Marcus Lyall 📈

Diabetes and Endocrinology/Internal Medicine consultant in Edinburgh. Healthcare innovation through data. #Rstats 📊, running, climate change. All views my own.

[Marcus Lyall 📈 @marcus_lyall]

@CalMac_Updates Hello. Are prebooked ardrossan - Brodick tickets next week valid for Troon- Brodick or do we need to rebook?

[Marcus Lyall 📈 @marcus_lyall]

@AnilMakam @RogueRad Fits perfectly with this! https://t.co/q0ZlfCfsT3

Experience matters. Short admissions and (almost certainly) fewer tests with no affect on readmission or death.

[Marcus Lyall 📈 @marcus_lyall]

@drfrasergibb Note improvement in TIR within a week of implementation in the treatment arm.

[Marcus Lyall 📈 @marcus_lyall]

@jfdwolff @Clin_Med @acutemedicine @djbeckett

[Marcus Lyall 📈 @marcus_lyall]

@kidneydoc101 @jfdwolff @Clin_Med @acutemedicine @SteveBarclay @RishiSunak Thanks Liz. I think what's remarkable is that this study actually needed done. It's a straightforward question affecting many 10s of thousands of patients a week. There is a woeful lack of research interest in multimorbid unscheduled medical care.

[Marcus Lyall 📈 @marcus_lyall]

@Marktheliverdoc @drphiliplee1 As time goes on I wonder if consultants are just less interested in asking an -ology!!!

Duration of consultant experience and patient outcome following acute medical unit admission: an observational cohort study https://t.co/q0ZlfCfsT3

[Marcus Lyall 📈 @marcus_lyall]

@pash22 @ICULone Hopefully a positive message about the importance of investing in careers and retention of said consultants.

[Marcus Lyall 📈 @marcus_lyall]

@drol007 @PCRScommittee @nicolagwhite I used #finalfit in R. Accept no substitute! Referenced appropriately @ewenharrison

[Marcus Lyall 📈 @marcus_lyall]

@Archiejcoulter @jfdwolff @Clin_Med @acutemedicine Great question. Raised by a few people in the study. Sadly impossible to separate date of CCT from generation as they are pretty much the same thing. Await the follow up study in due course!!!!

[Nick Scriven @nickscr1]

Conclusions- Increasing consultant physician experience associates with early safe discharge after AMU admission. These data suggest that the support and retention of experienced clinicians is vital if escalating pressures on unscheduled medical care are to be addressed

[Marcus Lyall 📈 @marcus_lyall]

@Trisha_the_doc @jfdwolff You will not have been included as an admitting consultant nowever I've no doubt you'd be responsible for some positive outcomes!!

[Marcus Lyall 📈 @marcus_lyall]

@jfdwolff @Cooper00Nicola @dr_shibley @Clin_Med @acutemedicine Agree. Of course there is massive individual variation, however this study is analysed at the level of the patient, controlled for a plethora of relevant variables and grouped by consultant. There are no more thorough analyses that I am aware of in the AMU model.

[Jacob de Wolff 🇳🇱🚲☕️ @jfdwolff]

Experienced consultants discharge more patients from the Acute Medical Unit without increasing harm. Interesting Scottish study in @Clin_Med. More power to @acutemedicine. https://t.co/e2Gtv7bqSr

[Marcus Lyall 📈 @marcus_lyall]

@jfdwolff @Clin_Med @acutemedicine Delighted this is getting some discussion. I'm afraid expertise is impossible to measure. The study was designed to analyse the effect of duration of post CCT practice.

[Marcus Lyall 📈 @marcus_lyall]

@whitworthce The weekend AMU shift is 3 days rathet than 2 so there is more time to effect discharge. This needed inclusion as some consultants do more weekends than others. I have done the NHSL 'weekend effect' on inpatient mortality which is a nascent manuscript. Happy to chat about that.

[Marcus Lyall 📈 @marcus_lyall]

https://t.co/q0ZlfCfsT3 New data analysing the importance of consultant retention in medicine. Bottom line = sustainable job plans, avoidance of burnout and retention of experienced clinicians is ESSENTIAL to address increasing demand in acute medical admissions. @BMA 1/3

[Ed James @whitefleece8127]

Valuable insight into the importance of retention in supporting flow throughout the system

[Marcus Lyall 📈 @marcus_lyall]

@RCPEdinTrainees @RCPEdin @lothianlmc

[Marcus Lyall 📈 @marcus_lyall]

This clearly demonstrates that maintaining experienced consultants within AMU model can improved flow, reduce A+E congestion and maintain DC safety. @goldstone_tony @BMAScotland @NHS_Lothian @hall_nhs @tegedinburgh @whitworthce @DanLasserson @acutemedicine @AndrewElder