Hospitals Can Improve Outcomes of Weekend Surgeries

A new study identifies five resources that can help hospitals overcome the “weekend effect,” wherein patients who undergo surgeries on weekends tend to experience longer hospital stays and higher mortality rates and readmissions.

Researchers at the Loyola University Health System (Chicago, IL, ISA) examined records of 126,666 patients at 117 Florida hospitals participating in a database program to test the hypothesis that boosting hospital resources before, during, and after surgery could overcome the weekend effect. They tested their hypothesis in patients undergoing three types of urgent procedures that could not be delayed: appendectomies, hernia repairs, and gall bladder removals. Of the 21 distinct hospital resources researchers examined, five were found to help overcome the weekend effect, after controlling for patient characteristics.

Hospitals with increased nurse-to-bed ratios were 1.44 times more likely to overcome the weekend effect; hospitals that fully adopted electronic medical records (EMRs) were 4.74 times more likely to overcome the weekend effect; hospitals with inpatient physical rehabilitation programs were 1.03 times more likely to overcome the weekend effect; hospitals with home health programs were 2.37 times more likely to overcome the weekend effect; and hospitals with pain management programs were 1.48 times more likely to overcome the weekend effect. The study was presented at the American Surgical Association meeting, held during April 2015 in San Diego (CA, USA).

“Large new databases, electronic medical records, and more powerful computers are enabling researchers to conduct such studies. We're now able to ask and answer a broad range of questions that could significantly help improve patient care and reduce costs,” said senior author Paul Kuo, MD, MS, MBA. “Specific hospital resources can overcome the weekend effect seen in urgent general surgery procedures.”

The so-called “weekend effect” on patient outcomes has been well documented in cases of heart attack, stroke, aneurism, and head trauma in many countries. Reasons for the effect are diverse, and include fewer experienced doctors and nurses working on weekends, reduced diagnostic and interventional services, and patients with less severe conditions delaying treatment during workdays.

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