Clin Med
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Weekend handover is vital for patient safety--poor handover is a cause of avoidable adverse events. This study evaluated whether the quality of information handed over for patients requiring weekend review was adequate. Two external doctors imagined themselves as the doctor on-call and judged whether the handed-over information was adequate for each case. ⋯ Similarly 70.6% and 75.8% of handovers of action plans were of adequate quality. Use of computerised proforma and discussion at a handover meeting gave the highest percentage of handovers of adequate quality, however, there was room for improvement. Training in handover may improve communication.
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As society changes, doctors must adapt. Despite remarkable advances in medicine, the pace of change--greater now than ever--is challenging doctors to define their role and relevance. Is medicine really facing a crisis? Are claims for a malaise in medicine overstated? Regardless, the profession has been called upon to respond collectively to change. ⋯ Approaches will vary but one constant should be a steadfast adherence to the scientific basis of medicine as a way of thinking. Engagement with the medical humanities will also help doctors stay fresh and deepen their understanding of what it feels like to be ill. In so doing, clinicians will find inspiration in the ordinary.
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The impact of twice-daily consultant ward rounds on the length of stay in two general medical wards.
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. ⋯ 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.