Time to Renew our Hospitals.

Actor Gabriel Byrne speaks out

Actor Gabriel Byrne with Prof. Roger Ulrich at the June 19th public lecture

Design & Dignity : The case for renewing our hospitals (PPT) (10.5 Mb)

New Design & Dignity Guidelines CLICK HERE (PDF)

Each year almost 30,000 people die in Ireland.  These deaths are increasingly associated with older age and with chronic illness and, despite the fact that a large majority of people wish to die at home, the reality is that approximately two-thirds die in hospitals of one sort or another and 40% die in acute hospitals.  Research internationally has raised concerns about the quality of end-of-life care in hospitals and a consensus is emerging that care at the end of life should become an indicator of the performance of health systems.  In Ireland the Irish Hospice Foundation was sufficiently concerned as to undertake a feasibility study, followed by a pilot project, to examine how a comprehensive approach could be developed to change the culture of care and organisation regarding dying, death and bereavement in hospitals.  The Pilot Project (2004 - 2006) was undertaken at Our Lady of Lourdes Hospital in Drogheda in partnership with the Health Service Executive.  It was one of three winners of the 2006 Public Service Excellence Awards selected to represent Ireland in Europe.  The Atlantic Philanthropies supported the Foundation during 2006 in using the learning from the project to inform the planning and development of a national programme. 

The Foundation has now established a national programme to mainstream hospice principles in hospital practice.  It focuses on four key themes generated from the pilot project: Integrated Care; Communication; Dignity & Design; Patient Autonomy.  A series of strategy workshops and consultations has considered issues relating to each of these themes.  A public call for ‘Expressions of Interest’ in participating in the programme resulted in 9 submissions covering 18 hospitals; 50% of acute hospitals with emergency facilities. Three submissions covering 19 non-acute community hospitals and facilities for older people were also received.  There are now over 40 hospitals participating in the programme of which 20 are acute hospitals. 

The supports to assist hospitals participate in the programme include: employment of development co-ordinators to develop the capacity of the hospitals to improve services and standards; training in communications skills; development of information, awareness and education strategies around patient autonomy and end-of-life issues; specialist advice relating to improvements in physical infrastructure and facilities. 

The Hospice Friendly Hospital Programme (HfH) is being undertaken in two phases over a 5 year period in a creative partnership with the HSE, Atlantic Philanthropies, HIQA and a range of public service and academic organisations.  Crucial to its success will be the development of comprehensive patient-focused standards regarding dying, death and bereavement within the first 3 years.  The programme will cost €10M in operational costs with Atlantic Philanthropies contributing €5M, Irish Hospice Foundation €1.72M, Dormant Accounts Fund €1.53M.  It is expected that the HSE will contribute €1.75M. 

The programme was officially launched by President Mary McAleese on May 12th.  The following activities have already been initiated: