New research to improve health challenges in seven day hospital care

The lottery of patient prognosis determined by the time of day, and day of the week that a patient is admitted to hospital is to be challenged thanks to a new research collaboration between researchers at Bath and the city’s Royal United Hospital (RUH).

Currently, a patient in the UK that falls seriously ill over the weekend has a higher chance of dying over the next 30 days compared to an almost identical patient admitted to the same hospital during the week.

Researchers from our School of Management will team up with clinicians and managers at the RUH to study this international problem and identify black spots for patient care throughout the year, be that out of hours or weekend admission, and the scale of the issue.

Research project team: (l-r) Professor Mark Tooley, Director of R&D at the RUH; Dr Monica Baird, Head of Surgery; PhD researcher Marianna Frangeskou and Dr Christos Vasilakis, senior lecturer in the School of Management

They will identify the factors that contribute to hospital patients being more at risk if they are admitted out of hours, likely to range from reduced staffing levels, to limited access to diagnostic equipment and other services, and use computer simulation modelling to develop and test solutions for improving the design of healthcare systems.

Dr Christos Vasilakis, senior lecturer in operations and supply management, who will lead the research, said: “The so-called ‘weekend or out-of-hours phenomenon’ has been well documented, but as yet the causes of the problem have only been the subject of speculation.

“It’s usually not a single event that leads to an adverse event, including the untimely death of a patient, but a chain of events, or a combination of things.

“This is potentially a very important project for patients in the local area, the UK, and around the world, and it cements a growing relationship between the University’s School of Management and key providers within our local health economy.”

Professor Mark Tooley, Director of Research & Development at the RUH, said: “This is a very exciting joint PhD project, the first collaboration of its kind between the two institutions that will bring new understanding to the variation of outcomes involved with different days of admission that should lead to better care of our patients here and throughout the UK.” 

Dr Monica Baird, Head of Surgery at the RUH, said: “This project has the potential to improve the outcomes for patients and save many thousands of lives, not just in Bath but in the UK and the rest of the world.”

A PhD researcher, Marianna Frangeskou, will work on the project for the next three years, beginning with clinicians in the acute stroke ward and emergency general surgery. This research post is made possible through a charitable gift and the support of the RUH and the University.

“The research will focus on quantitative and qualitative research techniques, including data analysis, shadowing clinicians, observing clinical meetings, and process mapping, leading to the development of a simulation model of different care processes,” said Ms Frangeskou. “This will allow us to test the likely impact of changes in the design of health services on patients and staff without experimenting with the real system.”

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