The organization of and social practices in a Danish emergency department – possible explanations of the ‘weekend effect’

Studies have shown that acute patients admitted to hospitals during weekends experience worse outcomes than those admitted on a weekday (i.e. 30-days mortality, length of stay and number of adverse events). My interdisciplinary PhD-project explores whether the organization of and the social practices in an Danish emergency department can explain the existence of this ‘weekend effect’ in the emergency department.
The existing studies of the weekend effect are based on epidemiologic analysis. They can explain that a weekend effect exist, but are not able to explain why. The answer to why these variations occur remains unclear.
My study is a prolonged 6-months ethnographic study. Fieldwork consisted of app. 700 hours of participant observations in an emergency department, 25 in-depth interviews with nurses, physicians, secretaries, therapists and the management of the department, and 4 focus groups with 16 nurses in total. The empirical material was generated in autumn 2015 in a medium-sized regional hospital in Denmark.
In addition I have done a descriptive observational study consisting of 229 adverse events, occurred in the emergency department, reported to the mandatory national reporting system during a two year period (2014-2015). Another possible explanation for the weekend effect is changes in patient characteristics, e.g. disease severity. The existing studies have suggested this may be an explanation. A register-based cohort study is done as well.