Observational studyJournal of general internal medicine2015
Impact of an Intervention to Improve Weekend Hospital Care at an Academic Medical Center: An Observational Study.
Observational study in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Machine learning-based predictions of healthcare contacts following emergency hospitalisation using electronic health records.NPJ digital medicine · 2025Article
- Systemic solutions to emergency department boarding: the hospitalist's perspective on the need for broader alignment and collaboration.Health affairs scholar · 2025Article
- Clinical Decision Support Leveraging Health Information Exchange Improves Concordance with Patients' Resuscitation Orders and End-of-Life Wishes.Applied clinical informatics · 2025Article
- Article
- Reducing Weekend Hospital Discharge Delays Without Seven-Day Coverage by Leveraging Thursday and Friday Planning.Cureus · 2025Review
- Gastrojejunostomy junction perforation resulting from Dobhoff tube insertion in a patient with a history of Roux-en-Y surgery: a case report.Journal of medical case reports · 2024Article
- Article
- Observational
- Exploring the Ramifications of Delayed Hospital Discharges: Impacts on Patients, Physicians, and Healthcare Systems.Cureus · 2024Review
- Clinical Outcomes according to Timing to Non Invasive Ventilation Initiation in COPD Patients with Acute Respiratory Failure: A Retrospective Cohort Study.Journal of clinical medicine · 2023Article
- COVID-19 deaths on weekends.BMC public health · 2023Article
- Initiatives for improving delayed discharge from a hospital setting: a scoping review.BMJ open · 2021Article
- Comparisons of Clinical Outcomes between Weekday-Only and Full-Time, 24-Hour/7-Day Coverage Hospitalist Systems.Journal of Korean medical science · 2020Article
- Seven-day services in surgery and the "weekend effect" at a Japanese teaching hospital: a retrospective cohort study.Patient safety in surgery · 2020Article
- Quality and safety of in-hospital care for acute medical patients at weekends: a qualitative study.BMC health services research · 2018Article
- Effect of Hospital Readmission Reduction on Patients at Low, Medium, and High Risk of Readmission in the Medicare Population.Journal of hospital medicine · 2018Article
- Impact of an emergency department electronic sepsis surveillance system on patient mortality and length of stay.Journal of the American Medical Informatics Association : JAMIA · 2018Article
- Multi- and univariate analyses of the weekend effect for elective lower-limb joint replacements.Annals of the Royal College of Surgeons of England · 2018Article
- Association Between Elements of Electronic Health Record Systems and the Weekend Effect in Urgent General Surgery.JAMA surgery · 2017Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundHospital care on weekends has been associated with delays in care, reduced quality, and poor clinical outcomes.
objectiveThe purpose of this study was to evaluate the impact of a weekend hospital intervention on processes of care and clinical outcomes. The multifaceted intervention included expanded weekend diagnostic services, improved weekend discharge processes, and increased physician and care management services on weekends. DESIGN AND PATIENTS: This was an interrupted time series observational study of adult non-obstetric patients hospitalized at a single academic medical center between January 2011 and January 2014. The study included 18 months prior to and 19 months following the implementation of the intervention. Data were analyzed using segmented regression analysis with adjustment for confounders. MAIN MEASURES: The primary outcome was average length of stay. Secondary outcomes included percent of patients discharged on weekends, 30-day readmission rate, and in-hospital mortality rate. KEY
resultsThe study included 57,163 hospitalizations. Following implementation of the intervention, average length of stay decreased by 13 % (95 % CI 10-15 %) and continued to decrease by 1 % (95 % CI 1-2 %) per month as compared to the underlying time trend. The proportion of weekend discharges increased by 12 % (95 % CI 2-22 %) at the time of the intervention and continued to increase by 2 % (95 % CI 1-3 %) per month thereafter. The intervention had no impact on readmissions or mortality. During the post-implementation period, the hospital was evacuated and closed for 2 months due to damage from Hurricane Sandy, and a new hospital-wide electronic health record was introduced. The contributions of these events to our findings are not known. We observed a lower inpatient census and found differences in patient characteristics, including higher rates of Medicaid insurance and comorbidities, in the post-Hurricane Sandy period as compared to the pre-Sandy period.
conclusionsThe intervention was associated with a reduction in length of stay and an increase in weekend discharges. Our longitudinal study also illuminated the challenges of evaluating the effectiveness of a large-scale intervention in a real-world hospital setting.
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