A Three-Step System to Ensure Correct Attribution of Named Clinicians for Inpatients

Abstract

Background: The Francis report recommends that all patients admitted into a UK hospital must have a named identifiable and suitably trained consultant or clinician in charge of their care. This is regarded as a shared responsibility as highlighted by the recommendations made by the General Medical Council Best Practice guidance. However, this can become more error-prone, particularly in acute trauma and orthopaedic inpatients when the named consultant may change numerous times.

Methods: We conducted an audit reviewing all the inpatients in the acute trauma and orthopaedic wards and then reaudited twice following the introduction of the three-step system. The results were then analysed and compared with previous cycle results.

Results: Initially following the introduction of the three-step system, there were poorer outcomes. Inpatients with the correct named consultant declined from 47% to 37%. However, following further education and training of each respective member of the multidisciplinary roles, the results were much improved with 88.9% of the inpatients having the correct named consultant.

Conclusions: Ensuring that all inpatients have the correct named consultant is a shared responsibility amongst all health and social care staff involved with the patient. This audit highlights that attributing specific roles to relevant members of the multidisciplinary team can improve communications and patient care.

Keywords: communication; named consultant; quality improvement; responsible clinician; trauma and orthopaedics.

Figure 1. Trend of Audit Results