Electronic health records improve weekend surgery outcomes

March 29, 2017, Loyola University Health System

Electronic health record (EHR) systems significantly improve outcomes for patients who undergo surgeries on weekends, according to a Loyola Medicine study published in JAMA Surgery.

Past research has shown that surgery tend to experience longer stays and higher mortality rates and readmissions, a phenomenon known as the "weekend ."

The Loyola study by corresponding author Paul Kuo, MD, MS, MBA, and colleagues identified the components of EHR systems that can help overcome the weekend effect. These elements include electronic systems designed to seamlessly schedule surgeries and move patients into and out of hospital rooms. Patients at hospitals with electronic operating room scheduling were 33 percent less likely to experience the weekend effect than patients at hospitals with paper-based scheduling. At hospitals with electronic bed-management systems, patients were 35 percent less likely to experience the weekend effect.

Loyola University Medical Center was among the earliest hospitals to adopt EHR and Loyola University Health System has reached one of the most advanced stages of implementation, according to HIMSS Analytics, a respected healthcare advisor in information technology.

The Loyola study included 2,979 patients who were admitted during weekends to Florida hospitals for three types of urgent surgeries: appendectomy, acute hernia repair and cholecystectomy (gallbladder removal). Florida was picked because of its large, diverse population.

Researchers retrospectively examined patient data from the Agency of Healthcare Research and Quality-sponsored Healthcare Cost and Utilization Project State Inpatient Database.

Of the 2,979 weekend surgery patients, 946 (32 percent) experienced the weekend effect, defined as having longer hospital stays than normally would be expected. Patients who did not experience the weekend effect were more likely to be at hospitals with high-speed EHR connectivity, EHR in the operating room, electronic operating room scheduling, computerized physician ordering systems and electronic bed management systems.

A 2015 Loyola study published in Annals of Surgery identified five factors that helped hospitals overcome the weekend effect: full adoption of , home health programs, pain management programs, increased registered nurse-to-bed ratios and inpatient physical rehabilitation. In the new study, Loyola researchers followed up by identifying the specific elements of EHR systems that help mitigate the weekend effect.

The research was conducted by Loyola's predictive analytics program, which mines big data to predict health outcomes. Large new databases, electronic medical records and more powerful computers are enabling researchers to conduct such studies. "We're now able to ask and answer a broad range of questions that could significantly help improve patient care and reduce costs," Dr. Kuo said. Dr. Kuo is chair of Loyola's department of surgery. He heads Loyola's analytics group, One to Map Analytics. (One-to-map is a common computer command in analytics research.)

The new study, which is published as a research letter in JAMA Surgery, is titled, "Association between elements of electronic health record systems and the in urgent general ."

First author is Anai Kothari, MD, a surgical resident and a lead investigator in One to Map. Dr. Kothari is an example of how Loyola is training systems-based thinkers of tomorrow. Dr. Kothari also is immediate past chair of Loyola's House Staff Patient Safety Committee and was a member of a national panel that established new work rules for residents.

Explore further: How hospitals can improve outcomes of weekend surgeries

Related Stories

How hospitals can improve outcomes of weekend surgeries

April 25, 2015
Studies have shown that patients who undergo surgeries on weekends tend to experience longer hospital stays and higher mortality rates and readmissions.

Hospital factors can overcome 'weekend effect'

October 12, 2015
(HealthDay)—More nurses and electronic medical records can help hospitals overcome the "weekend effect" (WE) associated with urgent general surgery procedures performed on weekends, according to a study published in the ...

Kidney stone patients hospitalized on the weekend may get delayed treatment

April 11, 2016
Patients with severe cases of kidney stones are 26 percent less likely to receive timely treatment when they're admitted to the hospital on the weekend, according to a study by researchers at Loyola Medicine and Loyola University ...

'Post-hospital syndrome' found to be a risk factor for elective surgery

November 10, 2015
A condition known as "post hospital syndrome" (PHS) is a significant risk factor for patients who undergo elective outpatient surgery, a Loyola study has found.

Atrial fibrillation after surgery increases risk of heart attacks and strokes

May 18, 2015
As many as 12 percent of patients undergoing major, non-cardiac surgery experience an irregular heartbeat called atrial fibrillation.

Study examines 'weekend effect' in emergency surgery patients

August 15, 2016
Research has pointed to a 'weekend effect' in which patients admitted to the hospital on Saturdays or Sundays are more likely to die than those admitted on week days. A new study has now assessed whether a weekend effect ...

Recommended for you

Cold open water plunge provides instant pain relief

February 12, 2018
A short, sharp, cold water swim may offer an alternative to strong painkillers and physiotherapy to relieve severe persistent pain after surgery, suggest doctors in the journal BMJ Case Reports.

Study spotlights risks in anesthesiologist handoffs

February 9, 2018
Most patients are totally unaware that the anesthesiologist who put them under for surgery might not be the same one who brings them out even though that 'handoff' between the two doctors has been linked to a series of negative ...

One in five older adults experience brain network weakening following knee replacement surgery

February 7, 2018
A new University of Florida study finds that 23 percent of adults age 60 and older who underwent a total knee replacement experienced a decline in activity in at least one region of the brain responsible for specific cognitive ...

New algorithm decodes spine oncology treatment

February 6, 2018
Every kind of cancer can spread to the spine, yet two physician-scientists who treat these patients describe a paucity of guidance for effectively providing care and minimizing pain.

Patients and doctors often disagree in evaluation of surgical scarring

February 1, 2018
When it comes to the physical scars surgery leaves behind, a new study shows patients and doctors often don't assess their severity the same way. Researchers from the Perelman School of Medicine at the University of Pennsylvania ...

Boosting a key protein to help bones that won't heal

February 1, 2018
When a patient breaks a bone, there's a possibility the fracture won't heal properly or quickly—even with the aid of pins, plates or a cast.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.