I’ve heard it said that each hospital really operates as four distinct entities. There is the daytime hospital, the nighttime hospital, the weekend hospital, and finally the holiday hospital. What makes the difference and why is it so palpable in many organizations? Over the weekend, I was visiting my mother in a hospital where she had never before been a patient. My husband had been there with her the two previous days and also accompanied me on Saturday. He was the one who noticed the whiteboard hadn’t been updated in 24 hours, and after two staff encounters he said, “It was nothing like this during the week.” I asked what was different, and he said, “There seems to be a little chaos, and the aids aren’t as in-tune with your mom as the ones we had on Thursday and Friday. They don’t seem to notice that she only hears well on one side when they talk to her.” Not having a comparison, I felt everything seemed fine. Not remarkable, or bad, but just OK. Read more...