5 ways hospitals can beat the 'weekend effect' in surgical outcomes

Hospitals can take five actions to fight the higher rate of complications, mortalities and readmissions for surgical patients who undergo emergency procedures on the weekend, also known as the "weekend effect," according to a Loyola University Medical Center and Loyola University Chicago study.

A July report found that patients admitted on Saturday and Sundays throughout the developed world are more likely to die within 30 days than patients admitted on a weekday.

That study found that "(t)he chance of death was 8 percent higher in 11 hospitals in England, 13 percent greater in five hospitals in the United States and 20 percent more likely in six Dutch hospitals."

The Loyola study authors hypothesized that boosting hospital resources before, during and after surgery would reduce the length of patient stays, as well as the risk of death and costly readmissions. 

The researchers examined data on 126,666 patients at 166 Florida hospitals from 2007 to 2011. The study zeroed in on 17 hospitals that were able to beat the weekend effect, studying 21 separate hospital resources and analyzing how these factors worked together to improve outcomes.

Five factors played a particularly key role:

  • A lower number of beds per nurse: Hospitals that focus on improved staffing ratios were "1.44 times more likely to overcome the weekend effect."
  • An integrated home health care program: The weekend effect was less pronounced at institutions that provide patients with home visits by skilled home healthcare workers who help with wound care and the administration of medications.
  • Fully electronic medical records systems: These help healthcare providers avoid medical errors and redundant care. Hospitals with electronic records were 4.74 times more likely to beat the weekend effect.
  • Inpatient physical rehabilitation programs: These programs help healthcare providers determine who will need additional help at home, such as patients with a risk of falls.
  • Programs for pain management: "Seventy percent of hospitals that overcame the weekend effect had pain management programs, compared with 49.3 percent of hospitals that had persistent weekend effects."

The Loyola researchers published their findings in the October, 2015 edition of the journal Annals of Surgery.

The study's senior author Paul Kuo, M.D., said in the announcement that the improved staffing ratios, inpatient and aftercare resources "can play an important role in ensuring patients are not disadvantaged by being admitted to the hospital on the weekend."

To learn more: 
- read the Loyola study announcement 
- here's the study abstract

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