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4.15. Pareto Principle = 80/20 rule

Italian economist Vilfredo Pareto first developed the 80/20 rule (aka the law of the vital few, or the principle of factor sparsity) from observing that approximately 80% of land in Italy was owned by 20% of the population.

The business world has long said that 80% of business comes from 20% of customers, and statisticians have noted that historically, 80% of events come from 20% of causes. 80% of traffic occupies 20% of roads, and perhaps nobody cares about this, but 80% of peas also come from 20% of pods, Mendel or no Mendel.
The Pareto Principle applies to healthcare in many ways. 80% of healthcare costs come from 20% of patients (same goes for readmissions), and along the same vein, 80% of clinical problems that arise throughout a shift come from 20% of patients. On the other hand, if we flip the rule, we also see that 20% of our efforts may produce 80% of effects. As nurses and medical professionals, we may prioritize the most critical and urgent 20% of tasks to produce 80% of results (and work towards preventing 80% of complications) any given day. The remainng 80% of tasks that will produce 20% of results, we'll try out best to get to, or delegate.

As normal people going about our business in real life, we may ask ourselves: "Of my mile-long, soulcrushingly overwhelming to-do list, what 20% of tasks will produce 80% of imperative and desired outcomes?" Paying bills on time helps, and meeting deadlines in general is good practice. Also, taking pills, getting nutrition and at least some sleep are essential to keeping our bodies functioning. Mopping and laundry can wait--unless you need that uniform tomorrow, in which case, it makes the cut.

In short, life is too short for us to sweat every tiny bit of the nonessential 80% when the more important 20% are urgently sounding alarms and requiring rapid responses. Take care of the big things first, and try your best. No one can do all the things, all the time.


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