title: Expanding what we know about off-peak mortality in hospitals.
abstract: For more than 30 years, a negative "off-peak effect" on patient outcomes has been associated with weekend and/or nighttime hospitalization in more than 25 diagnostic groups. Descriptive studies have verified the presence of this off-peak effect on patient outcomes but have done little to explain its cause. Institutional ethnography is a promising method for describing challenges nurses encounter and deal with on off-peak shifts and for exploring how those challenges arose in institutions designed to avoid such outcomes. The authors discuss their research and suggest a number of steps that nurse administrators might take to enhance their knowledge for handling off-peak challenges in their hospitals.
authors.affiliation: Midwestern State University, Wichita Falls, Texas 76308, USA. patti.hamilton@mwsu.edu
authors.forename: Patti
authors.initials: P
authors.lastname: Hamilton
authors.forename: Sondip
authors.initials: S
authors.lastname: Mathur
authors.forename: Gretchen
authors.initials: G
authors.lastname: Gemeinhardt
authors.forename: Valerie
authors.initials: V
authors.lastname: Eschiti
authors.forename: Marie
authors.initials: M
authors.lastname: Campbell
mesh_terms: D039602:After-Hours Care; D003266:Continuity of Patient Care; D017052:Hospital Mortality; D006801:Humans; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D011787:Quality of Health Care; D014481:United States