I’ll take the 9 o’clock slot

I’ll take the 9 o’clock slot

I had a hunch about this one, which unfortunately turns out to be right. Whenever a family member has had to have surgery I’ve suggested getting the first business hour slot (i.e., 8 or 9 am) if possible. My logic? The more experienced hospital staff is likely to be working then, they won’t be overtired, and the surgery is less likely to be delayed. The patient (and family) also won’t waste the day stressing out about the event.

A study in this month’s Quality & Safety in Health Care reinforces one aspect of this hunch. In a review of anesthesia-related adverse events for 90,000 surgeries at Duke University Medical Center, researchers found that adverse events were four times as likely to occur when surgery started at 4 pm than when it started at 9 am. The authors attribute the higher levels of AEs to “staff load, fatigue and caregiver transitions,” and said that these differences were “expected.”

Expected, perhaps. But totally unacceptable as far as I’m concerned. Do you remember the worst days of Detroit’s quality problems? Insiders would tell you about quality problems with cars assembled on Mondays (because workers were hungover) or around long weekends (workers skipping out). Big 3 management denied the problem, but it was real. Somehow Honda and Toyota didn’t have these problems, even when they shifted to building cars in the US.

We shouldn’t put up with processes whose quality varies so much based on factors like time of day. It’s a scandal.

August 8, 2006

Leave a Reply

Your email address will not be published. Required fields are marked *