Re:Maybe today’s Navy is just not very good at driving ships
by arjie on Tuesday August 29, 2017 @02:30AM
(#15122503)
From 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.
Re:Maybe today’s Navy is just not very good at driving ships
by brownbat on Tuesday August 29, 2017 @06:43AM
(#15123370)
Agreed, 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.
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=article...
https://psnet.ahrq.gov/primers/primer/9/handoffs-and-signout...
...
> 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?