More weekend admits can ease overcrowding

Scheduling more patients for mid-week and weekend admissions can help hospitals avoid crowded conditions and the care problems overcrowding causes, according to a study in this month's Journal of Hospital Medicine.

The study of 39 children's hospitals investigated the concept of "smoothing," or deliberately scheduling pre-planned admissions for lower occupancy times of the week. It may sound like an obvious solution, but it's not one that hospitals often attempt, according to a statement from the study's authors, released yesterday.

"Children's hospitals have substantial unused capacity that could be used to smooth occupancy," Evan Fieldston, study leader and pediatric researcher at The Children's Hospital of Philadelphia, said in the statement. "The concept is to proactively control the entry of patients, to achieve more even levels of occupancy instead of peaks and troughs."

The first area hospitals should target smoothing are the up to 30 percent of admissions that are planned weeks or months in advance, researchers say. Most of that 30 percent are scheduled for weekdays, with only 12 percent of admissions scheduled for weekends, researchers found. Moving just seven patients per week to weekends or slower admit days is all it would take to reduce average weekday occupancy levels by 6 percent.

The smoothing concept could have a profound effect on hospital practice and culture, researchers posit, encouraging facilities to provide the same level of care seven days a week, rather than five, notes ScienceDaily. Recent studies have clearly shown mortality and injury rates increase on the weekends.

To learn more:
- here's the study abstract
- read the Childrens' Hospital of Philadelphia press release
- check out the Medscape coverage
- get more detail from ScienceDaily

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