Increased mortality among the critically ill patients admitted on weekends: a global trend

Critical illness and injury have no concept of time and do not always occur within regular business hours or at times conducive to optimal hospital function. In fact, it is a global trend that critically ill patients admitted to hospitals on weekends suffer higher mortality rates than those admitted during the week. Using a Canadian nursing lens, it is clear that there are some obvious differences in hospital function on weekends that include decreased hospital staffing, access to diagnostic services, intensivist coverage and the reluctance of patients to seek care on weekends. However, the exact differences contributing to the increased mortality in this patient population on weekends and the solutions remain unclear in the literature, and further research is needed. Possible solutions include moving to a "closed" ICU system, increasing nurse staffing, intensivist coverage and diagnostic accessibility, and creating a true seven-day hospital system. Finally, it is unclear exactly how to solve the nurse staffing portion of this problem, as it appears internally linked to the nursing profession and externally to hospital management, recruiting difficulties and financial restraints, and a problem that will take more than change in nursing management strategy to resolve.