Wednesday, April 22, 2015

Never mind, I'll wait till Monday

Lisa Rapaport at Reuters summarizes the findings of an intriguing BMJ article. The lede:

Patients admitted to the hospital on weekends are more likely to get a preventable illness or injury during their stay than people admitted during the week, a large U.S. study finds.

Even after adjusting for patient characteristics, including the severity of the condition that brought them to the hospital, weekend admission was still linked with more than a 20 percent increased likelihood of hospital-acquired conditions when compared to weekday admissions, lead author Dr. Frank Attenello, a researcher at the University of Southern California, said by email. 


Even though most admissions - 81 percent - were on weekdays, preventable complications were more common on weekends. Hospital-acquired conditions occurred in 5.7 percent of weekend admissions, compared to 3.7 percent in people admitted on weekdays.

"This increased hospital-acquired condition rate is significant because we found presence of at least one hospital-acquired condition to be associated with an 83 percent likelihood of increased healthcare cost and a 38 percent increase in the likelihood of a prolonged hospital stay," Attenello said. 

Those of us who are Lean adherents would likely conclude that this phenomenon is an indication of a lack of "standard work" in caring for patients during different times of the week.  Yes, staffing patterns differ, but a Lean organization would have noticed a difference in the quality of service offered (aka, defects) and would have acted to improve it.

Indeed, it would be fascinating to repeat the study and compare results between non-Lean and Lean hospitals to see if there were any difference.

The study also stimulated a BMJ editorial--"Patients need safer hospitals, every day of the week."   It's hard to argue with that.  The level of patient harm, worldwide, in hospitals remains unacceptably high--every day of the week.

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