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Table 2 The match of information processing and the situation on weekends

From: Exploring reasons for the weekend effect in a hospital emergency department: an information processing perspective

Uncertainty sources Capacities Situation on weekends
Task complexity Admission of patients with diverse symptoms, treatment needs, and treatment stages • Matrix structure supported by contracts and matrix managers • Triage system • Self-contained subunits managed by emergency physicians • Morning conference • Different roles • Less effective morning conference, because the conference is managed by a physician from another department • One single emergency physician covers both A1 and A2
Different numbers of patients • Flexible self-contained subunits • Matrix structure • External agreements about calling physicians from other departments when their skills are needed • Less flexibility of resources between self-contained subunits, because only two units are in operation and one is “outsourced”
Patients with a mix of conditions • Emergency physicians and nurses with emergency care skills • Flow master to coordinate • The temporary physicians have limited skills, e.g., skills in surgery and coordination
Lack of information about the influx of patients • Hospital visitation • Less time to use the information provided by the hospital visitation
Lack of knowledge about the patients' conditions and which competences are needed • Triage system • Formalized rules and SOP guide less experienced physicians • Supervision • Less supervision of the less experienced physicians because of the emergency physician’s limited time (and skills if a temporary physician is on duty)
Task inter-dependence High degree of co-solving of tasks, employees rely on one another to perform their individual tasks • Flow master and coordinating nurses coordinate overall tasks • Staff employed in the same department treat most of the patients • Cetrea and EPR facilitate communication • Triage system and formalized rules to coordinate the subtasks • The emergency physician has too much to do, leaving a lot of coordination to the coordinating nurse • Less use of Cetrea due to the “outsourcing” of tasks
Inter-unit task inter-dependence Dependence on extensive collaboration with other departments at the hospital • Matrix structure supported by contracts and matrix managers • More tasks are solved by physicians from other departments on weekends → increased uncertainty, requiring more coordination • Focus is changing from the emergency care process to a focus on specialty