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, Y-F.‏‎, Watson, Samuel I. and Lilford, Richard (2017) Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays. BMJ Open, 7 (12). e018747. doi:10.1136/bmjopen-2017-018747 ISSN 2044-6055.

Preview

PDF WRAP-two-epoch-cross-sectional-case-record-review-protocol-comparing-Lilford-2017.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1388Kb) | Preview

Request Changes to record.

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.

Item Type:	Journal Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Hospital patients -- Mortality, Hospital care -- Great Britain, Medical personnel -- Supply and demand -- Great Britain, Emergency medical services -- Great Britain, Hospitals -- Admission and discharge -- Great Britain
Journal or Publication Title:	BMJ Open
Publisher:	BMJ
ISSN:	2044-6055
Official Date:	22 December 2017
Dates:	Date Event 22 December 2017 Published 2 November 2017 Accepted 11 October 2017 Submitted
Volume:	7
Number:	12
Article Number:	e018747
DOI:	10.1136/bmjopen-2017-018747
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	19 March 2018
Date of first compliant Open Access:	20 March 2018
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID Health Services and Delivery Research Grant: 12/128/17 National Institute for Health Research http://dx.doi.org/10.13039/501100000272
Open Access Version:	Publisher

Request changes or add full text files to a record

Repository staff actions (login required)

View Item

Downloads