title: The impact of twice-daily consultant ward rounds on the length of stay in two general medical wards.
abstract: Excess average length of stay (ALoS) not only results in an increased cost to hospitals but also increases the risk of hospital-acquired infection and thromboembolism. Various factors suggested to affect ALoS have yet to demonstrate a significant impact in clinical practice. Increased consultant input has been identified as an important factor influencing ALoS. As a result, a radical and innovative consultant job plan, replacing twice-weekly with twice-daily ward rounds (WRs) on a university teaching hospital's two medical words has been designed. The number of discharges (NoDs) significantly increased (p < 0.01), ALoS reduced (p < 0.01), whereas, readmission rate and mortality remained unchanged (p = NS) over 12 months following twice-daily WRs compared to two other wards with twice-weekly WRs. This innovative model resulted in almost doubling the NoDs and halving the ALoS. This study suggests that ALoS can be reduced and sustained with a cultural and behavioural shift in consultant working patterns, without affecting readmission rate or inpatient mortality.
authors.affiliation: Department of Diabetes/Endocrinology and General Medicine, Royal Liverpool University Hospital. aftab.ahmad@rlbuht.nhs.uk
authors.forename: Aftab
authors.initials: A
authors.lastname: Ahmad
authors.forename: Tejpal S
authors.initials: TS
authors.lastname: Purewal
authors.forename: Dushyant
authors.initials: D
authors.lastname: Sharma
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Weston
mesh_terms: D003253:Consultants; D017052:Hospital Mortality; D006757:Hospital Units; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008505:Medical Staff, Hospital; D010351:Patient Discharge; D010359:Patient Readmission; D056164:Teaching Rounds