Main Article Content
The Francis Inquiry report (2013) states that hospitals should review and reinstate identification of a named consultant and nurse (recommendation 236). This reiterates emphasis of the report on accountability and communication.
The audit assessed the number of patients able to correctly name the consultant and nurse responsible for their care, to ensure that clinical practice is in line with the standards outlined in the Francis inquiry report.
Materials and Methods
45 patients were included in the baseline audit, through use of a questionnaire. Thereafter, Plan Do Study Act (PDSA) cycle 1 was introduced, educating junior doctors. They were responsible for verbally informing patients who their named consultant was, and ensuring accurate head-board information. A subsequent re-audit using the same questionnaire included 32 patients.
Only 44% of patients could correctly name their consultant at baseline, increasing to 56% after PDSA1. Of the emergency patients included, 0% could name their consultant at baseline, increasing to 25% after PDSA1. 60% of elective patients could name their consultant at baseline, increasing to 88% after PDSA1. 40% of headboards were correct at baseline, increasing to 56% after PDSA1. There was a strong correlation between correct headboard information and the ability to name the responsible consultant.
Significant improvements were made with the introduction of PDSA1, but the hospital is still significantly underperforming in line with recommendation 236. PDSA2 will utilise a top-down management approach, with the consultant surgeons driving the change, to improve motivation amongst junior doctors. PDSA3 will introduce an ‘admission card’ given to all patients, stating their named consultant and nurse.