Intended for healthcare professionals


Should we rethink the scheduling of elective surgery at the weekend?

BMJ 2013; 346 doi: (Published 28 May 2013) Cite this as: BMJ 2013;346:f3353
  1. Janice L Kwan, chief medical resident,
  2. Chaim M Bell, associate professor
  1. 1Department of Medicine, Mount Sinai Hospital and University of Toronto, Toronto, ON, Canada
  1. cbell{at}

Higher 30 day mortality for elective procedures scheduled Friday through Sunday

Ideally, the quality of care that patients receive should not differ according to the day of the week. In reality, however, patients admitted to hospital at the weekend seem to have poorer outcomes than those admitted during the working week. Many studies have shown this so called “weekend effect.”1 2 3 4 A proposed explanation for this phenomenon is that quality of care at weekends is worse because of reduced or altered staffing levels. Reassuringly, this observation does not hold true across the spectrum of care.5 6

Most studies that have examined the outcomes of medical care at the weekend have focused on emergency care. In a linked paper (doi:10.1136/bmj.f2424), Aylin and colleagues assessed the association between day of elective surgical procedure and 30 day postoperative mortality using retrospective analysis of English …

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