Expanding What We Know About Off-peak Mortality in Hospitals
Bibliographic record
Abstract
For more than 30 years, a negative "off-peak effect" on patient outcomes has been associated with weekend and/or nighttime hospitalization in more than 25 diagnostic groups. Descriptive studies have verified the presence of this off-peak effect on patient outcomes but have done little to explain its cause. Institutional ethnography is a promising method for describing challenges nurses encounter and deal with on off-peak shifts and for exploring how those challenges arose in institutions designed to avoid such outcomes. The authors discuss their research and suggest a number of steps that nurse administrators might take to enhance their knowledge for handling off-peak challenges in their hospitals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.097 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.002 | 0.008 |
| Scholarly communication | 0.008 | 0.022 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.005 | 0.008 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".