When it comes to dangerous operations and surgeries, patients rightly expect the best of care – the stakes are simply too high otherwise. In reality though, there are many factors that can affect the quality of the healthcare – even within the same institute. Things like available staff, the number of patients, and general hospital resource fluctuations are all things that vary all the time. A patient could get quite a different level of care one month compared to another.
However, when it comes to individual surgeries – when the surgeons are there to perform them – we might expect that the risks are not higher or the level of care lower depending on when we attend the operation. Unfortunately, this is not the case. Furthermore, even with the number of variables considerably fewer, certain factors have been seen to make the quality of the operations, at one institution and always by a qualified professional, vary with time.
Of the most notable examples of these has been the so-called “weekend effect”, which seems to show that hospital capability for all manner of operations and treatments can be lessened if the patient is admitted on the weekend.
The Weekend Effect
A number of researchers have asserted that when a patient is coming in for an operation or into ER at the weekend, they are more likely to suffer a range of negative outcomes. One of them, unfortunately, is indeed death. But what is causing this? What changes at the weekend?
As it happens, the evidence is not conclusive, and we cannot point to exact reasons. Nevertheless, a number of factors have been suggested that seem almost certain to play a role in poorer healthcare for serious conditions being available at the weekend. These can be broadly divided into two distinct categories – hospital organizational factors and patient factors.
The healthcare jobs market is currently seen as a strong job seekers market, meaning that there is a dearth of talent relative to positions available. Health Jobs Nationwide, an online healthcare jobs board service offering nurse practitioner jobs, among others, say that this has two major effects on hospital staffing. The first is lowering of standards for admission to roles and the second being a high turnover of staff at certain institutions. This means staff can be tight – and tighter at the weekends.
Some of the further effects of this situation include an increased waiting times for patients and substandard care, in rare instances. This seems sure to be playing a role.
There is also the issue of the most experienced and professional surgeons and doctors having reached a point in their career where they can take weekends off, leaving more junior staff on the ward. Nonetheless, there is no cause for massive alarmism here – these staff should still be fully trained, educated, and adequately experienced.
There are also factors relating to the patients themselves. At the weekend – a time of increased leisure tied in with a need to be “fit to work” – individuals might wait longer before approaching healthcare institutions if they are ill or injured, thereby worsening their condition. There is also the matter of overcrowding and the increased numbers of admissions related to weekend activities, often involving alcohol.
In whichever was these factors are the ultimate cause of the weekend effect, it’s clear that it does exist. It is a relatively small but discernable drop in the ability of hospitals to treat patients effectively. So, as long it exists, there will surely be initiatives set up to deal with it. And investigating what may be causing it is surely the first step to solving the problem.