Narrative review highlights strategies to improve patient flow and reduce hospital length of stay without weekend coverage.
Weekend discharge delays remain a significant contributor to prolonged hospital length of stay, often resulting from reduced availability of consultants, imaging, case management, and therapy services on Saturdays and Sundays. Expanding hospital operations to full seven-day coverage is often proposed. However, such solutions are frequently cost-prohibitive and have shown inconsistent benefits in general inpatient settings. This review proposes a more practical and scalable alternative that focuses on leveraging Thursday and Friday as high-impact planning days to mitigate weekend-related discharge bottlenecks. Through a narrative review of 15 studies published between 2010 and 2024, we identified key operational strategies, including early multidisciplinary rounds, Friday discharge huddles, and coordination guided by standardized discharge checklists, that enable teams to proactively clear discharge barriers before the weekend. These interventions improve weekend discharge volume, reduce unnecessary hospital days, and enhance patient flow without requiring full weekend staffing models. In addition, embedding case management within the emergency department can reduce avoidable weekend admissions by directing low-acuity patients toward outpatient services and follow-up. Together, these targeted weekday efforts form a cost-effective, immediately actionable framework that hospitals can adopt to reduce weekend delays, improve efficiency, and lower overall length of stay without compromising safety or quality of care.
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George Bechir (2025) studied this question.
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