AB92. 66. The effect of ultrasound availability on emergency admissions for biliary pathology: a weekend effect

Background: The weekend effect is an ongoing concern in healthcare and the exact cause is not fully understood. Recent reports show around 90,000 wasted hospital bed hours due to delayed discharges. We hypothesised that lack of routine ultrasound availability over weekends can lead to delayed discharges. It would be prudent to investigate the possible causes of the “weekend effect” in order to attempt to reverse them.

Methods: Surgical Sign-out and HIPE databases were queried to identify all emergency patients with biliary pathology admitted between January and July 2017, inclusive. Included were patient demographics, date and time of admission, date, time and type of radiological scan performed, specifically ultrasound, length of stay and patient mortality.

Results: A total of 90 patients were identified with biliary pathology that underwent ultrasound. Of these, 14 patients presented over the weekend (defined Friday 17:00–Monday 00:00). Those who presented over the weekend had greater lengths of stay by 1.42 days (7.31 days for weekday vs. 8.73 days for weekend). The time to ultrasound was greater at the weekend by 28.46 hours (23.71 hours during weekday vs. 52.17 hours during weekend).

Conclusions: Patients admitted over the weekend for biliary pathology are at an increased risk for longer hospital stays. This seems to correlate with length of time to ultrasound; however, there are many possible confounding factors.

Keywords: Surgery; ultrasound; weekend effect; biliary pathology; emergency