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Beating the weekend trend: increased mortality in older adult traumatic brain injury (TBI) patients admitted on weekends.
Schneider EB, Hirani SA, Hambridge HL, et al. J Surg Res. 2012;177:295-300.
Being admitted to the hospital on a weekend is potentially dangerous, as studies have shown that preventable complications and mortality are increased across a range of common diagnoses for weekend admissions compared with weekdays. One exception appears to be trauma, as a prior study found equal outcomes in patients with traumatic injuries regardless of the day of admission, a finding ascribed to the protocolized and closely supervised nature of trauma care. However, this study of older adults admitted with traumatic brain injury did find increased mortality for those patients admitted on the weekend, despite the fact that patients admitted on the weekend were less severely injured. A limitation of this study is that the authors were not able to analyze outcomes for patients cared for at specialized trauma centers. Nevertheless, the study adds to the considerable body of research documenting the dangers of weekend hospital admission.
Journal Article > Study
The association between a prolonged stay in the emergency department and adverse events in older patients admitted to hospital: a retrospective cohort study.
Ackroyd-Stolarz S, Read Guernsey J, Mackinnon NJ, Kovacs G. BMJ Qual Saf. 2011;20:564-569.
Overcrowding in emergency departments (ED) gained significant attention after publication of a seminal Institute of Medicine report in 2006. Since that time, studies illustrating the nature of unintended events, the role of teamwork training, and provider perception of safety risks have further highlighted opportunities for ED error prevention. This study discovered that prolonged ED stays in older patients were associated with increased inpatient adverse events, as well as longer hospital stays. The authors discuss the domino effect of these findings as patients with prolonged inpatient stays reduce bed availability and increase ED stay and overcrowding. A past AHRQ WebM&M commentary discussed a near miss medication error in a busy ED.