The Phantom Menace of Sleep Deprived Doctors
Great NY Times article from Friday…
Interns can no longer work the 24 hour shifts of medicine’s historically hazing past. Surprisingly, studies have shown that this actually has not made a huge impact on medical errors. It is not only the sleep-deprivation of doctors that is the problem… It’s procedures like inadequate, interrupted sign outs and operational management issues, as well.
“In 2000, the British psychologist James Reason wrote that medical systems are stacked like slices of Swiss cheese; there are holes in each system, but they don’t usually overlap. An exhausted intern writes the wrong dose of a drug, but an alert pharmacist or nurse catches the mistake. Every now and then, however, all the holes align, leading to a patient’s death or injury.
On a national scale, it seems safe to conclude that the efforts to cut doctors’ work hours failed because the change was made in isolation. A rested doctor plugs a hole in only one slice of cheese. Holes in other layers — the frequency of patient handoffs, the continued use of antiquated pen-and-paper medical charts — remain.”
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