Abstract
Consultants have considerable freedom and power to improve the quality and safety of clinical care within their services. Whatever happens to healthcare in the future, patients acutely unwell with critical illnesses will be taken to hospital. The priority work of acute hospitals will always be to treat these patients with high-quality effective clinical care to swiftly and safely restore their health so that they can resume living outside hospital. For a small proportion of patients the work is to anticipate and provide for a calm end of life. Integral to this work is also the training of the next generation of healthcare professionals. Over the last five years I have been working to improve quality and safety at the point of care in acute general medicine. I discuss some of the successes and hope to open the reader's eyes to the potential for improvement in acute care processes, if clinicians and managers work together to optimize working at the point of care.
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