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.

Weekend specialist intensity and admission mortality in acute hospital Trusts in England: a cross-sectional study

Published: 11 May 2016
Author(s) Aldridge, Bion et al; HiSLAC Collaboration

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