02.04.12
Consultants’ time improves patient outcomes
Patients have better outcomes when consultants are on call for more than one day at a time, a survey of 100 hospitals suggests. The Royal College of Physicians (RCP) found that having no other routine duties and undertaking two or more ward rounds per day also improved care.
The RCP commissioned the research through its Clinical Effectiveness and Evaluation Unit (CEEU), in association with the Society for Acute Medicine and the British Geriatrics Society.
It matched various systems of consultant cover against patient outcome data from hospital episode statistics, to see if there was an advantage to patient care from any of the different systems.
Hospitals with consultants working for more than one day in a row had lower excess weekend mortality, research found. Two or more acute medical unit (ACU) rounds per day led to a lower adjusted case fatality rate for patients and where the consultant was present for more than four hours for seven days per week, there was a lower readmission rate.
The RCP is now recommending this system of cover for all hospitals.
Professor Derek Bell, chair of the steering group, said: “This study is important as it reaffirms previous RCP recommendations in relation to patient outcomes, and provides the foundation for future studies in this area aimed at examining the role of multidisciplinary care in acutely unwell patients.”
Dr Kevin Stewart, clinical director of the RCP’s CEEU said: “Traditional rotas are neither safe for patients, nor good for clinicians. Now, patients are older, sicker and have more complex conditions, and they require dedicated consultants to be available on site 7 days per week for at least 12 hours a day.’
Dr Chris Roseveare, president of the Society for Acute Medicine, said: “For the first time, specific patterns of consultant working on the Acute Medical Unit have been shown to be associated with improved patient outcomes; hospitals now have a fantastic opportunity to identify the number of acute medicine consultants required to deliver best practice and to provide sustainable rotas for 7 day working in acute medicine.”
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