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Day of week of procedure and 30 day mortality for elective surgery (2013)

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71–80 of 88 posts

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#71

I can't find a source, but 70's-era wisdom I got from my grandfather was when buying an American car, buy one assembled on a Tuesday. People are hungover on Monday, Tuesday is their best work day, it's downhill on Wednesday and Thursday, and they're checked out on Friday.

It's surprising that Monday was the best day. I'd expect the surgeons and staff to be impaired from weekend activities, and back to normal on Tuesdays. Tuesday was not much different from Monday and may be the wiser choice, in case your surgeon is a hard partier.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#72
post #67

I can't find a source, but 70's-era wisdom I got from my grandfather was when buying an American car, buy one assembled on a Tuesday. People are hungover on Monday, Tuesday is their best work day, it's downhill on Wednesday and Thursday, and they're checked out on Friday.

How can you possibly figure out when a car was assembled?

The sticker on the door jam with the VIN usually has the month and year.

The VIN has an indicator for which factory it was built in. You may find rumors/wisdom/witchcraft around one factory having better quality controls compared to another.

Which day of the week your car was "Manufactured" probably isn't a thing that even makes sense. That's just going to be final assembly. Each individual part will of course been manufactured on a different day. Even if you believed the magic of Tuesday is the best day, do you want to know the day your doors were hung on the hinges, or the day the pistons were machined?

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#73

I'd believe it. Rushed to the hospital on a Saturday night when my father in law suffered a massive heart attack... and he was held stable for almost 2 hours before a surgeon capable of working the situation was able to make it in and insert a stent. It seemed strange to me that a hospital would have a schedule like that... where most doctors work 9 to 5 monday to friday, and most everybody goes home for the weekends…

[deleted]

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#74

I'd believe it. Rushed to the hospital on a Saturday night when my father in law suffered a massive heart attack... and he was held stable for almost 2 hours before a surgeon capable of working the situation was able to make it in and insert a stent. It seemed strange to me that a hospital would have a schedule like that... where most doctors work 9 to 5 monday to friday, and most everybody goes home for the weekends…

I think you missed the word "elective", I guess the whole point was to remove emergency surgery from the study.

I think the principal is still the same. Surgeons do not perform surgeries every day. They usually have some days of the week they meet with their patients in an office setting. And then other days of the week they are in back to back surgery all day. It would be interesting to know what, if any, industry standards determine which days are allocated for which. Or if there is a hierarchy of surgeons who get "dibs" on scheduling their surgeries on Mondays.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#75
Reminds me of a study they did for... chance to get parole approved based on time of day. Findings were early in morning and after lunch breaks was the most successful time. Just before clock-off and lunch inmates chances were reduced.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#76

Reminds me of a study they did for... chance to get parole approved based on time of day. Findings were early in morning and after lunch breaks was the most successful time. Just before clock-off and lunch inmates chances were reduced.

The effects reported in that study are probably not real [0, 1].

[0]: http://nautil.us/blog/impossibly-hungry-judges

[1]: http://journal.sjdm.org/16/16823/jdm16823.html

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#77

Earlier quoted context omitted.

I am willing to accept bias, but Why would Monday surgeries be statistically different from Wednesday? Clearly weekend surgeries might be different, but the effect is still present Monday-Thursday. I don't work in healthcare so there might be a selection bias that I am blind to, and I am curious if you have a bias in mind. Also they did track specific procedures and for all but one (with a low n) the procedures track…

The problem is with multiple-day recovery periods after the surgery. The later in the week your surgery is scheduled, the more likely you'll overlap with the weekend when care is hypothesized to be lower quality.

Part of me also wonders if people who elect to have Monday surgeries are in a better socioeconomic place to take more time off to recover.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#79

Are there any other interesting things like this that people know of? I guess you could consider them advanced life hacks in a way. One things I was thinking of is trying to schedule meetings right after lunch. I'm basing this on the research of judges being more lenient after lunch. https://www.theguardian.com/law/2011/apr/11/judges-lenient-b...

I have always scheduled job interviews in the morning because the hiring manager is more alert and (I read somewhere) in a more upbeat mood before having to deal with tragedies of work. I extended this later in life to making sales calls as the first thing I do in the morning because I am more awake and alert.

Switched on its head, I prefer morning interviews because I can really focus on the candidates without thinking of (or being annoyed for stopping work on) a deep problem I began working on. If a sales person calls me in the morning, I'm more likely to answer and have a conversation.

Re: Day of week of procedure and 30 day mortality for elective surgery (2013)

#80
post #53

Earlier quoted context omitted.

Sure, but that implies that surgeons control the operating room schedules. I am not sure that's true (it might be), but it's a contested resource in most hospitals.

Outside of emergency surgeries, I imagine anything scheduled that isn't of immediate risk surgeons have a reasonable amount of control over, given of course the magnitude and distribution of surgeries that need performed. I can't imagine they don't look at their schedules regularly and talk to whomever does scheduling to make their lives more bearable. When they're on ER rotation, surgeons of course really have no po…

The amount of influence a surgeon has in her schedule varies from place to place and specialty to specialty. It ranges from little control, to being able to look at a calendar and pick the date. Also, most surgeons do not operate on all days. In most large hospitals, surgeons have set OR days (ex. Monday, Tuesday, and half of Thursday) every week and it is incredibly difficult to change that.
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