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First consultant review
Time to first consultant review was poorly recorded. Of the 439 sets of notes reviewed we were only able to extract this information in 40 cases. A consultant physician reviewed 23 of the 40 patients (58%) within 24 hours of admission to hospital. 28 of these 40 patients had a ward stay of greater than 24 hours prior to ICU admission (and therefore had a greater potential to be reviewed within 24 hours). A consultant physician reviewed 11 of these 28 patients (39%) within 24 hours of admission to hospital. The Federation of the Royal Colleges of Physicians of the UK recommend that 90% of acute admissions should be reviewed by a consultant within 24 hours 9, and the recommendations contained in Acute medicine: making it work for patients states that all patients should be reviewed by a consultant within 24 hours 8. From the limited data available it appears that care is not reaching this standard, although caution should be exercised due to the large number of casenotes not amenable to study due to poor record keeping.
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