Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital of the King's Daughters, Norfolk, Virginia, United States of America.
Eastern Virginia Medical School, Norfolk, Virginia, United States of America.
PLoS One. 2022 Sep 12;17(9):e0271708. doi: 10.1371/journal.pone.0271708. eCollection 2022.
Emergency department (ED) teams have had to adjust limited staffing resources to meet the fluctuating levels of patient volume and acuity during the COVID-19 pandemic. Historically, Mondays have had the highest reported ED volumes. We are unaware of any studies reporting on the change of this Monday effect during the COVID-19 pandemic.
This retrospective, observational study of a single pediatric ED compared a pandemic lockdown period (3/23/2020-11/1/2020) with a seasonally comparative period (3/25/2019-11/3/2019). We compared the mean number of patients who arrived on Monday versus any other specific weekday (Tuesday, Wednesday, Thursday, or Friday) and the aggregate of other weekdays (Tuesday to Friday) for both study periods. Secondary analyses investigated overall mean volumes, admission rates, and differences in triage acuity levels.
There were 31,377 and 18,098 patients in the comparative and pandemic periods. The mean number of ED visits on Mondays in the comparative period was significantly more than any other weekday and the aggregate of weekdays (latter p<0.001). In contrast, there were no significant differences in the mean number of ED visits on Mondays in the pandemic period relative to any other weekday and the aggregate of weekdays (all p>0.05). The pandemic period had significantly lower mean volumes, higher admission rates, and more patients with higher acuity levels.
The previously experienced Monday effect of increased relative ED patient volumes was not seen during the pandemic period. This change has operational implications for scheduling ED staffing resources. Larger database studies are needed to determine the generalizability of these findings.
在 COVID-19 大流行期间，急诊科 (ED) 团队不得不调整有限的人员配备资源，以满足患者数量和病情波动的情况。从历史上看，星期一的 ED 就诊量最高。我们不知道有任何研究报告在 COVID-19 大流行期间这种星期一效应的变化。
这项回顾性、观察性研究比较了单一儿科 ED 在大流行封锁期间（2020 年 3 月 23 日至 2020 年 11 月 1 日）和季节性可比期间（2019 年 3 月 25 日至 2019 年 11 月 3 日）的情况。我们比较了两个研究期间星期一就诊的患者平均人数与其他任何特定工作日（星期二、星期三、星期四或星期五）以及其他工作日（星期二至星期五）的总和。次要分析调查了总体平均就诊量、入院率以及分诊 acuity 水平的差异。
比较期和大流行期间分别有 31377 名和 18098 名患者。在比较期，星期一的 ED 就诊人数明显多于其他任何工作日和工作日的总和（后者 p<0.001）。相比之下，大流行期间星期一的 ED 就诊人数与其他任何工作日和工作日的总和相比没有显著差异（所有 p>0.05）。大流行期间的就诊量明显较低，入院率较高，且 acuity 水平较高的患者较多。
在大流行期间，没有出现之前观察到的相对 ED 患者就诊量增加的星期一效应。这种变化对 ED 人员配备资源的安排具有操作意义。需要更大的数据库研究来确定这些发现的普遍性。
