Hospitals and the Weekend Effect

The weekend effect is a recognized phenomenon in the medical world.  You and I aren’t the only people who like to have some time off on the weekends.  So do doctors and nurses and the many other workers who are necessary to make modern hospitals run.  Oftentimes, it is the most senior, most experienced doctors, nurses and employees who get the time off.  Guess who that leaves minding the store on the weekend?

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Hospitals address this problem by slowing down on the weekends.  Generally speaking, elective procedures or admissions will not be scheduled for the weekend.  Urgent or emergency procedures or admissions have their own schedules and account for most of the weekend admissions at hospitals.  All of this has implications for you as a potential hospital patient.

First lesson to be learned from this is avoid being in the hospital on the weekend, if at all possible.  Holiday weekends are the worst in terms of the care received.  Weekend patients are likely to find lower staffing levels everywhere in the hospital.  Fewer scheduled patients means the hospital doesn’t need as many people there to care for them.  More staff may be in an on call situation, ready to come to the hospital, if called.  All this means that patients may not get the care they need as quickly as during the week when the full staff is present and ready to go.  The Weekend Effect has been linked to a higher risk of death, a higher rate of infection and higher rates of significant bleeding.

In one study the Weekend Effect was examined in the context of pediatric surgery.  The researchers found that children undergoing surgical procedures on the weekend had a higher risk of death, of requiring a transfusion and of other procedural complications than children undergoing the same procedures during the week.

The second lesson is that, whenever possible, get your procedure or admission scheduled earlier in the week.  This will reduce the chance that you will find yourself still in the hospital on the weekend.  It also means that you arrive before the hospital gets filled up with patients.  The hospital gets filled up because it also wants its patients out the door before the weekend so it doesn’t have to keep so many people on duty caring for them.  The middle of the week is therefore the busiest time at most hospitals.  This has often been described as hospital gridlock when the services are overtaxed.  The busiest time is when things can go wrong as doctors and nurses have many demands on their time and tests and studies take a long time to accomplish.  A study also found increased mortality when patient turnover was high with transfers, admissions and discharges, presumably because these events took the nurses away from their duties caring for their patients.

We can’t control our need for urgent or emergent medical care but we can control when we go to the hospital for elective procedures.  When planning an elective procedure, select your doctor wisely using some of the guidelines I have discussed in other posts and try to get your procedure scheduled for Tuesday (best) or Monday.

Posted in Doctors, health, Hospital Negligence, Hospitals, Infection, medical errors, Nurses |