G193(P) Senior doctors improve efficiency – a postnatal ward experience

Aims In September 2014 a new neonatal speciality doctor role was created in a busy central London teaching hospital. The remit was to enhance patient and parent experience on post natal ward. Timely and expert senior review of infants with any extra care needs were prioritised. It was anticipated that this might result in earlier intervention where needed and facilitate earlier discharge in well infants. Post natal reviews were previously managed by junior peadiatric trainee doctors. Babies who are screened and treated in view of a risk for sepsis and are on IV antibiotics form the majority of the cohort who were deemed to require early review. We aimed to demonstrate that this post would improve family centred care with a reduced length of hospital stay resulting in cost saving for the trust. Methods A database was created with contemporaneous recording of septic screens, number of antibiotic doses, length of stay and sepsis related readmissions. Two years of activity were recorded, one pre and one post the specialty doctor appointment. Results During the 2 year study period, of 10,768 live born infants, 1,425 babies were screened and treated for risks for sepsis and received IV antibiotics in the postnatal ward. Each day of a postnatal ward stay without consumables costs £365.31. Results are shown in the table below: There were no sepsis related readmissions. Conclusion A significant reduction in antibiotic doses and IV antibiotic related length of stay was observed with an estimated cost saving of £270,000 pa. The presence of an experienced clinician on postnatal ward appears cost effective and beneficial for the patient experience.