TY - JOUR
T1 - Opportunistic decision making and complexity in emergency care
AU - Franklin, Amy
AU - Liu, Ying
AU - Li, Zhe
AU - Nguyen, Vickie
AU - Johnson, Todd R.
AU - Robinson, David
AU - Okafor, Nnaemeka
AU - King, Brent
AU - Patel, Vimla L.
AU - Zhang, Jiajie
PY - 2011/6
Y1 - 2011/6
N2 - In critical care environments such as the emergency department (ED), many activities and decisions are not planned. In this study, we developed a new methodology for systematically studying what are these unplanned activities and decisions. This methodology expands the traditional naturalistic decision making (NDM) frameworks by explicitly identifying the role of environmental factors in decision making. We focused on decisions made by ED physicians as they transitioned between tasks. Through ethnographic data collection, we developed a taxonomy of decision types. The empirical data provide important insight to the complexity of the ED environment by highlighting adaptive behavior in this intricate milieu. Our results show that half of decisions in the ED we studied are not planned, rather decisions are opportunistic decision (34%) or influenced by interruptions or distractions (21%). What impacts these unplanned decisions have on the quality, safety, and efficiency in the ED environment are important research topics for future investigation.
AB - In critical care environments such as the emergency department (ED), many activities and decisions are not planned. In this study, we developed a new methodology for systematically studying what are these unplanned activities and decisions. This methodology expands the traditional naturalistic decision making (NDM) frameworks by explicitly identifying the role of environmental factors in decision making. We focused on decisions made by ED physicians as they transitioned between tasks. Through ethnographic data collection, we developed a taxonomy of decision types. The empirical data provide important insight to the complexity of the ED environment by highlighting adaptive behavior in this intricate milieu. Our results show that half of decisions in the ED we studied are not planned, rather decisions are opportunistic decision (34%) or influenced by interruptions or distractions (21%). What impacts these unplanned decisions have on the quality, safety, and efficiency in the ED environment are important research topics for future investigation.
KW - Across-task decisions
KW - Complexity
KW - Emergency department
KW - Methodology
KW - Opportunistic decision making
KW - Opportunistic planning
KW - Taxonomy of decision types
UR - http://www.scopus.com/inward/record.url?scp=79957589002&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79957589002&partnerID=8YFLogxK
U2 - 10.1016/j.jbi.2011.04.001
DO - 10.1016/j.jbi.2011.04.001
M3 - Article
C2 - 21511054
AN - SCOPUS:79957589002
SN - 1532-0464
VL - 44
SP - 469
EP - 476
JO - Journal of Biomedical Informatics
JF - Journal of Biomedical Informatics
IS - 3
ER -