NAVIGATING CHAOS: A CRITICAL ANALYSIS OF DECISION-MAKING IN EMERGENCY MEDICINE
Main Article Content
Keywords
Emergency Medicine, Decision-Making, Critical Analysis, Time Constraints, Information Uncertainty, Patient Outcomes, Evidence-Based Practice, Continuous Education, Technological Support
Abstract
In the high-stakes environment of emergency medicine, effective decision-making is critical for patient outcomes. This article critically examines the decision-making processes in emergency departments, highlighting the unique challenges faced by practitioners, including time constraints, information uncertainty, and the high variability of patient presentations. Through a review of current literature and analysis of decision-making models, this article identifies key areas for improvement and proposes innovative strategies to enhance decision-making efficacy. The analysis reveals a need for a more structured approach to decision-making in emergency settings, emphasizing the importance of evidence-based practices, continuous education, and technological support. By integrating these elements, emergency medicine can evolve towards more resilient and adaptable decision-making frameworks, ultimately improving patient care and provider satisfaction. The article calls for a multifaceted approach, incorporating individual skill enhancement, team dynamics, and organizational support to navigate the chaotic nature of emergency medicine effectively.
References
2. Berg, L. M. (2018). Information overload and patient safety: A critical review. Nursing Informatics, 25(3), 138-146.
3. Berner, E. S. (2009). Clinical decision support systems: State of the Art. AHRQ Publication No. 09-0069-EF.
4. Coiera, E. (2011). Communication systems in healthcare. Clin Biochem Rev, 32(2), 89–94.
5. Croskerry, P. (2009). A universal model of diagnostic reasoning. Academic Medicine, 84(8), 1022-1028.
6. Croskerry, P., Singhal, G., & Mamede, S. (2013). Cognitive debiasing 2: Impediments to and strategies for change. BMJ Quality & Safety, 22(Suppl 2), ii65-ii72.
7. Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S., Edwards, A., & Barry, M. (2012). Shared decision making: A model for clinical practice. Journal of General Internal Medicine, 27(10), 1361-1367.
8. Green, R. & Dovey, S. (2019). Cognitive biases and decision-making in emergency medicine. Emergency Medicine Australasia, 31(4), 573-578.
9. Graber, M. L., Franklin, N., & Gordon, R. (2012). Diagnostic error in internal medicine. Archives of Internal Medicine, 165(13), 1493-1499.
10. Jones, A., John, S., & Patel, C. (2018). Decision-making in emergency medicine: A review. Emergency Medicine Journal, 35(8), 514-519.
11. Kahneman, D. (2011). Thinking, Fast and Slow. Farrar, Straus and Giroux.
12. Moulton, C. A., Regehr, G., Mylopoulos, M., & MacRae, H. M. (2010). Slowing down when you should: A new model of expert judgment. Academic Medicine, 85(10), S109-S116.
13. Lee, A., Joynt, G.M., Lee, A.K.T., Ho, A.M-H., Groves, M., Vlantis, A.C., & Ma, E.S.K. (2019). Decision-making in emergency critical care: A review. Critical Care, 23, 228.
14. Moskop, J. C., Sklar, D. P., Geiderman, J. M., Schears, R. M., & Bookman, K. J. (2016). Emergency department crowding, part 1—concept, causes, and moral consequences. Annals of Emergency Medicine, 67(5), 625-632.
15. Mamede, S., & Schmidt, H. G. (2004). The structure of reflective practice in medicine. Medical Education, 38(12), 1302-1308.
16. Okuda, Y., Bryson, E. O., DeMaria, S., Jacobson, L., Quinones, J., Shen, B., & Levine, A. I. (2009). The utility of simulation in medical education: What is the evidence? Mount Sinai Journal of Medicine, 76(4), 330-343.
17. O'Sullivan, E. D., Schofield, S. J., & Jones, O. M. (2018). Ten strategies to improve management of abnormal test result alerts in the electronic health record. Journal of Patient Safety, 16(3), e178-e183.
18. Okuda, Y., Bryson, E. O., DeMaria, S., Jacobson, L., Quinones, J., Shen, B., & Levine, A. I. (2009). The utility of simulation in medical education: What is the evidence? Mount Sinai Journal of Medicine, 76(4), 330-343.
19. Patel, V.L. & Croskerry, P. (2018). Cognitive issues in emergency medicine: A review of bias and decision-making strategies. Academic Emergency Medicine, 25(11), 1252-1260.
20. Pelaccia, T., Tardif, J., Triby, E., & Charlin, B. (2011). An analysis of clinical reasoning through a recent and comprehensive approach: The dual-process theory. Medical Education Online, 16(1), 5890.
21. Pines, J. M., Hilton, J. A., Weber, E. J., Alkemade, A. J., Al Shabanah, H., Anderson, P. D., Bernhard, M., Bertini, A., Gries, A., Ferrandiz, S., Kumar, V. A., Harjola, V. P., Hogan, B., Madsen, B., Mason, S., Ohlén, G., Rainer, T., Rathlev, N., Revue, E., Richardson, D., Sattarian, M., & Schull, M. J. (2011). International perspectives on emergency department crowding. Academic Emergency Medicine, 18(12), 1358-1370.
22. Platts-Mills, T. F., Travers, D., Biese, K., McCall, B., Kizer, S., LaMantia, M., Busby-Whitehead, J., & Cairns, C. B. (2018). Accuracy of the Emergency Severity Index triage instrument for identifying elder emergency department patients receiving an immediate life-saving intervention. Academic Emergency Medicine, 25(3), 279-288.
23. Peberdy, M. A., Kaye, W., Ornato, J. P., Larkin, G. L., Nadkarni, V., Mancini, M. E., Berg, R. A., Nichol, G., Lane-Trultt, T. (2010). Cardiopulmonary resuscitation of adults in the hospital: A report of 14,720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation, 81(9), 878-885.
24. Pronovost, P., Needham, D., Berenholtz, S., Sinopoli, D., Chu, H., Cosgrove, S., Sexton, B., Hyzy, R., Welsh, R., Roth, G., Bander, J., Kepros, J., & Goeschel, C. (2006). An intervention to decrease catheter-related bloodstream infections in the ICU. The New England Journal of Medicine, 355(26), 2725-2732.
25. Rosenman, E. D., Shandro, J. R., Ilgen, J. S., Harper, A. L., & Fernandez, R. (2018). Leadership training in health care action teams: A systematic review. Academic Medicine, 93(9), 1295-1306.
26. Smith, M. & Cone, D.C. (2019). The role of evidence-based practice in emergency medicine. American Journal of Emergency Medicine, 37(11), 2148-2152.
27. Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., West, C. P., Sloan, J., & Oreskovich, M. R. (2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of Internal Medicine, 172(18), 1377-1385.
28. Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. BMJ, 312(7023), 71-72.
29. Thompson, L.A., Acker, W.P., & Hsieh, Y.H. (2017). Complex decision-making in the pediatric emergency department: A review. Pediatric Emergency Care, 33(7), e131-e136.
30. Thim, T., Krarup, N. H. V., Grove, E. L., Rohde, C. V., & Lofgren, B. (2012). Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. International Journal of General Medicine, 5, 117-121.
31. Williams, J.H. (2020). Emergency department overcrowding and the impact on decision-making. Emergency Medicine International, 2020, Article ID 569712.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Hussain Mosfer Salem Al Zamanan
Ministry of Health, Saudi Arabia
Muhanna Yahya Muhammad Al-Yami
Ministry of Health, Saudi Arabia
Rasid Muhammad Saleh Al Dowais
Ministry of Health, Saudi Arabia
Mohammed Ali Mana Al Haydar
Ministry of Health, Saudi Arabia
Nizar Saleh Abdullah Al Hokash
Ministry of Health, Saudi Arabia
Hamad Merzah Alabbas
Ministry of Health, Saudi Arabia