.

june.shannon@imt.ie