@article {Goodacre51, author = {S Goodacre and S Mason and R Kersh and A Webster and N Samaniego and F Morris}, title = {Can additional experienced staff reduce emergency medical admissions?}, volume = {21}, number = {1}, pages = {51--53}, year = {2004}, doi = {10.1136/emj.2003.005876}, publisher = {British Association for Accident and Emergency Medicine}, abstract = {Background: 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 {\textquotedblleft}A\&E physician{\textquotedblright}, 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 {\textquotedblleft}A\&E physician present{\textquotedblright} or {\textquotedblleft}A\&E physician absent{\textquotedblright}. 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 were discharged home, apparently saving 1.4 admissions per day. However, randomised comparison showed that presence of the A\&E physician was associated with a reduction of only 0.7 medical admissions per day (95\% CI -1.7 to 3.2, p = 0.561), and an increase of 1.1 non-medical admissions (95\% CI -0.2 to 2.3, p = 0.09) and 0.3 transfers to other hospitals per day (95\% CI zero to 0.6, p = 0.09). Overall, hospital admissions were increased by 0.9 per day when the A\&E physician was present (95\% CI -1.8 to 3.6, p = 0.5). Conclusion: Despite receiving many referrals and discharging a substantial proportion of these patients home, the A\&E physician did not significantly change emergency medical admissions and may have increased admissions to other specialties.}, issn = {1472-0205}, URL = {https://emj.bmj.com/content/21/1/51}, eprint = {https://emj.bmj.com/content/21/1/51.full.pdf}, journal = {Emergency Medicine Journal} }