Can additional experienced staff reduce emergency medical admissions?
Accident and Emergency Department, Northern General Hospital, Sheffield, UK. s.goodacre@sheffield.ac.ukBACKGROUND: Increases in emergency medical admissions are placing a strain upon hospitals throughout the world. The aim of the study was to evaluate the effect of a new post, the “A&E physician”, upon emergency medical admissions to a hospital. METHODS: For six months the A&E physician workload was audited and a randomised controlled comparison undertaken. Days were randomised to “A&E physician present” or “A&E physician absent”. The A&E physician recorded details of all patients referred for medical admission, any intervention made, and their disposal from A&E. Routine hospital data compared the mean daily number of medical admissions, non-medical admissions, and referrals to other hospitals. RESULTS: 124 days were randomised: 59 to A&E physician present, 65 to A&E physician absent. The A&E physician received 581 referrals and intervened in the management of 142 (24%). Of these, 80 w
