St John’s Hospital: Innovation and excellence
Is í ár bhfís a bheith mar phríomhsholáthraí seirbhís cúram sláinte ina bhfuil nuálaíocht agus sármhaitheas ag croílár eispéireas an othair.
Our vision is to be a leading provider of healthcare service where innovation and excellence are at the heart of the patient experience.
Central to how we work at St John’s is the belief that patients come first, to act with integrity at all times and to strive for excellence. Our strategic plan is built around the hospital’s vision of being a leading provider of healthcare services where innovation and excellence are at the heart of the patient experience. It was developed following deep consultation with all staff, healthcare partners, University of Limerick, GPs, our Patient Partnership Forum and the wider public.
The five-year plan 2022-27 outlines our vision to deliver high-quality, patient-centred care while strengthening collaboration, innovation, and staff wellbeing. The strategy ultimately focuses on the hospital proactively responding to healthcare needs by ensuring it has the capacity to safely deliver services, reduce public waiting lists and accelerate, where possible, the further development of integrated care pathways between the hospital and wider health region.
CEO of the hospital Emer Martin says that “our plans emphasise the connections between the high-quality services we provide while working with our HSE partners to achieve better outcomes, more effectively”.
Driving efficiency through technology
2025 was dominated by high demand for our services, complex operational pressures, financial and staffing challenges. Despite these pressures, our staff have continued to work tirelessly to deliver compassionate, high-quality care whilst meeting rising service demands.
The hospital is an intensive generator and user of digital information and makes extensive use of a wide range of information and communications technologies in the delivery of its healthcare services and in the general administration and running of the Hospital.
On quality and innovation, we were delighted to gain national recognition by HSE Spark for a quality improvement initiative to boost patient flow tracking. Led by Mairead O’Donoghue, registered ANP in Emergency Medicine and Alan O’Connor, deputy information systems manager, this involved rolling out a major new in-house program in the Injury Unit titled InjuryNet, a bespoke digital patient clinical record and unit worklist. It streamlines patient flow tracking, enhances the accuracy and legibility of clinical documentation, and facilitates efficient e-referrals to GPs, physiotherapy, and the fracture clinic. By eliminating paper-based processes, we have reduced clinician fatigue, expedited patient care, enabled customised reporting for discharge coding and unit activity, and supported our sustainability goals. The project was put forward for the HSE 2025 Spark Summit award and won the Best Digital Product award.
Undoubtedly, our patients and staff benefit significantly from collaborative working relationships. We value the opportunity to have played a key role in this project initiative, strengthening our working partnerships internally and with the HSE national innovation team.
Spotlight on pharmacy
The Pharmacy service delivers a wide range of services including clinical pharmacy, antimicrobial stewardship, medication safety, medication reconciliation, anticoagulation stewardship, supporting appropriate prescribing and patient education and follow-up. Pharmacy team members contribute to the work of 14 different committees, including four internal, two within University of Limerick hospitals and two at national level.
Through its key partnerships and other opportunities, the department enjoys links with the Affiliation for Pharmacy Practice Experiential Learning (APPEL), the School of Pharmacy at University College Cork, the University of Limerick graduate entry medical school (GEMs) and, through facilitating a pharmacy student for work experience, Queen’s University Belfast School of Pharmacy.
Building research capability and best practice in care of the elderly patients
‘Building partnerships’ is identified as an important theme of the hospital’s strategy 2022-2027. One of our 2024 goals was to develop research capability in dementia and Care of the Elderly with a university partner and begin to implement National Clinical Guideline Two (Appropriate Prescribing of Psychotropic Medication for Non-cognitive Symptoms in People with Dementia). The realisation of this goal is well under way. One of our pharmacists successfully applied for a work-based funded PhD in UCC while working as a clinical pharmacist in St John’s Hospital. The partnering university is UCC School of Pharmacy.
A continuous quality improvement model helps to deliver our internal departmental goals of:
- safe, effective and economic use of medicines;
- promotion of medicines optimisation for best possible patient outcomes; and
- delivery of excellence in the practice of pharmacy.
Recent development of a pharmacy dispensary tool allows tracking of medications at patient level plus easy documentation and management of patient care. Pharmacists obtain patient data through PID patient search and apply dispensary comments behind authenticated logged-in accounts for auditing purposes. Investment in digital transformation of clinical pharmacy workflow and process reaps rewards, allowing patients with the highest need and greatest risk to be reviewed first. The approach reflects international best practice in clinical pharmacy and is of growing interest in Ireland. St John’s Hospital Pharmacy is at the pioneering edge with its digital approach, with increasing opportunities to present its work to a wider clinical audience.
Digital quality improvements
Reducing interruptions: increasing communication; a safety initiative
From the Human Factors perspective, spoken and written communications are crucial to maintaining patient safety. Effective communication is essential when a medication query is handed over to a clinical pharmacist for follow-up and timely response. Multiple phone calls led to multiple interruptions, a well recognised risk factor for medication error.
In order to reduce interruptions and maintain a safe working environment for ward pharmacy staff and the dispensary, an excel file was created for two-way communication. A trial period to evaluate its effectiveness was undertaken. Phone calls and interruptions reduced significantly; written communication ensured timely information transfer to enable the right drug to be dispensed for the right patient at the right time.
However, use of an excel file by multiple users had limitations and the next step taken was to ask the IS Department to build a programme from the excel file. This became the ‘Pharmacy Communication Whiteboard’, with individual password access and time-stamped communications. The experience of using this programme has already delivered a verdict – the best work-environment quality improvement we have experienced in the Pharmacy, notwithstanding medication and patient safety benefits.
St John’s might be among Limerick’s and the country’s oldest hospitals, but it is very much at the pioneering edge with a clear plan for a vibrant future at the heart of Mid-West healthcare.
