Colectomy Patients Should Schedule Surgery for Monday

Many industries tell their customers that visiting or shopping on particular days of the week delivers certain advantages. Grocery stores offer senior discounts on the slowest weekdays, while airlines discount fares. However, few healthcare studies examine the specific weekday when most surgeries are performed, but doing so could reveal which days are associated with better outcomes and lower costs.

Although they function 24 hours a day, seven days a week, hospitals curtail many services on evenings and weekends. In light of the current health care environment’s diminishing resources, a team from Beth Israel Deaconess Medical Center in Boston decided to compare the outcomes of colon resections performed during various days of the week.

With the knowledge that colon resection demands a multidisciplinary perioperative care period, the researchers hypothesized that operations performed on Monday would take advantage of hospital resources and facilitate discharge by Friday, which could preserve healthcare resources, and perhaps, improve patient care.

Using a retrospective review of prospectively collected colorectal surgical data, they identified all patients who underwent segmental colon resection at a single tertiary care referral center from 2004 to 2010 (n=868). The researchers then compared length of stay, patient and surgeon demographics — which were similar among patients — and postoperative outcomes and complications in patients undergoing elective open and minimally-invasive segmental colectomy by day of the week.

Compared to those whose surgery occurred on other days, patients whose surgery occurred on Monday had significantly shorter lengths of stay (LOS), as they were discharged three-fourths of a day earlier on average. LOS was also shorter regardless of surgeon, comorbidities, and complications.

The researchers reported that experienced surgeons and hospital staff deal with complicated patients more efficiently and effectively, which ensures timely discharge. In addition, the most experienced and least taxed staffing pattern occurs during the week, while staffing suffers on weekends. Patients undergoing procedures later in the week may experience complications over the weekend when recognition of the problem and treatment delays may occur.