RT Journal Article
SR Electronic
T1 What is the effect of a consultant presence in an acute medical unit?
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 214
OP 218
DO 10.7861/clinmedicine.9-3-214
VO 9
IS 3
A1 Gregor BS McNeill
A1 Darshan H Brahmbhatt
A1 A Toby Prevost
A1 Nicola JB Trepte
YR 2009
UL http://www.rcpjournals.org/content/9/3/214.abstract
AB A cornerstone of the development of acute medicine has been the principle of consultant presence within the acute medical unit (AMU). There is the hypothesis that consultant supervision improves patient care. This view is not currently supported by firm scientific evidence. When Ipswich AMU opened in 2004, there was a consultant presence on some weekdays only. Admission data were collected and assessed with respect to the presence or absence of the consultant. Overall length of stay was significantly lower, by a mean of 1.3 days, when there was a consultant present, and 9% more patients were discharged on the same day of their assessment (95% confidence interval 5.7% to 12.6%, p<0.001) without affecting readmission or mortality. These results suggest the absence of a consultant leads to fewer same-day discharges and causes the inappropriate admission of patients not needing inpatient management. Further study is required to determine whether these findings are shared by other AMUs.