Unlike most other medical and surgical specialties – in which staffing and resources vary on nights and weekends – trauma centers are required to have round-the-clock resources for emergency medicine, radiology, surgery, and post-operative intensive care immediately available 24 hours a day, seven days a week, 365 days a year.
The report suggests that the greater odds of survival on weekends may be influenced by hospital scheduling. Since elective surgeries are typically not performed on weekends, there is less competition for practitioners' time, operating rooms, blood bank, pharmacy and other hospital resources.
Despite the indication that trauma patients may, overall, be safer during off hours, the findings revealed that both weeknight and weekend presentation was associated with longer ICU stays, and those who came to the hospital on weeknights were more likely to have a longer hospital stay overall than those who were admitted on a weekday. The report said this may be due to hospital factors not entirely related to the patient's condition, including greater bed availability because few elective admissions and surgeries occur on weekends.
"It is unrealistic to think that all hospitals can be fully staffed to provide optimal care for all time-sensitive conditions all of the time, so our challenge is to develop an integrated system of emergency care for unplanned -- but inevitable -- critical illness," Carr said. "The trauma system has a plan of care in place long before we ever need it, and it offers many lessons for the remainder of emergency care."