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The Q**** Study – basic randomised evaluation of attendance at a children's emergency department
  1. Graham Johnson


Introduction Health Professionals are superstitious; be it a little ritual before sitting a cannula, or wearing a particular item of clothing while on-call, there are many things that we irrationally do day-to-day. One of the most well known superstitions is that uttering the word “quiet” (Q****) will immediately turn what has previously been a pleasant day into an extremely busy one. This belief is strongly at odds with modern Evidence Based Medicine, in fact a thorough literature review revealed no published research in this area. The aim of this study was to establish if there was any evidence that saying the word “Q****” influenced the number of attendances to a Children's Emergency Department.

Method We measured attendance during three time periods per day for the study duration (A – 00:00 to 07:59; B – 08:00 to 15:59; C – 16:00 to 23:59). At the beginning of each time period a randomised envelope was opened that contained either the word “Q****”, “Busy” or was blank, this prompted the doctor and nurse in charge to utter a sentence containing the word from the envelope, which was also displayed for the rest of the 8 h.

Results 1454 patients were included in the intervention period and 2818 were included in the 4 week control period to measure typical attendance. Mean attendance for intervention and control were: A 7.29 and 7.71; B 40.86 and 40; C 55.57 and 52.86 respectively. “Q****” and Busy were uttered 12 times each. There was no statistically significant difference in attendance for either word.

Conclusion This study has shown that the long-held belief that saying the word ‘Quiet’ has dire consequences is unfounded. We would recommend further research to explore whether other words could be used to influence Emergency Department attendances.

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