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“No more bets please…”

August 17, 2012

Las Vegas…also known, as I am often reminded, as the city of “Lost Wages”. I’m going to be headed there in November, the 11th through the 14th to be exact, to attend KronosWorks – the World’s Leading Workforce Information Exchange. In order to prepare, I have been doing some extensive research on the game of roulette. I like to gamble…(huge understatement!)

Roulette is my game. Basically, you place bets in three different ways. The bet can be on a certain number, group of numbers or a color – red or black! Depending on the type of bet, if it’s a winner, the return varies. Winning is determined by a little white ball traveling around a wheel of numbers and eventually falling onto the wheel and resting on a specific number and color. I’m interested in increasing my chances of winning. To that end, I have been interested in predictive forecasting of the winning numbers.

It seems I am not alone in the quest for predictive forecasting of winning numbers. There are lots of people out there more than willing to sell me their book or their “system” for predicting winning numbers and colors. Even the casinos themselves are feeding into my desire for predictability, with LCD displays of the most recent winning numbers at each roulette table. That display is meant to influence my belief about the outcome of the next spin. If there has been a “run” of red numbers winning, the next winner surely must be black!

The truth is each spin of the wheel and journey of the little white ball is unique! It doesn’t really matter what the last result was – I have as good a chance of winning this time as I did last time. So there is really no point to “chasing” the next winning number! The only thing I can predict is that the winning number will be one of the following: 0, 00, 1-36, red or black – those are the only choices on the table.

As I struggle to internalize the fact that I cannot accurately predict the next winning number, and I am struggling – crying actually, it occurs to me that the same is true in trying to predict a patient’s movement throughout the hospital stay. There are those in healthcare today who will say that the ability to predict where a patient will be and proactively staff for that event is doable. I contend it is not!

There is variation even in patients with identical diagnoses. They are of different ages, body sizes, resiliency, degree of emotional stability and may have different co-morbidities that influence their experience. Each patient is unique and will run the course of hospitalization with some variation.

In addition, the system is not “perfect”. The patient may be ready to move from critical care to a step-down unit as expected but perhaps the step-down isn’t able to accept the patient. The housekeeping department is short staffed and the receiving bed isn’t ready to accept the patient. You just simply cannot predict the future with certainty!

The average patient is rare. The average experience is just as rare. Why expend time and resources to plan for a rare event? When in truth “average” will only occur if you’re lucky…

The one thing I do believe in is “The Flaw of Averages” . On average, averages are wrong!

Now back to the task at hand, I need to predict what the winning number will be on the “average” Sunday night in November at approximately 8PM PST at the Aria Hotel and Casino…that’s when I’ll be placing my first bet at the roulette table! Wish me luck…

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