how does it go? accept the things you cannot change, have courage to change the things you can, and have the wisdom to know the difference?
there's this interesting little study that was just published in the new england journal of medicine that is, besides interesting, also very disturbing, i think. and odd. i suppose it makes sense when you think about it, but then it quickly goes under the heading of "i don't really want to think about that sort of thing, and if i do it might throw off the delicate balance of things i just accept because i'm supposed to."
daylight savings is one of those things that one learns from a decently young age "just happens," and so we accept the fact that however many times a year there will be mornings when we wake up and it actually isn't the time that our clock says it is. never mind that we rely on that same clock every day of the year; on this particular day it's simply mistaken. i was recently discussing the daylight savings adjustment that occurred this year, which i first got wind of when i received an e-mail at work from the information & technology department regarding our outlook calendars and such. and when i actually thought about it, it seemd a bit absurd to get a work e-mail telling me that my entire sense of time-keeping was about to change. as in, how does this sort of thing just get mandated? isn't there some overarching sense of "rightness" and fact that should mean someone can't just decide that we're going to make a new time this spring? it seems bizarre when looked at in that light.
anyway, that's a long-winded way of saying that i think some things shouldn't be subject to change because they are dependant on other things. like time should just be time. similarly, if you have a heart attack on a tuesday, the chance you'll survive it should be the same as if you have one on saturday. well, apparently, that's not so.
according to this new study that was conducted by the robert wood johnson foundation, (and don't even ask me why they decided to launch a full study on this; if that doesn't make you wonder...) heart attack patients have a better chance of surviving if admitted to hospital for treatment on a weekday than if they are admitted on a weekend. and yes, researchers did look at other factors at the same time — demographic attributes, other medical conditions that might be ivolved, and "other variables between patients taken into hospital over the weekend as opposed to during the week" — but it turned out that the significant findings had nothing to do with those factors. it's as simple as this: more people die on the weekends of heart attacks than they do during the week. and that is because there are more specialists on staff during the week, more staff in general on staff, and patients receieve more invasive cardiac procedures that, evidently, are saving lives of heart attack patients. patients admitted during the weekend were less likely, for example, to receive angioplasty. time is also very clearly of the essence; succesful treatment is very heavily dependent on quick diagnosis and subsequent action, and it seems that this happens more during the week than on the weekend. that makes sense if we know that there are more hospital wokers on staff during the week.
though it sounds minute in percentage tems, from the very little understanding i have of anything medical, the discrepancy here is rather alarming. just for the sake of laying out the numbers, the difference was about 1 per cent more deaths within 30 days in the weekend admission. in layman's (read, my) terms, the researchers concluded that this 1 per cent increase in mortality "could account for several thousand deaths annually in the united states".
whoah, right?
this whole thing is pretty much a joke about waiting to have your heart attack during the week waiting to happen, but i'd actually like to try and avoid that route. it's pretty disturbing that an issue of staffing or which procedures happen when (most likely a result of the staffing issue) — in other words something people are deciding — is having this much of an effect on whether patients live or die. daylight savings is one thing; sure, let someone just decide that. it's not doing any harm, so that can be one of those things that — in my mind, anyway — shouldn't necessarily be subject to change due to someone's whim (or meticulous forethought, even), but if people in our hospitals are actually dying with more frequency as a direct result of the way higher-ups are choosing to do things, that's just problematic.
as i mentioned above, i have no idea why this study was conducted. but since it was indeed conducted, and the results are so overwhelmingly and plainly decipherable — even for someone like myself — there is no excuse for not making some attempts at correcting the problem. if hospital staff needs to be paid more to work on the weekends, then we need to find some money to pay them more. and more specifically, if more specialists need to be available on weekends, then we need to find a way to make sure that they are. it's simple. i'm not saying that the means by which we do this is simple, but the goal is. this is not an instance where we should take that information, digest it, and just accept it.
and if you happen to know anyone who is high-risk for a heart attack or who has already suffered one, encourage them to save extremely strenuous activities for the weekdays. i said i wasn't going to go there. too easy.
daylight savings is one of those things that one learns from a decently young age "just happens," and so we accept the fact that however many times a year there will be mornings when we wake up and it actually isn't the time that our clock says it is. never mind that we rely on that same clock every day of the year; on this particular day it's simply mistaken. i was recently discussing the daylight savings adjustment that occurred this year, which i first got wind of when i received an e-mail at work from the information & technology department regarding our outlook calendars and such. and when i actually thought about it, it seemd a bit absurd to get a work e-mail telling me that my entire sense of time-keeping was about to change. as in, how does this sort of thing just get mandated? isn't there some overarching sense of "rightness" and fact that should mean someone can't just decide that we're going to make a new time this spring? it seems bizarre when looked at in that light.
anyway, that's a long-winded way of saying that i think some things shouldn't be subject to change because they are dependant on other things. like time should just be time. similarly, if you have a heart attack on a tuesday, the chance you'll survive it should be the same as if you have one on saturday. well, apparently, that's not so.
according to this new study that was conducted by the robert wood johnson foundation, (and don't even ask me why they decided to launch a full study on this; if that doesn't make you wonder...) heart attack patients have a better chance of surviving if admitted to hospital for treatment on a weekday than if they are admitted on a weekend. and yes, researchers did look at other factors at the same time — demographic attributes, other medical conditions that might be ivolved, and "other variables between patients taken into hospital over the weekend as opposed to during the week" — but it turned out that the significant findings had nothing to do with those factors. it's as simple as this: more people die on the weekends of heart attacks than they do during the week. and that is because there are more specialists on staff during the week, more staff in general on staff, and patients receieve more invasive cardiac procedures that, evidently, are saving lives of heart attack patients. patients admitted during the weekend were less likely, for example, to receive angioplasty. time is also very clearly of the essence; succesful treatment is very heavily dependent on quick diagnosis and subsequent action, and it seems that this happens more during the week than on the weekend. that makes sense if we know that there are more hospital wokers on staff during the week.
though it sounds minute in percentage tems, from the very little understanding i have of anything medical, the discrepancy here is rather alarming. just for the sake of laying out the numbers, the difference was about 1 per cent more deaths within 30 days in the weekend admission. in layman's (read, my) terms, the researchers concluded that this 1 per cent increase in mortality "could account for several thousand deaths annually in the united states".
whoah, right?
this whole thing is pretty much a joke about waiting to have your heart attack during the week waiting to happen, but i'd actually like to try and avoid that route. it's pretty disturbing that an issue of staffing or which procedures happen when (most likely a result of the staffing issue) — in other words something people are deciding — is having this much of an effect on whether patients live or die. daylight savings is one thing; sure, let someone just decide that. it's not doing any harm, so that can be one of those things that — in my mind, anyway — shouldn't necessarily be subject to change due to someone's whim (or meticulous forethought, even), but if people in our hospitals are actually dying with more frequency as a direct result of the way higher-ups are choosing to do things, that's just problematic.
as i mentioned above, i have no idea why this study was conducted. but since it was indeed conducted, and the results are so overwhelmingly and plainly decipherable — even for someone like myself — there is no excuse for not making some attempts at correcting the problem. if hospital staff needs to be paid more to work on the weekends, then we need to find some money to pay them more. and more specifically, if more specialists need to be available on weekends, then we need to find a way to make sure that they are. it's simple. i'm not saying that the means by which we do this is simple, but the goal is. this is not an instance where we should take that information, digest it, and just accept it.
and if you happen to know anyone who is high-risk for a heart attack or who has already suffered one, encourage them to save extremely strenuous activities for the weekdays. i said i wasn't going to go there. too easy.
posted by blythe at 9:55 AM
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