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 wards has been designed. The number of discharges (NoDs) significantly increased (p≲λτ∀0.01), ALoS reduced (p≲λτ∀ 0.01), whereas, readmission rate and mortality remained unchanged (p∇NS) over 12 months following twice-daily WRs compared to twoother wards with twice-weekly WRs. This innovative modelresulted 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. © Royal College of Physicians, 2011. All rights reserved.