Ever notice colleagues are especially sluggish at Monday morning meetings? Do you find physicians in your hospital are significantly less likely to attend rounds that occur on Wednesday afternoon? Have you found that public announcements that have the potential to damage to your hospital's reputation seem to be less so when they are released on Friday afternoons? It is no secret to most administrators that the timing of an event or intervention has significant influence upon its outcome or implications. It turns out that patient care is also sensitive to timing. Intensive care unit patients who were discharged to the floor between 10 p.m. and 7 a.m. had an adjusted in-hospital mortality that was 50% higher than that for other patients (Goldfrad and Rowan 2000). Last year, Drs. Bell and Redelmeier from the Institute for Clinical Evaluative Sciences showed that patients admitted on weekends with particular diagnoses had higher in-hospital mortality than those admitted on weekdays (Bell and Redelmeier 2001).
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