A LARGE regional study has found people treated for heart attacks at Hunter hospitals outside normal working hours had worse outcomes than those treated in business hours.
The research, recently published in the Heart, Lung and Circulation journal, has already prompted increased staffing and work hour changes at the John Hunter Hospital's cardiology department.
Cardiologist Dr Michael McGee said the "weekend effect" phenomenon - whereby patient outcomes are significantly worse for those admitted to hospital on the weekend compared to weekdays due to reduced staffing levels - was well-documented. But this Hunter New England-based research had sought to assess the effect of the time of a patient's admission on outcomes, and explore other factors such as out-of-hours admissions and patient transfers.
"We had noticed that patients from our smaller peripheral hospitals like Scone and Muswellbrook, that if they were well, they would usually get shipped through the day," Dr McGee said. "But if they were critically unwell they would often get transferred straight away.
"When they arrive at John Hunter Hospital outside of normal business hours, obviously the staffing runs at a reduced level - much like it would on a weekend.
"But when we looked at patients who were transferred, arriving outside of normal working hours, we found that people being transferred with heart attacks were having worse outcomes than those who were transferred when we had lots of people around."
Dr McGee said based on that research, the cardiology department at John Hunter Hospital was able to make some changes to increase the number of doctors and make it "business as usual" for more hours of the day.
"Looking after patients after hours is obviously very critical," he said.
"In an ideal world you'd have everything running 24 hours a day, but we have to balance that against staff needs and staff health, responsible working hours and patient ratios."
Dr McGee said a cardiology team works "all hours" at the hospital for emergency cases, and they had increased cardiology-specific coverage until 10pm each week night and until 6pm on weekends.
The study said any steps to reduce the weekend effect needed to move to a system where weekend practices were not substantially different to a usual business day.
Ongoing research was needed to see whether the staffing changes at the John Hunter Hospital would have an impact on improving patient outcomes.
"This research has at least made us more aware so we can work towards correcting it to improve outcomes for patients," he said
"We're aware no one wants to come to a hospital after hours, but if you have a heart condition and you think you need treatment, come to the hospital or call an ambulance, and we'll assess you and do the best they can to look after patients and their families."
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