• Aftab Ahmad, Tejpal S Purewal, Dushyant Sharma, and Philip J Weston.
• Department of Diabetes/Endocrinology and General Medicine, Royal Liverpool University Hospital. aftab.ahmad@rlbuht.nhs.uk
• Clin Med. 2011 Dec 1; 11 (6): 524528524-8.

AbstractExcess 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.

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