3 ms·
> I've heard doctors say this, but they never cite evidence. Seems pretty well researched by a quick google. Maybe they're eliding the support not because it's
by brownbat 9y ago
> I've heard doctors say this, but they never cite evidence.
Seems pretty well researched by a quick google. Maybe they're eliding the support not because it's an assumption, but because it's so thoroughly established they take it for granted?
http://www.nejm.org/doi/full/10.1056/NEJMsa1405556#t=articleBackground http://www.nejm.org/doi/full/10.1056/NEJMsa1405556#t=article...
https://psnet.ahrq.gov/primers/primer/9/handoffs-and-signouts https://psnet.ahrq.gov/primers/primer/9/handoffs-and-signout...
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> But there is a wealth of evidence that says that doctor performance drops significantly with motor performance being harmed
That's true too, but I worry you're trying to rebut (X & Y) with evidence for Y.
If we find ourselves slipping into a battle of emphasis, maybe we face a problem of optimization?
- arjie 9y agoFrom what I'm seeing, your hypothesis about this being a question of optimisation seems well supported. I worry that medical professionals resist changes here out of cultural belief or a resistance to process. That wouldn't be without precedent. Even something as well-established as washing hands between patients isn't done without explicit process (compliance is near 13% without explicit reinforcement for something that everyone learns the legend of Semmelweis for), and surgeons refuse even _private_ outcomes tracking.
- brownbat 9y agoAgreed, I can't know from first principles if the right shift length is 4 or 8 or 30. I'm sympathetic to your suggestion that it would be a surprising coincidence if doctors landed on the perfect number through historical accident. Maybe they have a feel for safety in shift length, but they don't in other areas like washing, so maybe not. It probably varies by specialty and even individuals, probably a monster of a problem.