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Try landing on a carrier, the pilots get graded on every single landing, in one of the most stressful environments out there. They have Landing Signal Officers

Try landing on a carrier, the pilots get graded on every single landing, in one of the most stressful environments out there. They have Landing Signal Officers who make sure the pilot is safely on the glidepath, and in difficult conditions "sweet talk" the pilot with instructions [0] If the LSO & Air Boss (in charge of the flight deck) and staff don't do their job, and a jet runs out of gas in the pattern they will have some major explaining to do. The officers involved will be called before a mishap board. If a hospital ED patient flow was actually ran like the Air Boss runs the carrier deck, then things would go a lot smoother. An F/A-18 at landing weight ends up in the water if they have to wait more than about 30-45 minutes, unless refueled in the air. The other thing to remember is that in major hospitals, the Trauma service and the Emergency Department have a separate patient flow. If someone is having a heart attack or serious injury, they will be handled by the trauma service. The nurses handling the ED are not treating immediately critical patients, except perhaps on initial triage. Also, a "broken leg" can easily end up critical from puncturing the femoral artery if its not stabilized and/or the patient will go into shock, if not given appropriate pain meds. I personally think that ED staff should be graded for QA of treatment and "Patient Interaction". Neither of which requires lengthy interaction with the patient, only maintaining standards. I'm not sure I'd apply the typically subjective Yelp standards to ED evaluation either. [0] https://www.youtube.com/watch?v=sD_mUwzpUs4 https://www.youtube.com/watch?v=sD_mUwzpUs4

jlg23 11y ago
I don't think that comparison is valid. * On a carrier 100% of the people are well trained professionals. Not so in a hospital, were patients have never been trained to be good patients. * Not only are people not trained to be patients, they are, especially in situations of distress, usually not helpful at all. As a rule, you do not trust a diagnosis provided by a patient (even if a doctor!) because the person might exhibit an acute stress reaction (https://en.wikipedia.org/wiki/Acute_stress_reaction https://en.wikipedia.org/wiki/Acute_stress_reaction) - avoiding this state by prior exposition is one of the reasons why pilots train emergency situations in flight simulators. * Managing "hospital ED patient flow" is something that has improved a lot (see your example of direct transfer to trauma units), but it still is the attempt to manage the inherently unmanageable: On a carrier you know how many jets you have in the air and how long their fuel lasts and thus you can coordinate, in an ED you can only, if such a system exists in your region, have incoming ambulances diverted to other hospitals. But you still have no idea who will stumble through your door the next moment, brought by friends or taxis. I am all for collecting data and applying metrics to make a process better, but there are some areas where the collection and evaluation should be done by professionals who understand what they are grading, not by amateurs who either entered that area involuntarily (actual emergencies) or who just try play the system for their own advantage (getting prescriptions).

jlg23 11y ago

I don't think that comparison is valid. * On a carrier 100% of the people are well trained professionals. Not so in a hospital, were patients have never been trained to be good patients. * Not only are people not trained to be patients, they are, especially in situations of distress, usually not helpful at all. As a rule, you do not trust a diagnosis provided by a patient (even if a doctor!) because the person might exhibit an acute stress reaction (https://en.wikipedia.org/wiki/Acute_stress_reaction https://en.wikipedia.org/wiki/Acute_stress_reaction) - avoiding this state by prior exposition is one of the reasons why pilots train emergency situations in flight simulators. * Managing "hospital ED patient flow" is something that has improved a lot (see your example of direct transfer to trauma units), but it still is the attempt to manage the inherently unmanageable: On a carrier you know how many jets you have in the air and how long their fuel lasts and thus you can coordinate, in an ED you can only, if such a system exists in your region, have incoming ambulances diverted to other hospitals. But you still have no idea who will stumble through your door the next moment, brought by friends or taxis. I am all for collecting data and applying metrics to make a process better, but there are some areas where the collection and evaluation should be done by professionals who understand what they are grading, not by amateurs who either entered that area involuntarily (actual emergencies) or who just try play the system for their own advantage (getting prescriptions).