Waiting for urgent procedures on the weekend among emergently hospitalized patients.
OBJECTIVE
Many hospital departments tend to have lower staffing levels on weekends. We evaluated the use of selected urgent procedures for emergently hospitalized patients and measured the time until procedure based upon the day of hospital admission.


METHODS
We analyzed all acute care admissions from all 190 emergency departments in Ontario, Canada, between 1988 and 1997. We selected patients (n = 126,754) who underwent one of six prespecified procedures as their most responsible procedure: fiberoptic bronchoscopy, esophageal gastroduodenoscopy, magnetic resonance imaging, echocardiography, ventilation-perfusion scanning, or coronary angiography. We noted each patient's day of procedure and day of hospital admission. For waits of less than 8 days, we analyzed the time to procedure based upon the day of admission.


RESULTS
Only 5% (n = 5903) of the urgent procedures were performed on the weekend. Of the six selected procedures, coronary angiography showed the most skewed pattern of performance (1.5% performed on the weekend) and esophageal gastroduodenoscopy showed the least skewed pattern (8% performed on the weekend). Patients admitted on Fridays or Saturdays had the longest waits for procedures. For all six procedures, patients with relatively longer waits had relatively longer total in-hospital stays (P <0.001 for each).


CONCLUSIONS
Relatively few urgent procedures are performed in emergently hospitalized patients on the weekend, suggesting that greater attention to weekend care might result in more timely interventions and shorter lengths of stay.
Department of Medicine, University of Toronto, Canada. bellc@smh.toronto.on.ca
Chaim M
CM
Bell
Donald A
DA
Redelmeier
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D002170:Canada; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D004384:Duodenoscopy; D019560:Echocardiography, Three-Dimensional; D004630:Emergencies; D004945:Esophagoscopy; D005260:Female; D005773:Gastroscopy; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D008505:Medical Staff, Hospital / Q000600:supply & distribution*; D008875:Middle Aged; D010561:Personnel Staffing and Scheduling; D013995:Time; D013997:Time Factors; D014692:Ventilation-Perfusion Ratio