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Yes, I've heard that argument before. I've asked before if the research shows the problem is handoffs per se, or the protocol around them, but haven't had a g
by ska 8y ago
Yes, I've heard that argument before. I've asked before if the research shows the problem is handoffs per se, or the protocol around them, but haven't had a good answer. There also doesn't seem to be good research into the longer term impact of these negative consequences on the practitioners.
I've worked around clinicians and clinical staff, and several times been surprised how much is left to personal memory and scheduling, including some inherently risky protocols/procedures that are at all functional only because the people doing them are careful ... some of these obviously easily improvable.
- kelnos 8y agoI have several friends who are doctors or nurses, and have talked with most of them about this. They all parrot the "doctor/nurse-patient continuity" line, but when pressed as to whether fewer handoffs actually outweigh the effects of exhaustion on outcomes, they all seem to take it as a given that it does, without being able to support it. I suspect that, even if fewer handoffs does take an edge over exhaustion, the handoff process could be improved greatly; from what I'm told, handoff processes vary wildly, often aren't formalized, and even when they are, adherence to process is pretty lax, in part due to the effects of exhaustion.
- ska 8y agoIt’s really interesting to do workflow analysis in clinical settings. It’s not uncommon to run into “we do it this way because that’s the way we’ve always done it” situations. There is also a bit of machismo/pride for the shifts worked thing, which isn’t helpful.