Making decisions and the medical mistake: Approach in the situations of crisis

Abstract:

This article presents an overview of the literature concerning the medical decision-making process when medical personnel are performing under pressure, specifically in response to crisis situations. Studies were analysed between 1.985-2.015, to understand the compound ori-gins of medical errors, when people and systems are performing under pressure. A six-stage thematic analysis framework was used. How the work pressure affects the performance of health professionals and clinical outcomes of the pa-tient? A literature search was performed using a Summons search service platform; the search criteria included a variety of approaches, 89 studies were considered in this review. Six themes emerged in this narrative review using thematic analysis: organisational systems, work-load, time pressure, teamwork, individual human factors, and case complexity. This study un-derlined the importance of clinical outcomes in crisis situations, as well as a variety of interre-lated factors. The interactions between these factors at different levels of the decision-making process can intensify the complexity of situations and the decisions to be made. Medical errors must be considered from the “whole-system” perspective, and not as the sole respon-sibility of individuals. The challenge for re-searchers is to construct a body of knowledge regarding patient safety, especially under pressure in changing situations of high uncertainty in response to crisis and emergency situations, for which it is necessary to identify the limita-tions and dynamics of the interactions that may affect results of medical decisions.

Año de publicación:

2018

Keywords:

• Decision-making
• UNCERTAINTY
• pressure
• Patient Safety
• emergency department

Fuente:

scopus