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A retrospective study of seven-day consultant working: reductions in mortality and length of stay

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A retrospective study of seven-day consultant working: reductions in mortality and length of stay. / Leong, King Sun; Titman, Andrew; Brown, Mark; Powell, Robyn; Moore, Evan; Bowen-Jones, David.

In: The Journal of the Royal College of Physicians of Edinburgh, Vol. 45, No. 4, 2015, p. 261-267.

Research output: Contribution to journalJournal article

Harvard

Leong, KS, Titman, A, Brown, M, Powell, R, Moore, E & Bowen-Jones, D 2015, 'A retrospective study of seven-day consultant working: reductions in mortality and length of stay' The Journal of the Royal College of Physicians of Edinburgh, vol. 45, no. 4, pp. 261-267. https://doi.org/10.4997/JRCPE.2015.402

APA

Leong, K. S., Titman, A., Brown, M., Powell, R., Moore, E., & Bowen-Jones, D. (2015). A retrospective study of seven-day consultant working: reductions in mortality and length of stay. The Journal of the Royal College of Physicians of Edinburgh, 45(4), 261-267. https://doi.org/10.4997/JRCPE.2015.402

Vancouver

Leong KS, Titman A, Brown M, Powell R, Moore E, Bowen-Jones D. A retrospective study of seven-day consultant working: reductions in mortality and length of stay. The Journal of the Royal College of Physicians of Edinburgh. 2015;45(4):261-267. https://doi.org/10.4997/JRCPE.2015.402

Author

Leong, King Sun ; Titman, Andrew ; Brown, Mark ; Powell, Robyn ; Moore, Evan ; Bowen-Jones, David. / A retrospective study of seven-day consultant working: reductions in mortality and length of stay. In: The Journal of the Royal College of Physicians of Edinburgh. 2015 ; Vol. 45, No. 4. pp. 261-267.

Bibtex

@article{db80e02d51a34cd39b5b4c76b4efe6c0,
title = "A retrospective study of seven-day consultant working: reductions in mortality and length of stay",
abstract = "Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether providing enhanced weekend staffing for acute medical inpatient services reduces mortality or length of stay is unknown.METHODS: This paper describes a retrospective analysis of in-hospital mortality and length of stay before and after introduction of an enhanced, consultant-led weekend service in acute medicine in November 2012. In-hospital mortality was compared for matching admission calendar months before and after introduction of the new service, adjusted for case volume. Length of stay and 30-day postdischarge mortality were also compared; illness severity of patients admitted was assessed by cross-sectional acuity audits.RESULTS: Admission numbers increased from 6,304 (November 2011-July 2012) to 7,382 (November 2012-July 2013), with no change in acuity score in elderly medical patients but a small fall in younger patients. At the same time, however, a 57{\%} increase in early-warning score triggered calls was seen in 2013 (410 calls vs 262 calls in 2012; p<0.01). Seven-day consultant working was associated with a reduction in in-hospital mortality from 11.4{\%} to 8.8{\%} (p<0.001). Mortality within 30 days of discharge fell from 2.4{\%} to 2.0{\%} (p=0.12). Length of stay fell by 1.9 days (95{\%} CI 1.1-2.7; p=0.004) for elderly medicine wards and by 1.7 days (95{\%} CI 0.8-2.6; p=0.008) for medical wards. Weekend discharges increased from general medical wards (from 13.6{\%} to 18.8{\%}, p<0.001) but did not increase from elderly medicine wards.CONCLUSIONS: Introduction of an enhanced, consultant-led model of working at weekends was associated with reduced in-hospital and 30-day post discharge mortality rates as well as reduced length of stay. These results require confirmation in rigorously designed prospective studies.",
keywords = "in-hospital, length of stay, mortality, 30 day mentality",
author = "Leong, {King Sun} and Andrew Titman and Mark Brown and Robyn Powell and Evan Moore and David Bowen-Jones",
year = "2015",
doi = "10.4997/JRCPE.2015.402",
language = "English",
volume = "45",
pages = "261--267",
journal = "The Journal of the Royal College of Physicians of Edinburgh",
issn = "1478-2715",
publisher = "NLM (Medline)",
number = "4",

}

RIS

TY - JOUR

T1 - A retrospective study of seven-day consultant working: reductions in mortality and length of stay

AU - Leong, King Sun

AU - Titman, Andrew

AU - Brown, Mark

AU - Powell, Robyn

AU - Moore, Evan

AU - Bowen-Jones, David

PY - 2015

Y1 - 2015

N2 - Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether providing enhanced weekend staffing for acute medical inpatient services reduces mortality or length of stay is unknown.METHODS: This paper describes a retrospective analysis of in-hospital mortality and length of stay before and after introduction of an enhanced, consultant-led weekend service in acute medicine in November 2012. In-hospital mortality was compared for matching admission calendar months before and after introduction of the new service, adjusted for case volume. Length of stay and 30-day postdischarge mortality were also compared; illness severity of patients admitted was assessed by cross-sectional acuity audits.RESULTS: Admission numbers increased from 6,304 (November 2011-July 2012) to 7,382 (November 2012-July 2013), with no change in acuity score in elderly medical patients but a small fall in younger patients. At the same time, however, a 57% increase in early-warning score triggered calls was seen in 2013 (410 calls vs 262 calls in 2012; p<0.01). Seven-day consultant working was associated with a reduction in in-hospital mortality from 11.4% to 8.8% (p<0.001). Mortality within 30 days of discharge fell from 2.4% to 2.0% (p=0.12). Length of stay fell by 1.9 days (95% CI 1.1-2.7; p=0.004) for elderly medicine wards and by 1.7 days (95% CI 0.8-2.6; p=0.008) for medical wards. Weekend discharges increased from general medical wards (from 13.6% to 18.8%, p<0.001) but did not increase from elderly medicine wards.CONCLUSIONS: Introduction of an enhanced, consultant-led model of working at weekends was associated with reduced in-hospital and 30-day post discharge mortality rates as well as reduced length of stay. These results require confirmation in rigorously designed prospective studies.

AB - Weekend admission is associated with higher in-hospital mortality than weekday admission. Whether providing enhanced weekend staffing for acute medical inpatient services reduces mortality or length of stay is unknown.METHODS: This paper describes a retrospective analysis of in-hospital mortality and length of stay before and after introduction of an enhanced, consultant-led weekend service in acute medicine in November 2012. In-hospital mortality was compared for matching admission calendar months before and after introduction of the new service, adjusted for case volume. Length of stay and 30-day postdischarge mortality were also compared; illness severity of patients admitted was assessed by cross-sectional acuity audits.RESULTS: Admission numbers increased from 6,304 (November 2011-July 2012) to 7,382 (November 2012-July 2013), with no change in acuity score in elderly medical patients but a small fall in younger patients. At the same time, however, a 57% increase in early-warning score triggered calls was seen in 2013 (410 calls vs 262 calls in 2012; p<0.01). Seven-day consultant working was associated with a reduction in in-hospital mortality from 11.4% to 8.8% (p<0.001). Mortality within 30 days of discharge fell from 2.4% to 2.0% (p=0.12). Length of stay fell by 1.9 days (95% CI 1.1-2.7; p=0.004) for elderly medicine wards and by 1.7 days (95% CI 0.8-2.6; p=0.008) for medical wards. Weekend discharges increased from general medical wards (from 13.6% to 18.8%, p<0.001) but did not increase from elderly medicine wards.CONCLUSIONS: Introduction of an enhanced, consultant-led model of working at weekends was associated with reduced in-hospital and 30-day post discharge mortality rates as well as reduced length of stay. These results require confirmation in rigorously designed prospective studies.

KW - in-hospital

KW - length of stay

KW - mortality

KW - 30 day mentality

U2 - 10.4997/JRCPE.2015.402

DO - 10.4997/JRCPE.2015.402

M3 - Journal article

VL - 45

SP - 261

EP - 267

JO - The Journal of the Royal College of Physicians of Edinburgh

JF - The Journal of the Royal College of Physicians of Edinburgh

SN - 1478-2715

IS - 4

ER -