Not even sure if there's such a thing.
An interesting idea which always turns up everywhere it seems. Do you spend time / effort preparing for the 90% of the time when things go right, or the 10% of the time when things go wrong?
Both sides can be argued of course. For example say you have a farm, and there's a 90% chance of good weather on any given year, and 10% chance of bad weather. Is the majority of your equipment going to focused on getting the most you can out of a year of good weather, or focused on salvaging what you can of a year of bad weather?
Say a hospital, is the majority of your equipment and staff going to be dedicated towards enchancing the comfort and care to the 90% of patients who come in with treatable problems, or are you going to dedicate the majority of your equipment and staff towards the 10% of patients that come in critically injured and probably going to die anyway?
Argument 1 : you should prepare for the 90% scenario, otherwise you're just spending time on the 10% situations that you cannot salvage anyway. Argument 2 : you should prepare for the worst case scenario since in the best case scenario you are going to do fine anyway no matter what.
There is always the temptation to play to your strengths, improve them further, and rely on them more and more. That's the 90% scenario.
Yet spending too much time on the 10% cases might even lead to a self fulfilling prophesy : not being fully prepared to take advantage of a "good" outcome might cause it to change into a "bad" outcome, in which you have to take the emergency measures which you have so carefully prepared for. To see what I mean, just look at the two examples above.
6 comments:
hmmm... not sure about this one.
In the dental world though we prepare for 90% of the cases. This I mean by hygience procedures. See 10% of your patients will comein with diseases like AIDS or TB or HepB, but you are usually only just equipped enough to handle these.
I think the preparation time and money involved to be that prepared is just not feasible
Thank you ash. That's very comforting. Really.
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CatR.
Hm ... Difficult. To throw another example into the mix, I'd say the realm of computing is geared to handle the 10%. For instance, servers have triple redundancy systems, so in the slim - but still existant - chance that there's a powercut the system is still online. Data is backed up periodically even though things might go down maybe once a year, less.
Yet perhaps this is a bad example, because in the 90% scenario everything is running smoothly and you don't need to do anything special.
I think the defining factor is $$$
For example if I wanted an operating thater to be full proof and always watch the 10% I would have to destroy all the operating equipment after each procedure. Which is insane! We already destroy all the needles and surgical blades and in itself that is a great great great cost. So financially that system would collapse
With the computing system I guess the 10% is the thing that would kill you if and when it goes wrong. And in dentistry the 10% has an infinitismal chance of killing you.
Sorry got to live in the real world. Sharp injuries with patients infected with AIDS is not unheard of. If it's of any comfort I am probably more at risk than any patient.
In the dental world though we prepare for 90% of the cases. This I mean by hygience procedures. See 10% of your patients will comein with diseases like AIDS or TB or HepB, but you are usually only just equipped enough to handle these.
That's insane... in med I'd say we are more likely to go with the 10% stuff. Sharps are thrown away, scalpels and other instruments are extensively autoclaved... it's very very unlikely that a patient will catch HIV from another patient. Given that the HIV rate in Aus is around 0.1% and Hep C is around 1% and these are lethal, yet preventable diseases, it seems almost criminal NOT to take adequate precautions.
I think it all depends on a cost/benefit risk analysis really. I mean, if the cost of ignoring the worst case scenarios is as bad as with HIV, then you must prepare for them. If they're more acceptable risks (like catching a urinary tract infection from having a urinary catheter put in), however, it becomes a much more interesting question, I feel.
sharps and all that are discarded. but that's cos more than just AIDS gets transmitted by blood. That's still the 90%
Considering there is an entire different protocol for AIDS patients. I'd say most of the time you do not follow that protocol since 1/1000 patients are going to walk in with it. I do not antibiotic cover everyone that walks into my chair and I prod with a probe to check their gums. Now that's the ten percent - the immunocompromised and special cases.
Of course we are safeguarded against AIDS and Hep C. But those aren't ten percent cases. Blood transmitted disease is way not in the ten percent. You can spread just about anything.
So I mantain 90% of the cases. I know we have nothing at the hospital to deal with the mentally challenged at least.
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