‘Hospital-at-Night’ Expedites Review of Trauma Patients without Affecting Outcome from Hip Fracture

Abstract

The UK Hospital at Night (H@N) programme is hypothesised to improve efficiency of out-of-hours care. No studies have assessed a surgical programme or mechanisms of effect. This prospective study aimed to do so in a trauma and orthopaedic department over 10 weeks. Senior house officers recorded night shift activity. Mean time to attend referrals reduced from 29 to 15 minutes as a result of the programme (p=0.007). Workload and 30 day mortality and morbidity for hip fracture remained unchanged. The mechanisms underlying improvements are unclear, but may represent central organisation of workload.