6 ms·

I’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

by dimal 2y ago

I’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 2y ago
Maybe, 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 2y 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 2y ago
Have you looked at the research regarding which of those two options leads to better patient outcomes?
- game_the0ry 2y ago
  Have you? I’d love to hear that answer.
  - CydeWeys 2y ago
    I have. Longer shifts with fewer turn-overs results in better patient outcomes.
    - game_the0ry 2y ago
      Source?
    - lukan 2y ago
      And 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 2y ago
      That'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 2y ago
        One 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.
      - CydeWeys 2y ago
        Quality does suffer as the hours drag on, but quality suffers more when you hand off a case (which can be quite complex) to someone else. The tired but experienced-with-this-case doctor still does a better job than the rested doctor who is brand new to the patient's case.
        game_the0ry 2y ago
- dimal 2y ago
  Just from looking at the massive amount research on the effects of sleep deprivation and burnout on humans, and assuming that medical professionals are humans, we can infer that performance would decline. But ok, I’ll play along. https://bmjopen.bmj.com/content/9/1/e024778 https://bmjopen.bmj.com/content/9/1/e024778 https://www.healthecareers.com/nurse-resources/nursing-patient-care/patient-safety-12-hour-shifts-vs-8-hour-shifts https://www.healthecareers.com/nurse-resources/nursing-patie... https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0256300 https://journals.plos.org/plosone/article/comments?id=10.137... It’s a mixed bag, but strongly leaning against longer shifts, in my opinion.
game_the0ry 2y ago
So would I.
Zenzero 2y ago
Rounding 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 2y ago
  I feel like technology could very easily solve this eventually
  - jolux 2y ago
    Only 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 2y ago
    Quite possibly one of the worst instances of “let me solve this problem with some code” I’ve heard.
  - Zenzero 2y ago
    If 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 2y ago
      The 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.

by dimal 2y ago

rr808 2y ago

Maybe, 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 2y 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 2y ago

Have you looked at the research regarding which of those two options leads to better patient outcomes?

game_the0ry 2y ago
Have you? I’d love to hear that answer.
- CydeWeys 2y ago
  I have. Longer shifts with fewer turn-overs results in better patient outcomes.
  - game_the0ry 2y ago
    Source?
  - lukan 2y ago
    And 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 2y ago
    That'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 2y ago
      One 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.
    - CydeWeys 2y ago
      Quality does suffer as the hours drag on, but quality suffers more when you hand off a case (which can be quite complex) to someone else. The tired but experienced-with-this-case doctor still does a better job than the rested doctor who is brand new to the patient's case.
      - game_the0ry 2y ago
dimal 2y ago
Just from looking at the massive amount research on the effects of sleep deprivation and burnout on humans, and assuming that medical professionals are humans, we can infer that performance would decline. But ok, I’ll play along. https://bmjopen.bmj.com/content/9/1/e024778 https://bmjopen.bmj.com/content/9/1/e024778 https://www.healthecareers.com/nurse-resources/nursing-patient-care/patient-safety-12-hour-shifts-vs-8-hour-shifts https://www.healthecareers.com/nurse-resources/nursing-patie... https://journals.plos.org/plosone/article/comments?id=10.1371/journal.pone.0256300 https://journals.plos.org/plosone/article/comments?id=10.137... It’s a mixed bag, but strongly leaning against longer shifts, in my opinion.

game_the0ry 2y ago

So would I.

Zenzero 2y ago

Rounding 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 2y ago
I feel like technology could very easily solve this eventually
- jolux 2y ago
  Only 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 2y ago
  Quite possibly one of the worst instances of “let me solve this problem with some code” I’ve heard.
- Zenzero 2y ago
  If 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 2y ago
    The 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.