[llimllib]

1. That's weird, what the heck ED do they do 30 hour shifts in? Non-US? My wife is an ED physician in the US and that does not ever happen in any ED she's been in.

2. She's also boarded in internal medicine, where she did have to do 30 hour shifts. They are terrible for patients and physicians, and I've been in heated arguments with physicians because I think the primary reason they exist is as hazing.

3. Handoffs are a legit problem; much more in other fields than in the ED. (Though handoffs do exist in the ED). It is a balancing act for that reason, though physicians could do a lot better with the handoff process IMO.

4. http://mef.med.ufl.edu/files/2010/01/Resident-and-Attending-... :

> Handoffs, the transfer of patient care from one health care provider to another, are known to be vulnerable to communication failures8 and have been called “remarkably haphazard.”

and

> When looking specifically at malpractice cases with communication breakdowns, 43% involved handoffs.

5. It's my belief that patient-centric design and communication could eliminate nearly all of these issues while reducing the need for long shifts, but there's a big [evidence needed] tag on that

[jblok]

What, with your knowledge, could be done with technology to solve this problem of handoff?

A notepad app probably wouldn't cut it, but is there any way to move the complex thoughts in a doctors mind into a database somehow?

[llimllib]

I don't know what the exact process would be, but I think that the key would be to focus on process. Start treating each patient mishap like the FAA treats every airline mishap, take steps to ensure that each doesn't happen in the same way again, and I think you could improve things a great deal.

I think doctors focus on, and are very good at, doctoring. A little more focus on process and the totality of the hospital experience could bring big gains relatively quickly.

That's just an outside opinion though, my wife would probably disagree with me.

[tdb7893]

I doubt it would scale. The FAA regulates one thing (flying planes) and there still are a ton of checklists and regulations, presumably if you tried the same thing with medicine it would collapse under it's own weight with all the different edge cases