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I've heard this rationalization from medical professionals before. They need to solve the problem with handoffs. It's a big problem, and problem requires rewri

I've heard this rationalization from medical professionals before. They need to solve the problem with handoffs. It's a big problem, and problem requires rewriting a lot of the process, but there's nothing more to it. It's solvable. The institution however, has beaten any imagination out of them and replaced it with resistance to change.

nradov 8y ago
How would you propose to solve the problem? Most attempts thus far have relied up getting attending doctors to do detailed data entry about patient state into an EHR, but that by itself is time consuming and detracts from immediate patient care. Maybe someday AI and NLP technology will serve to automate much of the data capture, but we're many years away from those technologies being a practical reality.
- cjcjcjcufu 8y ago
  What about doubling or tripling staff and then having them work in teams of two with half their shifts overlapping with someone that will be staying longer? Would that work?
  - rscho 8y ago
    How will you pay for that? Costs make that impossible even in the richest of countries.
    - cjcjcjcufu 8y ago
      All I'm interested in is whether it would work, not the cost. There are radical proposals that would manage cost better, but there's no point in considering them if it wouldn't help.
      - nradov 8y ago
        Which radical proposals would manage cost better?
  - deleted 8y ago
    [deleted]
- WalterSear 8y ago
  I could propose as many pat, armchair solutions as the next HN reader :) However, it's clearly not a problem that's conducive to quick fixes, or it would have been sorted. That said, the arguments for the status quo are laughable. There's no other field of human endeavour where people claim that 24 hour shifts are >safer< than 8 hour shifts. It's not like handoffs have even been eliminated: handouts are just done 3 times less, but by profoundly sleep-deprived people, who have to reiterate the last 24 hours to the incoming staff. When people defend behaviours of this nature, it's a 'culture smell': to a greater or lesser extent, the proponents have been indoctrinated to cling to a local maxima.

nradov 8y ago

How would you propose to solve the problem? Most attempts thus far have relied up getting attending doctors to do detailed data entry about patient state into an EHR, but that by itself is time consuming and detracts from immediate patient care. Maybe someday AI and NLP technology will serve to automate much of the data capture, but we're many years away from those technologies being a practical reality.

cjcjcjcufu 8y ago
What about doubling or tripling staff and then having them work in teams of two with half their shifts overlapping with someone that will be staying longer? Would that work?
- rscho 8y ago
  How will you pay for that? Costs make that impossible even in the richest of countries.
  - cjcjcjcufu 8y ago
    All I'm interested in is whether it would work, not the cost. There are radical proposals that would manage cost better, but there's no point in considering them if it wouldn't help.
    - nradov 8y ago
      Which radical proposals would manage cost better?
- deleted 8y ago
  [deleted]
WalterSear 8y ago
I could propose as many pat, armchair solutions as the next HN reader :) However, it's clearly not a problem that's conducive to quick fixes, or it would have been sorted. That said, the arguments for the status quo are laughable. There's no other field of human endeavour where people claim that 24 hour shifts are >safer< than 8 hour shifts. It's not like handoffs have even been eliminated: handouts are just done 3 times less, but by profoundly sleep-deprived people, who have to reiterate the last 24 hours to the incoming staff. When people defend behaviours of this nature, it's a 'culture smell': to a greater or lesser extent, the proponents have been indoctrinated to cling to a local maxima.