Patient safety on weekends and weekdays: A comparative study of two hospitals in California

Abstract

Background: Most clinicians believe that hospitals are less safe on the weekends, but the research findings have been mixed. In addition, the investigations have largely examined the outcomes of patients admitted on weekends versus weekdays and not patient harm that occurred on weekends against patient harm that occurred during the week.

Objective: To compare the extent of patient harm that occurred on weekend days with the harm that occurred on weekdays.

Methods: Using daily incident report data for an entire year from two hospitals in California we measured the number of incidents each day, the average harm per incident, and the total daily harm from all incidents. Analyses were done separately for the two different hospitals and controlled for daily patient census. Harm per incident was assessed to determine whether reporting patterns on weekdays differed from weekends.

Results: There were fewer incidents per day and less total daily harm on weekend days than days during the workweek in both hospitals (p < .05). Patient to nurse ratios are held at the same level across all days and shifts. There did not appear to be a systematic tendency to under-report incidents on the weekends.

Conclusion: The data strongly suggest that there is less harm to patients due to healthcare error on the weekends than during the week. Further work is needed to determine whether these findings would apply in hospitals with varying staffing levels.