This study purports to show the relationship between volume and patient harm due to health care error. Using 5 measures of volume and incident reports weighted for patient harm over the course of 515 days, it is shown that increased volume is related to increased harm to patients. As the number of areas in the hospital experiencing high volume increased, the likelihood of patients sustaining serious harm because of health care error also increased. This is attributed to reaching system capacity causing support services (ie, lab, pharmacy, radiology, housekeeping and engineering) to be overwhelmed and unable to keep up with requests from caregivers.

In today's healthcare environment, it is important to understand the dimensions along which healthcare consumers from their judgments about quality of care. This study was conducted to examine patient perceptions and observations about the coordination of care in a hospital setting and to identify the effect of patients' perspectives on satisfaction. The results suggest that even as lay observers, patients are interactors during their hospital experiences and their perceptions about care coordination are affected by communication patterns among healthcare professionals.

The results of this analysis are highly suggestive of a relationship between Hospital Systems Load and patient harm.

Background: Most clinicians believe that hospitals are less safe on the weekends, but the research findings have been mixed. In addition, the investigations have largely examined the outcomes of patients admitted on weekends versus weekdays and not patient harm that occurred on weekends against patient harm that occurred during the week.

Objective: To compare the extent of patient harm that occurred on weekend days with the harm that occurred on weekdays.

Methods: Using daily incident report data for an entire year from two hospitals in California we measured the number of incidents each day, the average harm per incident, and the total daily harm from all incidents. Analyses were done separately for the two different hospitals and controlled for daily patient census. Harm per incident was assessed to determine whether reporting patterns on weekdays differed from weekends.

Results: There were fewer incidents per day and less total daily harm on weekend days than days during the workweek in both hospitals (p < .05). Patient to nurse ratios are held at the same level across all days and shifts. There did not appear to be a systematic tendency to under-report incidents on the weekends.

Conclusion: The data strongly suggest that there is less harm to patients due to healthcare error on the weekends than during the week. Further work is needed to determine whether these findings would apply in hospitals with varying staffing levels.