Decreased patient discharges on weekends part 1: what do the data tell us?

Area of Science:

• Healthcare Management
• Hospital Operations
• Emergency Medicine

Background:

• Hospital and Emergency Department (ED) crowding is a significant issue.
• Crowding is hypothesized to worsen on Mondays due to reduced weekend discharges.

Purpose of the Study:

• To investigate the relationship between weekend patient discharges and subsequent hospital/ED crowding.
• To quantify the impact of reduced weekend discharges on Monday hospital occupancy and ED bed availability.

Main Methods:

• A data analysis of 18 months of patient data from The Ottawa Hospital (January 2022-June 2023).
• Comparison of total admissions, discharges, and hospital occupancy on weekends vs. Mondays/Tuesdays vs. mid-week.
• Assessment of ED bed occupancy by admitted patients and days with >70% occupancy.

Main Results:

• Weekend discharges were nearly 50% lower than weekday discharges.
• Hospital occupancy increased by 2.4% on Mondays/Tuesdays, often exceeding 100%.
• EDs experienced significant crowding, with admitted patients occupying 68% of beds on Mondays/Tuesdays, and >70% occupancy on nearly 50% of Mondays.

Conclusions:

• Reduced weekend discharges are directly associated with substantial hospital and ED crowding on Mondays.
• This crowding impedes safe and timely access to ED beds for new patients.
• Canadian hospitals should analyze their data to find solutions for this recurring problem.