Healthcare Professionals' Decision Making in Emergency Units: An Operation Impact Analysis Considering Their Cognitive Heuristics

Healthcare Professionals' Decision Making in Emergency Units: An Operation Impact Analysis Considering Their Cognitive Heuristics

Ana Carolina Pereira de Vasconcelos Silva (Rio de Janeiro State University, Brazil), Thais Spiegel (Rio de Janeiro State University, Brazil) and Daniel Bouzon Nagem Assad (Rio de Janeiro State University, Brazil)
DOI: 10.4018/978-1-5225-3725-0.ch009

Abstract

Cognitive theories on decision making show that individuals often do not decide in a full and rational way; they instead use cognitive strategies that allow them to overcome the limitations imposed by their limited rationality and the difficulties derived from uncertainty. In this context, this chapter aims to analyze the impact on operations caused by decisions taken by healthcare professionals in an emergency department when influenced by heuristics. Therefore, a systematic review of the literature for extracting the heuristics of healthcare professionals and a non-systematic review for constructing the theoretical framework about operations management, health operations management, hospital organizations, and heuristics were performed. Thus, having also described the object of study, the analytical model could be built. Then, three approaches were proposed for the synthesis, and deployment proposals were exposed for each.
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Background

The public health system is characterized in Brazil by the SUS (Unic Health System), which is based on the 1988 Constitution and the Organic Health Law (8,080 / 1990). According to article 197, health actions and services are of public relevance, and it is a Government responsibility to provide, under the terms of the law, its regulation, supervision and control. In this way, the SUS is based on the health context as a right of everyone and the duty of the State,

ensuring political and economic measures aimed at reducing the risk of disease and other diseases and universal and equal access to actions and services for its promotion, protection and recovery(article 196 of the 1988 Constitution).

Key Terms in this Chapter

Healthcare Professionals: Professionals responsible for healthcare and whose decisions impact all of the organization. We can cite medical directors, trauma surgeons, residents, nurses, nursing technicians, pharmacists, social assistants, among others.

Red Priority: Extremely severe cases; patients requiring immediate medical care.

Healthcare Operations Management: The decisions and actions that occur within the limits defined by the operating system design. These include activities such as the implementation of policies, procedures and strategies, contingent decision making, process coordination, problem identification and resolution, response to uncertainty and unforeseen problems, and rewarding people.

Emergency Unit: The structure that aims to solve most of the emergencies (intermediate severity injuries), such as high blood pressure and fever, fractures, cuts, heart attack, and stroke. They help to reduce queues in the hospital's emergency department.

Patient Process/Flow: Variety of path patterns that result in patient care.

Cognitive Heuristics: Cognitive strategies that can provide good solutions to complex problems under time and cognitive ability constraints.

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