Variations In The Day of The Week Discharge: An example of Unwarranted Variation? 1350

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Discharge from an intensive care nursery should be dependent upon the infant's clinical condition, and independent of the day of the week. We observed, however, that the timing of nursery discharge shows an uneven distribution across the days of the week, with the weekend discharge rates significantly lower than weekdays.

Methods: All patients (n=2385) managed by a national neonatal disease management systems and discharged from intensive care nurseries in 5 major metropolitan areas between 7/1/96 and 11/30/97 were included. See table below.

Table 1 No caption available.

Statistical Analysis: Data is represented as a percentage of total discharges for each weekday assignment, then using the normal approximation to the multinominal distribution, we tested for proportional difference in the discharges on each weekday.

Results: There was a difference in the rate of discharge day, with a weekend (Saturday and Sunday) discharge the least likely (p=0.0001). In addition, among weekdays infants were most likely to be discharged on Tuesday, Wednesday or Friday (p=0.0002).

The data suggest processes leading to infant discharge may differ with the day of the week, and effiencies may be gained by limiting these variables.

Proportinal data for discharge by day of the week are: Table

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Supported by Paidos Health Management Services, Inc.

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Touch, S., Kornhauser, M., O'Connor, J. et al. Variations In The Day of The Week Discharge: An example of Unwarranted Variation? 1350. Pediatr Res 43, 231 (1998) doi:10.1203/00006450-199804001-01371

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