14 hours to see the consultant…tick…tock
Aims
To reduce the amount of time taken for patients to obtain a review by a medical consultant.
Methods
The chief registrar at a large district general hospital was tasked with assessing the impact of implementing new measures to improve the proportion of patients who are assessed by a medical consultant within 14 hours. As with other similar district general hospitals, Warrington and Halton NHS Foundation Trust has suffered from low numbers of consultant acute physicians. In September 2015, only 38% of patients received a consultant review within 14 hours.
In order to address this, a new sessional system of consultant reviews was implemented with AMAU consultant presence from 08.00–21.30 seven days a week. This is in addition to a new medical handover system at 09.00, 17.00 and 21.00 that consultants were required to lead.
1100 notes were reviewed at random over an 11 month period.
Results
Of the 1100 notes pulled, 726 (66%) were correctly identified as medical patients. The others were mistakenly coded or incorrectly allocated as being under the care of the division of medicine.
2016 has seen consistent figures averaging over 80% of patients receiving a consultant review within 14 hours (Table 1).
Conclusions
A new sessional system of consultant reviews with consultant presence from 08.00–21.30 seven days a week in addition to a new medical handover system led by the medical consultants has been implemented. This has resulted in a dramatic improvement in the proportion of medical patients receiving a consultant review within 14 hours from 38% to consistent figures averaging over 80%.
Conflict of interest statement
None
- © Royal College of Physicians 2017. All rights reserved.
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