--- Doc Holiday <[log in to unmask]> wrote:
> --> The main problem with the 4-hour limit is that
> it tends generically to
> make SOME people do SOME things SOME of the time
> which are guided by how
> long it has been since the patient booked in and NOT
> by what they really
> think they want to do for the patient. It also makes
> SOME people bully and
> trouble shop-floor workers because they themselves
> are treated likewise by
> their managers who are all concerned about their
> chances for foundation
> status and how 4-hour performance affects that...
>
While I can see where you are coming from not having
any sort of limit causes problems too. Some of the
things I've seen/heard of:-
"We can't take a patient now, we are just about to
have hand over!"
"We can't take a patient just yet, we've only just had
one!" (Must try that on the next ambulance that comes
in!)
An SHO at a provincial teaching hospital explaining to
me that if the waiting time got above 6 hours all the
SHO's would sit down for a break for an hour in the
hope that the lengthening wait would persuade some
people to go home!
The tendency of some docs to spend 45 minutes writing
notes/signing letters/checking results/suturing minor
laceration so they don't have to see another patient
before their shift finishes.
The minors SHO that disappears round to majors and
never returns - when you go round you find him/her
sipping coffee and waiting for the results to return
on the 1 patient they have seen.
I agree that people should not be hounded over targets
particularly if the problem is one of inadequate
resources, but some people do need an incentive to get
them going.
Cheers Fred.
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