> I suggest who has the least 4 hr breeches while they the
> on-duty/on-call consultant !!!!!
>
A possible one. A similar one might be mortality of patients admitted on the on call day of each consultant. Either of these work only if there is a random element to it: most departments will find some days of the week regularly have a higher patient: staff ratio than others (but not high enough in any given hour that it can usefully be addressed by shifting staff around). I'd also expect mortality to differ significantly between patients admitted on a Sunday, Monday and Wednesday (not sure how it differs, but I'm pretty sure there's a difference in there).
Be aware that once an indicator becomes a bench mark it ceases to function as an indicator.
The other issue I have is that I'm not sure that a league table really works in an individual department. Leagues tend to be good at comparing the performance of different competing teams. This makes them singularly poor at fostering cooperative work within a team.
Matt Dunn
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