Abstract
Internationally, healthcare organizations are seeking to extend their services from a five-day working week to a seven-day model to improve equity, safety and efficiency in patient care, by removing the weekday-weekend variation in the delivery of healthcare services. However, before transitioning to such a model, a clear, evidence-based rationale must be established and should be grounded in rigorous academic research. The research question: “What core components and interactions make up the ecosystem of a 7-day service delivery model within healthcare organization?” will be used as a basis to generate search terms. The objective of this paper is to design a systematic literature review on the implementation of a 7-day service model in healthcare organizations from an ecosystem perspective. The review will adhere to Preferred Reporting Items for Systematic Literature Reviews and Meta-analysis (PRISMA) and has been registered in PROSPERO (CRD420261279813). Based on the PICOS (Population, Intervention, Comparison, Outcome, Study design) framework, our research question is as follows: What core components and interactions make up the ecosystem of a 7-day service delivery model within healthcare organization? The systematic literature review will include studies published from 1st January 2000 and before by 31st January 2026 in peer-reviewed journals, written in English, available on CINAHL, MEDLINE, PsycInfo, PubMed, Web of Science and Scopus. Search strategies will be developed using MeSH terms and key terms related to the topic. The screening process will include (1) an initial review of title/abstracts, and (2) full-text reviews. To reduce the risk of bias, data will be assessed independently by at least two people, with a process to resolve differences, in accordance with the CASP Qualitative Checklist. The GRADE-CERQual approach will also be applied to ensure confidence in qualitative findings. This systematic literature review will synthesize what is currently known about the components and interactions of the ecosystem of 7-Day healthcare delivery models on access, clinical outcomes and costs, utilization across care settings and healthcare professional outcomes.