Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays
Published: 08 January 2018
Author(s) Bion J, Aldridge C, Girling A, Rudge G, Beet C, HiSLAC Collaboration
The mortality associated with weekend admission to hospital (the ‘weekend effect’) has for many years been attributed to deficiencies in quality of hospital care, often assumed to be due to suboptimal senior medical staffing at weekends. This protocol describes a case note review to determine whether there are differences in care quality for emergency admissions (EAs) to hospital at weekends compared with weekdays, and whether the difference has reduced over time as health policies have changed to promote 7-day services.
A protocol for a team-based ethnography of weekend care for medical patients in acute hospital settings
Published: 15 March 2017
Author(s) Tarrant C, Sutton E, Angell E, Aldridge C, Boyal A, Bion J, HiSLAC Collaboration
It is now well-recognised that patients admitted to hospital at weekends are at higher risk of death than those admitted during weekdays. However, the cause(s) of this ‘weekend effect’ are poorly understood. Some contend that there is a deficit of medical staff at weekends resulting in poorer quality care, while others find that patients admitted to hospital at weekends are sicker and therefore at higher risk of adverse outcomes. Clarifying the causal pathway is clearly important in order to identify effective solutions. In this article we describe an ethnographic approach to evaluating the organisation and delivery of medical care at weekends compared with weekdays, with a specific focus on the role of medical staff as part of NHS England’s plan to implement seven-day services.
The magnitude and mechanisms of the weekend effect in hospital admissions: A protocol for a mixed methods review incorporating a systematic review and framework synthesis
Published: 23 May 2016
Author(s) Chen, Boyal et al; HiSLAC Collaboration
Growing literature has demonstrated that patients admitted to hospital during weekends tend to have less favourable outcomes, including increased mortality, compared with similar patients admitted during weekdays. Major policy interventions such as the 7-day services programme in the UK NHS have been initiated to reduce this weekend effect, although the mechanisms behind the effect are unclear. Here, we propose a mixed methods review to systematically examine the literature surrounding the magnitude and mechanisms of the weekend effect.