TY - JOUR
T1 - Decision-making Strategies for Telephone Triage in Emergency Medical Services
AU - Leprohon, Judith
AU - Patel, Vimla L.
PY - 1995/8
Y1 - 1995/8
N2 - Decision-making strategies used by nurses in telephone triage involving public emergency calls for medical help were investigated as a function of task urgency and complexity in the real-world dynamic environment. The sample included 34 nurses as call receivers. Tran scripts of 50 nurse-client dialogues and 50 explanations of the decision-making process, elicited immediately after completion of the calls, were analyzed using methods of discourse and protocol analyses. In high-urgency situations, heuristic rules based on symptoms were used, and the decisions were mostly accurate. With the increase in problem complexity, more causal explanations were found, and the decisions were more often inaccurate. Fur thermore, the explanations supporting the accurate decisions were often inaccurate, showing a decoupling of knowledge and action. Alternate strategies were used in moderate- to low- urgency conditions, where contextual knowledge of the situations was exploited to identify the needs of the clients and to negotiate the best plan of action to meet these needs, resulting in more accurate decisions. Key words: clinical reasoning; cognitive models; context; decision making strategies; emergency medical services; intuition; nursing decision making; telephone triage; uncertainty. (Med Decis Making 1995;15:240-253).
AB - Decision-making strategies used by nurses in telephone triage involving public emergency calls for medical help were investigated as a function of task urgency and complexity in the real-world dynamic environment. The sample included 34 nurses as call receivers. Tran scripts of 50 nurse-client dialogues and 50 explanations of the decision-making process, elicited immediately after completion of the calls, were analyzed using methods of discourse and protocol analyses. In high-urgency situations, heuristic rules based on symptoms were used, and the decisions were mostly accurate. With the increase in problem complexity, more causal explanations were found, and the decisions were more often inaccurate. Fur thermore, the explanations supporting the accurate decisions were often inaccurate, showing a decoupling of knowledge and action. Alternate strategies were used in moderate- to low- urgency conditions, where contextual knowledge of the situations was exploited to identify the needs of the clients and to negotiate the best plan of action to meet these needs, resulting in more accurate decisions. Key words: clinical reasoning; cognitive models; context; decision making strategies; emergency medical services; intuition; nursing decision making; telephone triage; uncertainty. (Med Decis Making 1995;15:240-253).
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U2 - 10.1177/0272989X9501500307
DO - 10.1177/0272989X9501500307
M3 - Article
C2 - 7564938
AN - SCOPUS:0029012877
SN - 0272-989X
VL - 15
SP - 240
EP - 253
JO - Medical Decision Making
JF - Medical Decision Making
IS - 3
ER -