Dr. Wachter said: “The study is telling us how hard improving safety really is. Process changes, like a new computer system or the use of a checklist, may help a bit, but if they are not embedded in a system in which the providers are engaged in safety efforts, educated about how to identify safety hazards and fix them, and have a culture of strong communication and teamwork, progress may be painfully slow.”
Earlier in the article however:
“A third of the errors in the intensive care unit disappear when residents work 16 hours or less,” Dr. Landrigan said, but noted that senior residents are still allowed to work longer.
Not having people work 16 hour days isn't hard, it's common sense. Of course there will be a few situations where it's beneficial but this is an instance where I see a cult of hard work having significant negative effects in the real world. I am certain it's not the only one. We need to stop talking about the hard work that goes into a 16 hour day as a good thing and start condemning it as reckless behavior. While the ill effects are clearest in medicine this is simply forcing people to do things we're not built to do. We need to build systems that work with people as they actually are, not as we wish them to be and to stop treating reckless behavior as something that should be honored. It reminds me of the bankers justifying their salaries through the long hours they work. My first reaction was that perhaps the system wouldn't have crashed if the lot of them had been getting enough sleep and weren't making stupid errors due to fatigue.