“Weekend Effect” –From the Other Side of the Bed

Many times when I’m working at the hospital on a weekend I’ve wondered how long hospitals can continue to offer fewer services during weekends than during the work week.  Usually if I’m there, I don’t want to hear that something has to wait until Monday.  It also puts me in the uncomfortable position of deciding whether something is urgent enough that on-call staff (eg. radiology, anesthesiology) need to be called in.  At the same time, some services in the hospital, for example, interventional radiology may have only one or two people who are qualified and it is unrealistic to expect them to be available 24/7/365.

A recent commentary (Klass P, NEJM 2015; 372: 402-405) helps provide a family’s perspective regarding this situation. Here are some of the key points:

  • “It can be shocking to hear, over and over, about the ways that weekends are slower and things don’t get done.”
  • Often many services are absent like physical therapy and psychiatry.  Most other services are understaffed and “cross-covering” patients with less familiarity.
  • For many conditions, morbidity and mortality are higher on weekends. (J Pediart Surg 2014; 49: 1087-91, NEJM 2001; 345: 1580, JAMA 2008; 299: 785-92))
  • “When you’re sick and scared, Sunday is the same as Tuesday.”

Bottomline: This commentary makes a strong case for saying “the hospital is not actually about patients. It’s about doctors and nurses, physical therapists and nutritionists.”

Question: Do you think weekend staffing should change or will change to address these shortcomings?

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2 thoughts on ““Weekend Effect” –From the Other Side of the Bed

  1. I don’t think weekend staffing/services is dictated by any member of clinical care team. Generally speaking, it appears to be a financial driven decision by administration. Maybe if more “patient satisfaction” surveys said “I want my PT on the weekend too!” administration would respond.

  2. Pingback: The Indispensable Physician | gutsandgrowth

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