Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays

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Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays. / Bion, Julian; Aldridge, Cassie P.; Girling, Alan; Rudge, Gavin; Beet, Chris; Evans, Tim; Temple, R. Mark; Roseveare, Chris; Clancy, Mike; Boyal, Amunpreet; Tarrant, Carolyn; Sutton, Elizabeth; Sun, Jianxia; Rees, Peter; Mannion, Russell; Chen, Yen-Fu; Watson, Samuel Ian; Lilford, Richard.

In: BMJ open, Vol. 7, No. 12, e018747, 22.12.2017.

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Bion, Julian ; Aldridge, Cassie P. ; Girling, Alan ; Rudge, Gavin ; Beet, Chris ; Evans, Tim ; Temple, R. Mark ; Roseveare, Chris ; Clancy, Mike ; Boyal, Amunpreet ; Tarrant, Carolyn ; Sutton, Elizabeth ; Sun, Jianxia ; Rees, Peter ; Mannion, Russell ; Chen, Yen-Fu ; Watson, Samuel Ian ; Lilford, Richard. / Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays. In: BMJ open. 2017 ; Vol. 7, No. 12.

Bibtex

@article{78a466765a7e4c35ab16fb8496376cb4,
title = "Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays",
abstract = "Introduction: The mortality associated with weekend admission to hospital (the ‘weekend effect’) has for many years been attributed to deficiencies in quality of hospital care, often assumed to be due to suboptimal senior medical staffing at weekends. This protocol describes a case note review to determine whether there are differences in care quality for emergency admissions (EAs) to hospital at weekends compared with weekdays, and whether the difference has reduced over time as health policies have changed to promote 7-day services.Methods and analysis:Cross-sectional two-epoch case record review of 20 acute hospital Trusts in England. Anonymised case records of 4000 EAs to hospital, 2000 at weekends and 2000 on weekdays, covering two epochs (financial years 2012–2013 and 2016–2017). Admissions will be randomly selected across the whole of each epoch from Trust electronic patient records. Following training, structured implicit case reviews will be conducted by consultants or senior registrars (senior residents) in acute medical specialities (60 case records per reviewer), and limited to the first 7 days following hospital admission. The co-primary outcomes are the weekend:weekday admission ratio of errors per case record, and a global assessment of care quality on a Likert scale. Error rates will be analysed using mixed effects logistic regression models, and care quality using ordinal regression methods. Secondary outcomes include error typology, error-related adverse events and any correlation between error rates and staffing. The data will also be used to inform a parallel health economics analysis.Ethics and dissemination: The project has received ethics approval from the South West Wales Research Ethics Committee (REC): reference 13/WA/0372. Informed consent is not required for accessing anonymised patient case records from which patient identifiers had been removed. The findings will be disseminated through peer-reviewed publications in high-quality journals and through local High-intensity Specialist-Led Acute Care (HiSLAC) leads at the 121 hospitals that make up the HiSLAC Collaborative.",
keywords = "case record review, consultants, hospital, quality, weekend",
author = "Julian Bion and Aldridge, {Cassie P.} and Alan Girling and Gavin Rudge and Chris Beet and Tim Evans and Temple, {R. Mark} and Chris Roseveare and Mike Clancy and Amunpreet Boyal and Carolyn Tarrant and Elizabeth Sutton and Jianxia Sun and Peter Rees and Russell Mannion and Yen-Fu Chen and Watson, {Samuel Ian} and Richard Lilford",
year = "2017",
month = "12",
day = "22",
doi = "10.1136/bmjopen-2017-018747",
language = "English",
volume = "7",
journal = "BMJ open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "12",

}

RIS

TY - JOUR

T1 - Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays

AU - Bion, Julian

AU - Aldridge, Cassie P.

AU - Girling, Alan

AU - Rudge, Gavin

AU - Beet, Chris

AU - Evans, Tim

AU - Temple, R. Mark

AU - Roseveare, Chris

AU - Clancy, Mike

AU - Boyal, Amunpreet

AU - Tarrant, Carolyn

AU - Sutton, Elizabeth

AU - Sun, Jianxia

AU - Rees, Peter

AU - Mannion, Russell

AU - Chen, Yen-Fu

AU - Watson, Samuel Ian

AU - Lilford, Richard

PY - 2017/12/22

Y1 - 2017/12/22

N2 - Introduction: The mortality associated with weekend admission to hospital (the ‘weekend effect’) has for many years been attributed to deficiencies in quality of hospital care, often assumed to be due to suboptimal senior medical staffing at weekends. This protocol describes a case note review to determine whether there are differences in care quality for emergency admissions (EAs) to hospital at weekends compared with weekdays, and whether the difference has reduced over time as health policies have changed to promote 7-day services.Methods and analysis:Cross-sectional two-epoch case record review of 20 acute hospital Trusts in England. Anonymised case records of 4000 EAs to hospital, 2000 at weekends and 2000 on weekdays, covering two epochs (financial years 2012–2013 and 2016–2017). Admissions will be randomly selected across the whole of each epoch from Trust electronic patient records. Following training, structured implicit case reviews will be conducted by consultants or senior registrars (senior residents) in acute medical specialities (60 case records per reviewer), and limited to the first 7 days following hospital admission. The co-primary outcomes are the weekend:weekday admission ratio of errors per case record, and a global assessment of care quality on a Likert scale. Error rates will be analysed using mixed effects logistic regression models, and care quality using ordinal regression methods. Secondary outcomes include error typology, error-related adverse events and any correlation between error rates and staffing. The data will also be used to inform a parallel health economics analysis.Ethics and dissemination: The project has received ethics approval from the South West Wales Research Ethics Committee (REC): reference 13/WA/0372. Informed consent is not required for accessing anonymised patient case records from which patient identifiers had been removed. The findings will be disseminated through peer-reviewed publications in high-quality journals and through local High-intensity Specialist-Led Acute Care (HiSLAC) leads at the 121 hospitals that make up the HiSLAC Collaborative.

AB - Introduction: The mortality associated with weekend admission to hospital (the ‘weekend effect’) has for many years been attributed to deficiencies in quality of hospital care, often assumed to be due to suboptimal senior medical staffing at weekends. This protocol describes a case note review to determine whether there are differences in care quality for emergency admissions (EAs) to hospital at weekends compared with weekdays, and whether the difference has reduced over time as health policies have changed to promote 7-day services.Methods and analysis:Cross-sectional two-epoch case record review of 20 acute hospital Trusts in England. Anonymised case records of 4000 EAs to hospital, 2000 at weekends and 2000 on weekdays, covering two epochs (financial years 2012–2013 and 2016–2017). Admissions will be randomly selected across the whole of each epoch from Trust electronic patient records. Following training, structured implicit case reviews will be conducted by consultants or senior registrars (senior residents) in acute medical specialities (60 case records per reviewer), and limited to the first 7 days following hospital admission. The co-primary outcomes are the weekend:weekday admission ratio of errors per case record, and a global assessment of care quality on a Likert scale. Error rates will be analysed using mixed effects logistic regression models, and care quality using ordinal regression methods. Secondary outcomes include error typology, error-related adverse events and any correlation between error rates and staffing. The data will also be used to inform a parallel health economics analysis.Ethics and dissemination: The project has received ethics approval from the South West Wales Research Ethics Committee (REC): reference 13/WA/0372. Informed consent is not required for accessing anonymised patient case records from which patient identifiers had been removed. The findings will be disseminated through peer-reviewed publications in high-quality journals and through local High-intensity Specialist-Led Acute Care (HiSLAC) leads at the 121 hospitals that make up the HiSLAC Collaborative.

KW - case record review

KW - consultants

KW - hospital

KW - quality

KW - weekend

U2 - 10.1136/bmjopen-2017-018747

DO - 10.1136/bmjopen-2017-018747

M3 - Article

C2 - 29275347

VL - 7

JO - BMJ open

JF - BMJ open

SN - 2044-6055

IS - 12

M1 - e018747

ER -