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Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

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Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#141

Post by newsgourmet »

colonwqbang wrote: post #84
Ensorceled wrote: post #79

Anecdotally, my father-in-law was chief of staff for a small city hospital and they had a rule about not scheduling afternoon surgeries on important days like anniversaries, birthdays, etc. Basically, if the surgery started going long, you didn't want the surgeon worrying about missing their spouses birthday, birthday with their kids or an anniversary. It actually wasn't that many surgeries delayed, as the surgeon ju…

This is a beautiful conjecture! The problem is amusingly circular. Even if you reject the conjure in parent comment, you will be tempted to reduce the number of birthday surgeries due to the increased mortality. This will mean that birthday surgeries are only done in even more desperate circumstances which of course will increase the risk. So mitigation of this problem will lead to the percentage increasing even more…

I think you have it backwards. The risk of the individual surgeries is not increased. Only the risk that a surgeon will be confronted with an above average critical surgery is increased.

It is not even clear that there actually is a problem. It's just a weird way to slice the data to produce an effect.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#142

Post by inglor_cz »

Reason077 wrote: post #90
onehp wrote: post #74

Earlier quoted context omitted.

In all the work environments I've been in (UK) the culture is the opposite, as the birthday person you are expected to bring in cake.

In that case, I'd be trying to keep my birthday a secret!

"I wasn't born. I just ... slowly coalesced over a year or so, just like celestial bodies do."

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#143

Post by someburner »

mhh__ wrote: post #52

https://www.england.nhs.uk/2019/01/surgical-safety-checklist... Getting surgeons to adopt the kind of "It's obvious but point and speak or you're fired"-style checklists a la operating an aircraft has reduced complications (from the minor to deaths) by several percent in the NHS. It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?".

I just got surgery in California and noticed I was asked to state my name and birthday anytime I moved rooms or saw a new person. Seems like this is now part of protocol in a lot of places.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#144

Post by jrh206 »

daniellarusso wrote: post #137
Galanwe wrote: post #104

Earlier quoted context omitted.

I don't think surgeons are fongible assets. There is a lot of planning and study taking place before a complex operation. Not to mention most surgeons have specialties.

A surgeon seems more fungible than a developer, to me. All sorts of standards, compliance, and licensing requirements.

Nobody's making any points about developers

My gut instinct is that this is incorrect, too, but I don't know enough about surgery to make a compelling argument.

I'd back myself to pick up Ruby (a language I've never touched before) and be productive, more than I'd trust a surgeon who only has experience with heart surgery to operate on my brain. Maybe that's ignorant of me.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#145

Post by MeinBlutIstBlau »

mhh__ wrote: post #52

https://www.england.nhs.uk/2019/01/surgical-safety-checklist... Getting surgeons to adopt the kind of "It's obvious but point and speak or you're fired"-style checklists a la operating an aircraft has reduced complications (from the minor to deaths) by several percent in the NHS. It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?".

As an advocate of checklists for specific tasks, yes that stuff is good. Oftentimes there are a lot of checks that one would go "yeah no duh." But most good checklist exist with a checkbox because that was an issue before.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#146

Post by kba »

tomxor wrote: post #80
mhh__ wrote: post #52

https://www.england.nhs.uk/2019/01/surgical-safety-checklist... Getting surgeons to adopt the kind of "It's obvious but point and speak or you're fired"-style checklists a la operating an aircraft has reduced complications (from the minor to deaths) by several percent in the NHS. It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?".

I'm probably going to sound silly now but I do this when doing any technical work I deem important or critical enough, point and say outloud what it's for or what state it should be in or in the imperative what to do to it... it does work, it somehow catches silly mistakes compared to keeping everything in your mind, and also gives you confidence because it works like a checklist. Known as pointing and calling in tra…

What you're describing is very similar to Rubber duck debugging. The idea here is that forcing you to explain what you're trying to do makes it easier for you to catch your mistakes.

https://en.wikipedia.org/wiki/Rubber_duck_debugging

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#147

Post by ninju »

someburner wrote: post #143
mhh__ wrote: post #52

https://www.england.nhs.uk/2019/01/surgical-safety-checklist... Getting surgeons to adopt the kind of "It's obvious but point and speak or you're fired"-style checklists a la operating an aircraft has reduced complications (from the minor to deaths) by several percent in the NHS. It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?".

I just got surgery in California and noticed I was asked to state my name and birthday anytime I moved rooms or saw a new person. Seems like this is now part of protocol in a lot of places.

I believe a lot of that is verifying that you are the right patient

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#148

Post by quietbritishjim »

newsgourmet wrote: post #141
colonwqbang wrote: post #84

Earlier quoted context omitted.

This is a beautiful conjecture! The problem is amusingly circular. Even if you reject the conjure in parent comment, you will be tempted to reduce the number of birthday surgeries due to the increased mortality. This will mean that birthday surgeries are only done in even more desperate circumstances which of course will increase the risk. So mitigation of this problem will lead to the percentage increasing even more…

I think you have it backwards. The risk of the individual surgeries is not increased. Only the risk that a surgeon will be confronted with an above average critical surgery is increased. It is not even clear that there actually is a problem. It's just a weird way to slice the data to produce an effect.

> The risk of the individual surgeries is not increased.

They never said that it did (unless they've edited their comment since you replied to it). They just said that the percentage [of deaths on surgeons' birthdays] will increase, and that is correct.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#149

Post by minikites »

someburner wrote: post #143
mhh__ wrote: post #52

https://www.england.nhs.uk/2019/01/surgical-safety-checklist... Getting surgeons to adopt the kind of "It's obvious but point and speak or you're fired"-style checklists a la operating an aircraft has reduced complications (from the minor to deaths) by several percent in the NHS. It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?".

I just got surgery in California and noticed I was asked to state my name and birthday anytime I moved rooms or saw a new person. Seems like this is now part of protocol in a lot of places.

I got in a medium-severity bicycle accident in 2010 and while I was being whisked around the hospital for different tests and procedures I had to do that too.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#150

Post by mhh__ »

tomxor wrote: post #80
mhh__ wrote: post #52

https://www.england.nhs.uk/2019/01/surgical-safety-checklist... Getting surgeons to adopt the kind of "It's obvious but point and speak or you're fired"-style checklists a la operating an aircraft has reduced complications (from the minor to deaths) by several percent in the NHS. It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?".

I'm probably going to sound silly now but I do this when doing any technical work I deem important or critical enough, point and say outloud what it's for or what state it should be in or in the imperative what to do to it... it does work, it somehow catches silly mistakes compared to keeping everything in your mind, and also gives you confidence because it works like a checklist. Known as pointing and calling in tra…

Its absolutely not silly.

It's similar to why formal verification is so important in hardware, because it's effectively forcing you to be specific about semantics and let's the computer walk through things for you.

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