TY - JOUR
T1 - Unmasking expert decisions
T2 - Clinicians decision making during a pandemic outbreak
AU - Bitan, Yuval
AU - Lilach-Gueta, Sagit
AU - Parush, Avi
N1 - Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Decision making is based on information, but in the early days of the COVID-19 pandemic, information was scarce, while healthcare organizations and individual caregivers were pressured to make decisions about working protocols and clinical procedures. This study examined decision-making of individual clinicians that were involved in clinical and operational decisions during the early days of the pandemic. The study followed the critical decision method, and the cognitive interview was administered to 10 healthcare professionals from three countries. The interviews were analysed with an inductive analysis, followed by a theoretical thematic analysis. The inductive themes included the key themes of missing information, information flood, collaboration, collective responsibility, new working procedures, organizational preparedness, over-reactions, operations, dynamic decision making, and personal experience. The theoretical themes that fit natural decision-making models included relevant clinical cues, plausible treatment goals, expectations, actions, and intuition. Additional themes were identified, including operational challenges, evolving goals, ad-hoc actions, and resilience in operational decisions, suggesting that some decisions were unprimed, presenting a new conceptual model. Theoretically, the study suggests that experts can face situations that require them to make decisions that are within their field of operation (within context) and yet ‘out of expertise’, and those decisions may be unprimed.
AB - Decision making is based on information, but in the early days of the COVID-19 pandemic, information was scarce, while healthcare organizations and individual caregivers were pressured to make decisions about working protocols and clinical procedures. This study examined decision-making of individual clinicians that were involved in clinical and operational decisions during the early days of the pandemic. The study followed the critical decision method, and the cognitive interview was administered to 10 healthcare professionals from three countries. The interviews were analysed with an inductive analysis, followed by a theoretical thematic analysis. The inductive themes included the key themes of missing information, information flood, collaboration, collective responsibility, new working procedures, organizational preparedness, over-reactions, operations, dynamic decision making, and personal experience. The theoretical themes that fit natural decision-making models included relevant clinical cues, plausible treatment goals, expectations, actions, and intuition. Additional themes were identified, including operational challenges, evolving goals, ad-hoc actions, and resilience in operational decisions, suggesting that some decisions were unprimed, presenting a new conceptual model. Theoretically, the study suggests that experts can face situations that require them to make decisions that are within their field of operation (within context) and yet ‘out of expertise’, and those decisions may be unprimed.
KW - COVID-19
KW - Naturalistic decision making
KW - out of expertise
KW - recognition-primed decision making
KW - thematic analysis
UR - http://www.scopus.com/inward/record.url?scp=85134217673&partnerID=8YFLogxK
U2 - 10.1080/20479700.2022.2097763
DO - 10.1080/20479700.2022.2097763
M3 - Article
AN - SCOPUS:85134217673
JO - International Journal of Healthcare Management
JF - International Journal of Healthcare Management
SN - 2047-9700
ER -