Decisions about critical events in device-related scenarios as a function of expertise. Academic Article uri icon

Overview

abstract

  • This paper presents the perspectives of personnel involved in decision-making about devices in critical care. We use the concept of "sharp and blunt ends" of practice to describe the performance of health care professionals. The "sharp end" is physically and temporally close to the system; the "blunt end" is removed from the system in time and space and yet affects the system through indirect influence on the sharp end. In this study, the sharp end is represented by the clinicians (nurses and doctors) and the blunt end by the administrators and biomedical engineers. These subjects represent the professionals involved in the decision-making process for purchasing biomedical equipment for the hospital. They were asked to "think aloud" while evaluating three error scenarios based on real events. The responses were recorded and transcribed for analysis. The results show differences in interpretation of critical events as a function of professional expertise. The clinicians (sharp-end practitioners) focused on clinical and human aspect of errors while the biomedical engineers focused on device-related errors. The administrators focused on documentation and training. These different interpretations mean that the problems are represented differently by these groups of subjects, and these representations result in variable decisions about devices. These results are discussed within a systems approach framework to help us assess the completeness of the problem representations of the subjects, their awareness of critical events, and how these events would collectively contribute to the occurrence of error.

publication date

  • December 9, 2004

Research

keywords

  • Decision Making
  • Decision Support Techniques
  • Equipment and Supplies
  • Professional Competence
  • Purchasing, Hospital
  • Task Performance and Analysis
  • Technology Assessment, Biomedical

Identity

Scopus Document Identifier

  • 19444382971

Digital Object Identifier (DOI)

  • 10.1016/j.jbi.2004.11.012

PubMed ID

  • 15896693

Additional Document Info

volume

  • 38

issue

  • 3