Curb Weekend Effect at Hospitals

Emerg pictureThank you, Mr. Blackwell, for highlighting the old-fashioned, bankers’ hours our hospitals still run on:

Curb ‘weekend effect’ at hospitals to make Saturday or Sunday admittance less risky for patients: study | National Post.

A fellow emergency physician commented:

“The bigger issue for weekends relates to non-MD staff.”

Surgeons want to operate, but there’s no staff to help out due to lack of staff or lack of money to pay staff.

Weekend Effect

Monday remains the busiest day, by far, in emergency departments across North America.

Acute care requires doctors AND nurses, not to mention an army of allied providers. We need to shift routine hospital business into weekend hours, or patients will continue to suffer for it.

Thanks, again, for writing about this!

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10 Commandments for Great Patient Flow

Follow these rules to improve patient flow, quality, and efficiency.  We made most of the list in a recent ED meeting, but it applies anywhere patients present.

1.  Add value for patients first, always, and without compromise.

2.  Never make patients wait unless it adds value for them.

3.  Triage means sorting, not primary nursing assessment (see 1 and 2 above).

4.  Time is Quality for most care.

5.   Nurses and physicians must pull in the same direction at the same speed: ED team = 2-horse chariot.

6.  Professionals must do what they do best: RNs do RN work, not clerical work.

7.  Remove or unload bottlenecks.

8.  Always design parallel processes, not sequential.

9.  Design for unlimited capacity; you cannot turn people away.

10.  Patients need humanity with every encounter, especially when ‘there’s nothing wrong’.

Do you have any to add?  Please share them in the comment section.  Thanks!

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Emergency doctors demand seven-day primary care support |

This headline comes from Britain (see the link at the bottom).

Many Canadians think they can stop “inappropriate visits” to emergency departments by educating the public.  They assume people need more information.

Patients need more access, not more information.

Until we design the system to offer great ways to access care that fits into patients’ lives, we will continue to have patients accessing emergency departments for concerns that could possibly be handled in private offices.

But, we can’t just demand longer office hours.  We need to support physicians in the community with acute lab and X-Ray support and attract physicians to work unsociable hours.  (We wouldn’t need to attract physicians to work unsociable hours if MDs had to compete for patients.)

Emergency doctors demand seven-day primary care support |


P.S.  If hospitals changed from their current Monday-Friday, 9-4:30 schedules to a 7 day/week approach, we would increase patient flow and patient access, too.

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