The fix is clearly to have a group of non-medical people in charge of that pooled pot of money who can deny payments for arbitrary reasons.
I think this is the most sane solution
towerful
joined 2 years ago
"Frank", it I don't think that name is in the same ballpark as you are looking for.
Yeh, same. Which is why I said ideally there would be 100% overlap with shifts. Always 2 doctors, offset by half a shift.
Like, that is the fix. Peer review of decisions, easy conference/council/whatever-the-word-is, context can be handed over better (outgoings doc/nurse briefs incoming doc/nurse while remaining doc/nurse listens & supplements)
But I have also been on gigs (I work in events) where there is a rig crew, a show crew and a derig crew.
When everything is meticulously planned out and everything goes according to plan with all the communications in advance, it works. It does. (As a tech, I'd rather set up the kit I'm using). If I know it has been set up according to pre-communicated spec then I can work it. If it deviates and I have been in the loop, I can work with it. But if it turn up and it doesn't make immediate sense then it is many times harder. If I am rigging kit without a clear concrete plan, then I am guessing what the tech wants.
And I also know 2 lampies can't co-light a gig unless they take turns.
Someone has to be incharge, someone has to take responsibility.
But I don't think (and from what I have read, and I'm sure I have been somewhat misinformed) that applies directly to healthcare. Meticulous plans don't exist. Every patient is different. Something minor reported and expected to go away on the last visit of the leaving doc that is then reported as slightly-more on the new docs visit... That could be significant. And a few extra hours on a shift could save a life, because of that easily dismissed/forgotten context/knowledge during a handover.
2 doctors at all times is the fix.
Or, actually, a voice-to-text and an LLM....
Likely a decent usage of an LLM.
It doesn't need to know who/what the patient is. It doesn't need to know co-morbidities, existing conditions, medications, treatmens etc. Just that the doctor is interacting with patient A, and here is a summary.
Patent A is the same patient that a nurse interacts with.
Helps with hangovers and context.
Patient A is still in the hospital? Patient A still has a transcribed record that can be quickly summarised by a local (or onsite) LLM.
Using onsite LLMs is no different than using a database. And it doesn't have to be massive. 30m before a shift change, there can be a "notes after this time will not be summarised during handover so previous context can be summarised". So doctors only have to remember the last 30m during a handover, and the rest of the context (even transcripts) are provided to prompt their memory for a better handover.
It's an information tool for doctors, not a crutch.
And now I sound like an AI shill.
Sorry for the wall of text. I've been drinking. I hate the "just use LLMs bro", but think they have genuine utility when applied safely and locally.
And I want doctors and nurses and janitors/cleaners/sterilisers/techs of hospitals to be treated like the fucking heros they are.
We aren't. But it's generally better for patient care. It's the same nurse/doctor seeing through more of the care of a patient with less handovers.
Handovers are where minor details or context can be forgotten, dropped or misunderstood - especially after a really tough shift.
Patients also get to see the same faces more often, which makes them feel like they are being taken care of - as opposed to a part being made in a machine.
But it's wrong. It would be better to have 8 hour shifts with 2-4 hour overlaps between shifts. So it's not a handover, it's an actual rounds, it's actually servicing patients and so on.
But that is likely very intrusive for patients, and 4-8 hours of the shift is with someone else (who you might not like or agree with) and communicating (which can be tiring).
So yeh, it's not great. Understaffing doesn't help, especially since these are people that genuinely care about their work. It's pure exploitation, because it is cheaper and hospital administration can justify it and get away with it (or whatever is higher that hospital admin in the case of free healthcare).
In some cases, it's budget and exploitation. And it's bullshit.
But there is a genuine argument that a doctor who is fully informed and tired is better than a doctor who is fresh and oblivious.
Ah, I must've skimmed that part. Silly me.
Glad my deduction was correct.
Maybe.
But it is part of CAA regulations: https://www.caa.co.uk/commercial-industry/airlines/dangerous-goods/changes-to-rules-on-the-carriage-of-lithium-cellsbatteries-and-power-banks/
Must be in carry-on and cannot be used in flight.
So, technically the plane was flying illegally.
Fires on planes are NO joke. And lithium batteries love fire, whether starting it themselves or getting hot enough to set other things on fire.
How they discovered it was charging in the hold during flight, I have no idea.
It had to have been a passenger mentioning it.
The cargo hold is completely sealed off from in-flight accessible areas (some older planes have small access hatches that require tools to open).
I'll grant it should be "a self fullfilling prophecy".
But it never has a "z" in it.
That comes from incorrectly thinking it needs similar similar patterns to other verbs.
And this isn't some "simplified English" Vs "English" scenario. It's not even recognised as part of American English.
A self prophesying comment! You got your wish
Gamers Nexus is great content.
They constantly seem to do the right thing. Like honest people wanting to report honest news, findings and research in depth to people transparently.
Like Louis Rossmann, tho I prefer Steve & GN
Yeh, it's an http site. So any browsers that require https will block/warn.
But also, holy hell is it obvious once you realise.
Arms up, then swipe down out to the sides, and repeat. Like frantically trying to fly.
As SOON as they are in trouble, it's arms flailing in that pattern. Like, look for white splashing water and assess if it's playing or panic.
A few you can tell who it is gonna be because they flip off their donut. And a few you can tell cause they are trying to swim but are looking up and aren't keeping their mouth above the water (I clicked on one of these to be told "it's fine" only for them to start thrashing and get rescued when I resumed the video)
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Never mind the damage it did to the launch pad.
And there is concern about possible damage to the other rocket in the FAB