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by amorphid 3469 days ago
That's a really interesting point. I wonder if it'd be practical to address the handoff problem with rolling start times. So if average ER patient takes 3 hours to treat from start to finish, for an 8 hour shift, you stop taking new patients at the 5 or 6 hour mark. That being said, if an ER doc is in the "graceful shutdown" part of their shift, and a spike in patients rolls in the door, it'd be hard to say no to helping out.
2 comments
snowwrestler 3468 days ago
I think that is how it works, but with longer periods of time. Instead of an 8 hour shift with overlap of 2, it's a 24 to 30 hour shift with overlap of 8 to 10.

On rounds, a doc might only see each patient every hour or two... even longer for specialists.

ER docs also work some shorter shifts. So in a week he might work one 24 or 30 hour shift, and one or two 8-hour shifts. The shorter shifts provide arms and legs for simple cases, and the longer shifts provide continuity for more serious cases. The docs take turns holding down the long shift.

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mjevans 3468 days ago
I had similar thoughts, except with 4s.

For the first 4 hours they take patients (and shadow some of the persisting cases from other doctors).

For the next 4 hours, they're purely cleanup/handoff... EXCEPT in the case that a major crisis happens. Things extend 4 hours at a time in that case.

This would, however, mean staggering the doctors in 6 different shifts that could each handle the ingress load for their ramp up period.

Naturally doctors that are 'morning' or 'evening' people should be binned in to shifts compatible with their biological schedules.

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Spooky23 3468 days ago
Where do you get the 5-6 doctors to make up the difference since you're working a short shift plus pairing with another doctor for half your shift?
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mjevans 3468 days ago
Think of the 'doctor slots' as cutting blades with overlap.

The first four hours (half shift) the doctors are taking in new patients. In the next four hours they aren't taking them in, they're finishing processing and starting to pass them off to the next shift if they appear to be complex cases.

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