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Some wards with really sick people benefit from having longer shifts as you see the person progress and have fewer shift changes. Ie with 2 people doing 12 hr s
by rr808 3y ago
Some wards with really sick people benefit from having longer shifts as you see the person progress and have fewer shift changes. Ie with 2 people doing 12 hr shifts is better than 3 people doing 8 hours shifts as the doctors and nurses see how a patient is doing and dont have to communicate to next shift. Something like ER where people come and go all day wouldn't benefit from this however.
- jajko 3y agoYes but you really don't want to be treated at the end of that 12-hour shift, quality of service drops down significantly, they are significantly more tired at that point. Doctors are just humans like rest of us, and those shifts are often brutal.
- game_the0ry 3y agoThat’s what I am trying to say, sleep deprivation causes people to make mistakes.
- dimal 3y agoI’d rather have three well-rested people and an additional shift change than two burned out, exhausted people. People who are exhausted make mistakes. Maybe it would be better to focus on improving internal communication.
- rr808 3y agoMaybe, I think we have to trust the medical people that they know what they're doing. My baby daughter was in incubated in ICU twice with severe Bronchiolitis. It was nice to see the same people look after her for a week rather than a continual stream of people clocking on and off.
- krisoft 3y ago> It was nice to see the same people look after her for a week rather than a continual stream of people clocking on and off. Surely those people were sleeping from time to time during the week, weren't they? That is the "people clocking on and off".
- GavinMcG 3y agoHave you looked at the research regarding which of those two options leads to better patient outcomes?
- game_the0ry 3y agoHave you? I’d love to hear that answer.
- CydeWeys 3y agoI have. Longer shifts with fewer turn-overs results in better patient outcomes.
- game_the0ry 3y agoSource?
- lukan 3y agoAnd that makes sense, but only if there are enough breaks and downtime in between, and probably not if the doctors hasten from one patient to the other. Could you link the studies?
- to1y 3y agoThat's strange as you would expect quality to suffer in every single respect when forced to work inhumane conditions. I would find a different mechanic if I thought the one I was considering was miserable from being overworked. Was there an explanation for why outcomes improved? Perhaps it is necessary to look into who conducts these studies as I imagine someone up the ladder profits greatly from having 1 doctor do the job of 2.
- samus 3y agoOne simple reason might be this over: people make errors over time, but they become familiar with the case. That familiarity is lost whenever they hand over a patient. And you can't solve that with documentation since people would be busy all day doing paperwork instead of caring for patients. This problem exist in every domain, and in medicine it can have deadly consequences. People sign up to become doctors knowing that they will have to work crazy shifts. But I guess they underestimate how the system hobbles them since it is focused on being efficient, not on achieving the best outcome for the patients.
- game_the0ry 3y agoSo would I.
- Zenzero 3y agoRounding is a major source of mistakes. It is very common that cases rounded through multiple people develop major gaps in information. This is not as simple of a problem as you think it is.
- starluz 3y agoI feel like technology could very easily solve this eventually
- jolux 3y agoOnly if you think it's possible to get all of the information in someone's head out of their head without consuming significantly more of their time and energy.
- ramraj07 3y agoQuite possibly one of the worst instances of “let me solve this problem with some code” I’ve heard.
- Zenzero 3y agoIf you find some problem that plagues millions of very smart people, and your thought is "technology could very easily solve this", the first thing you should ask yourself is what you're missing.
- zelphirkalt 3y agoThe problems are aversion to technology in places, unwillingness to adopt new (human) protocol/processes, entrenched proprietary technology, that does not adhere to standardized formats. Say you want to save a report for a patient for the next shift. That report needs to enter a computer system. If there is a system for that, it will most likely be a very expensive overpriced proprietary solution with expensive support contract, instead of something that has an open and intelligent format, that could be read by simply any software. The companies behind the tools will paint themselves as "specialists" for medical technology and do everything to dig a moat, at the cost of lives and they will avoid standards, as that will make their overpriced solution replaceable.
- elijaht 3y agoBut why not 3x12hr shifts rather than (what appears to be from outside perspective), 7x12hr shifts?
- zelphirkalt 3y agoIn reality it would probably be 2 people doing 13h shifts or 3 people doing 9h shifts, in order to have overlap for handovers and because of hygiene rules, that do not let you walk right in.