ArticleBMJ quality & safety2021
Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the 7-day services national health policy.
Article in BMJ quality & safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- A scoping review of work patterns of junior medical officer tasks in hospital out of hours.Internal medicine journal · 2025Article
- Temporal structures that determine consistency and quality of care: a case study in hyperacute stroke services.BMJ quality & safety · 2024Article
- Article
- The dose-response effect of time between emergency admission and inpatient care on mortality.Scientific reports · 2023Article
- Factors influencing patients' experience of communication with the medical team of the emergency department.Internal and emergency medicine · 2023Article
- Investigating Weekend Effect in the Management of Upper and Lower Extremity Degloving Injuries.Plastic and reconstructive surgery. Global open · 2023Article
- Mortality and readmission differences associated with after-hours hospital admission: A population-based cohort study in Queensland Australia.Health science reports · 2023Article
- Healthcare-associated adverse events and readmission to the emergency departments within seven days after a first consultation.Frontiers in public health · 2023Article
- Daylight saving time affects European mortality patterns.Nature communications · 2022Article
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2013, the English National Health Service launched the policy of 7-day services to improve care quality and outcomes for weekend emergency admissions.
aimsTo determine whether the quality of care of emergency medical admissions is worse at weekends, and whether this has changed during implementation of 7-day services.
methodsUsing data from 20 acute hospital Trusts in England, we performed randomly selected structured case record reviews of patients admitted to hospital as emergencies at weekends and on weekdays between financial years 2012-2013 and 2016-2017. Senior doctor ('specialist') involvement was determined from annual point prevalence surveys. The primary outcome was the rate of clinical errors. Secondary outcomes included error-related adverse event rates, global quality of care and four indicators of good practice.
resultsSeventy-nine clinical reviewers reviewed 4000 admissions, 800 in duplicate. Errors, adverse events and care quality were not significantly different between weekend and weekday admissions, but all improved significantly between epochs, particularly errors most likely influenced by doctors (clinical assessment, diagnosis, treatment, prescribing and communication): error rate OR 0.78; 95% CI 0.70 to 0.87; adverse event OR 0.48, 95% CI 0.33 to 0.69; care quality OR 0.78, 95% CI 0.70 to 0.87; all adjusted for age, sex and ethnicity. Postadmission in-hospital care processes improved between epochs and were better for weekend admissions (vital signs with National Early Warning Score and timely specialist review). Preadmission processes in the community were suboptimal at weekends and deteriorated between epochs (fewer family doctor referrals, more patients with chronic disease or palliative care designation). CONCLUSIONS AND IMPLICATIONS: Hospital care quality of emergency medical admissions is not worse at weekends and has improved during implementation of the 7-day services policy. Causal pathways for the weekend effect may extend into the prehospital setting.
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