Introduction
When taking a history from people who had been inpatients at other hospitals we were struck by how infrequently they knew the name of the consultant who had been responsible for their care. This is a poorly documented topic, and we decided to see if inpatients in our own hospital knew the name of their consultant. Queen Mary's is a district general hospital in Kent which does not have an acute admitting unit/ward. In an average 24-hour period there are 18 medical admissions. New patients are admitted directly to any one of eight medical wards depending on the specialty and on bed availability. Care of new patients is transferred to the ward-based medical team the following working day. At the time of our survey there were 10 general and elderly medicine physicians with inpatient beds, and it was hospital policy not to have the patient nor consultant name above the bed.
The study was undertaken to determine how frequently patients knew the name of the consultant responsible for their care, and if this was influenced by length of stay or by whether the patient had met their consultant.
Methods
Initial data were collected in September 2006. A proforma was devised to standardise questions. Lists of medical admissions were obtained daily over eight days from the on-call medical team and the Care
Records Service (information technology system). Data of patients who were still in hospital on the afternoon of day three of their admission, provided that at least two of the days had been normal working days, were collected. This was to ensure patients had had an opportunity to be seen on ward rounds by their new team.
A month later, four medical wards were surveyed and data collected from patients who had been on the ward for at least one week.
Patients were excluded if they were over 75 years and had an abbreviated mental test score (AMTS) of less than seven out of 10, or were under 75 years with a history of confusion or memory problems.
Results
Of 142 patients admitted over eight days in September 2006, 82 were still in hospital on day three of their admission. Of these 27 (33%) were excluded. Of the 55 included, 20 (36%) knew the name of their consultant.
When the survey of four medical wards was conducted one month later, of 108 possible patients, 67 (62%) were excluded as they had been an inpatient for less than one week, or had an AMTS of less than seven out of 10. Of the 41 included, 19 (46%) knew the name of their consultant.
Of the total 96 patients questioned, 77 (80%) had had a documented ward round with their new consultant. Of those that had met the physician on a ward round, 46% knew the name of their consultant, compared with 21% who had not met them (p=0.0125). Length of stay did not significantly affect whether patients knew the name of their consultant.
Discussion
The results of this ‘snapshot’ show that only a minority of hospital inpatients know the name of the consultant with overall responsibility for their care. Not surprisingly, patients were significantly more likely to know who their consultant was, if they had met them on a ward round. On ward rounds most physicians introduce themselves, but we all tend to forget names. It would seem sensible to have the consultant's name above the bed, but some trusts deem this paternalistic or a breach of confidentiality. We suggest that when doctors in training introduce themselves they should tell patients which consultant team is looking after them.