Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the seven day services national health policy.

Research output: Contribution to journalArticlepeer-review

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Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the seven day services national health policy. / Bion, Julian; Aldridge, Cassie; Girling, Alan; Rudge, Gavin; Sun, Jianxia; Tarrant, Carolyn; Sutton, Liz ; Willars, Janet ; Beet, Chris; Boyal, Amunpreet; Rees, Peter; Roseveare, Chris; Temple, Mark; Watson, Samuel; Chen, Yen-fu; Clancy, Mike; Rowan, Louise; Lord, Joanne; Mannion, Russell; Hofer, Timothy; Lilford, Richard.

In: BMJ Quality & Safety, 11.10.2020.

Research output: Contribution to journalArticlepeer-review

Harvard

Bion, J, Aldridge, C, Girling, A, Rudge, G, Sun, J, Tarrant, C, Sutton, L, Willars, J, Beet, C, Boyal, A, Rees, P, Roseveare, C, Temple, M, Watson, S, Chen, Y, Clancy, M, Rowan, L, Lord, J, Mannion, R, Hofer, T & Lilford, R 2020, 'Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the seven day services national health policy.', BMJ Quality & Safety.

APA

Bion, J., Aldridge, C., Girling, A., Rudge, G., Sun, J., Tarrant, C., Sutton, L., Willars, J., Beet, C., Boyal, A., Rees, P., Roseveare, C., Temple, M., Watson, S., Chen, Y., Clancy, M., Rowan, L., Lord, J., Mannion, R., ... Lilford, R. (Accepted/In press). Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the seven day services national health policy. BMJ Quality & Safety.

Vancouver

Author

Bion, Julian ; Aldridge, Cassie ; Girling, Alan ; Rudge, Gavin ; Sun, Jianxia ; Tarrant, Carolyn ; Sutton, Liz ; Willars, Janet ; Beet, Chris ; Boyal, Amunpreet ; Rees, Peter ; Roseveare, Chris ; Temple, Mark ; Watson, Samuel ; Chen, Yen-fu ; Clancy, Mike ; Rowan, Louise ; Lord, Joanne ; Mannion, Russell ; Hofer, Timothy ; Lilford, Richard. / Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the seven day services national health policy. In: BMJ Quality & Safety. 2020.

Bibtex

@article{d61b9e69de2c4db0be20bc9e03bfcad6,
title = "Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the seven day services national health policy.",
abstract = "Background: In 2013 the English National Health Service launched the policy of seven day services to improve care quality and outcomes for weekend emergency admissions. Aims: To determine whether the quality of care of emergency medical admissions is worse at weekends, and whether this has changed during implementation of seven day services. Methods: Using data from 20 acute hospital Trusts in England, we performed randomly selected structured case record reviews of patients admitted to hospital as emergencies at weekends and on weekdays between financial years 2012-13 and 2016-17. Senior doctor ({\textquoteleft}specialist{\textquoteright}) involvement was determined from annual point prevalence surveys. The primary outcome was the rate of clinical errors. Secondary outcomes included error-related adverse event rates; global quality of care; and four indicators of good practice. Results: Seventy-nine clinical reviewers reviewed 4000 admissions, 800 in duplicate. Errors, adverse events and care quality were not significantly different between weekend and weekday admissions, but all improved significantly between epochs, particularly errors most likely influenced by doctors (clinical assessment, diagnosis, treatment, prescribing, and communication): error rate odds-ratio 0.78; CI 0.70-0.87; adverse event odds-ratio 0.48, CI 0.33-0.69; care quality odds-ratio 0.78. CI 0.70-0.87; all adjusted for age, sex and ethnicity. Post-admission in-hospital care processes improved between epochs and were better for weekend admissions (vital signs with National Early Warning Score, timely specialist review). Pre-admission processes in the community were suboptimal at weekends and deteriorated between epochs (fewer family doctor referrals, more patients with chronic disease or palliative care designation). Conclusions and Implications: Hospital care quality of emergency medical admissions is not worse at weekends, and has improved during implementation of the seven day services policy. Causal pathways for the weekend effect may extend into the pre-hospital setting.",
author = "Julian Bion and Cassie Aldridge and Alan Girling and Gavin Rudge and Jianxia Sun and Carolyn Tarrant and Liz Sutton and Janet Willars and Chris Beet and Amunpreet Boyal and Peter Rees and Chris Roseveare and Mark Temple and Samuel Watson and Yen-fu Chen and Mike Clancy and Louise Rowan and Joanne Lord and Russell Mannion and Timothy Hofer and Richard Lilford",
year = "2020",
month = oct,
day = "11",
language = "English",
journal = "BMJ Quality & Safety",
issn = "2044-5415",
publisher = "BMJ Publishing Group",

}

RIS

TY - JOUR

T1 - Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the seven day services national health policy.

AU - Bion, Julian

AU - Aldridge, Cassie

AU - Girling, Alan

AU - Rudge, Gavin

AU - Sun, Jianxia

AU - Tarrant, Carolyn

AU - Sutton, Liz

AU - Willars, Janet

AU - Beet, Chris

AU - Boyal, Amunpreet

AU - Rees, Peter

AU - Roseveare, Chris

AU - Temple, Mark

AU - Watson, Samuel

AU - Chen, Yen-fu

AU - Clancy, Mike

AU - Rowan, Louise

AU - Lord, Joanne

AU - Mannion, Russell

AU - Hofer, Timothy

AU - Lilford, Richard

PY - 2020/10/11

Y1 - 2020/10/11

N2 - Background: In 2013 the English National Health Service launched the policy of seven day services to improve care quality and outcomes for weekend emergency admissions. Aims: To determine whether the quality of care of emergency medical admissions is worse at weekends, and whether this has changed during implementation of seven day services. Methods: Using data from 20 acute hospital Trusts in England, we performed randomly selected structured case record reviews of patients admitted to hospital as emergencies at weekends and on weekdays between financial years 2012-13 and 2016-17. Senior doctor (‘specialist’) involvement was determined from annual point prevalence surveys. The primary outcome was the rate of clinical errors. Secondary outcomes included error-related adverse event rates; global quality of care; and four indicators of good practice. Results: Seventy-nine clinical reviewers reviewed 4000 admissions, 800 in duplicate. Errors, adverse events and care quality were not significantly different between weekend and weekday admissions, but all improved significantly between epochs, particularly errors most likely influenced by doctors (clinical assessment, diagnosis, treatment, prescribing, and communication): error rate odds-ratio 0.78; CI 0.70-0.87; adverse event odds-ratio 0.48, CI 0.33-0.69; care quality odds-ratio 0.78. CI 0.70-0.87; all adjusted for age, sex and ethnicity. Post-admission in-hospital care processes improved between epochs and were better for weekend admissions (vital signs with National Early Warning Score, timely specialist review). Pre-admission processes in the community were suboptimal at weekends and deteriorated between epochs (fewer family doctor referrals, more patients with chronic disease or palliative care designation). Conclusions and Implications: Hospital care quality of emergency medical admissions is not worse at weekends, and has improved during implementation of the seven day services policy. Causal pathways for the weekend effect may extend into the pre-hospital setting.

AB - Background: In 2013 the English National Health Service launched the policy of seven day services to improve care quality and outcomes for weekend emergency admissions. Aims: To determine whether the quality of care of emergency medical admissions is worse at weekends, and whether this has changed during implementation of seven day services. Methods: Using data from 20 acute hospital Trusts in England, we performed randomly selected structured case record reviews of patients admitted to hospital as emergencies at weekends and on weekdays between financial years 2012-13 and 2016-17. Senior doctor (‘specialist’) involvement was determined from annual point prevalence surveys. The primary outcome was the rate of clinical errors. Secondary outcomes included error-related adverse event rates; global quality of care; and four indicators of good practice. Results: Seventy-nine clinical reviewers reviewed 4000 admissions, 800 in duplicate. Errors, adverse events and care quality were not significantly different between weekend and weekday admissions, but all improved significantly between epochs, particularly errors most likely influenced by doctors (clinical assessment, diagnosis, treatment, prescribing, and communication): error rate odds-ratio 0.78; CI 0.70-0.87; adverse event odds-ratio 0.48, CI 0.33-0.69; care quality odds-ratio 0.78. CI 0.70-0.87; all adjusted for age, sex and ethnicity. Post-admission in-hospital care processes improved between epochs and were better for weekend admissions (vital signs with National Early Warning Score, timely specialist review). Pre-admission processes in the community were suboptimal at weekends and deteriorated between epochs (fewer family doctor referrals, more patients with chronic disease or palliative care designation). Conclusions and Implications: Hospital care quality of emergency medical admissions is not worse at weekends, and has improved during implementation of the seven day services policy. Causal pathways for the weekend effect may extend into the pre-hospital setting.

M3 - Article

JO - BMJ Quality & Safety

JF - BMJ Quality & Safety

SN - 2044-5415

ER -