scholarly journals Management of burnout among the staff of primary care centres in Spain during the pandemic caused by the SARS-CoV-2

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Isaac Aranda-Reneo ◽  
Azucena Pedraz-Marcos ◽  
Montserrat Pulido-Fuentes
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Descriptive Analysis ◽  
Healthcare Management ◽  
Decision Makers ◽  
Medical Decision ◽  
Lower Probability ◽  
Specific Training ◽  
Decision Making Processes ◽  
Clinical Subtype

Abstract Background The provision of healthcare during the pandemic caused by the SARS-CoV-2 virus represented a challenge for the management of the resources in the primary care centres. We proposed assessing burnout among the staff of those centres and identifying factors that contributed to its appearance and those that limited it. Methods An observational study which, by means of anonymous questionnaires, collected information about: (i) demographic variables; (ii) the characteristics of each position; (iii) the measures implemented by the medical decision-makers in order to provide care during the pandemic; and (iv) the Burnout Clinical Subtype Questionnaire (BCSQ-36). We performed a descriptive analysis of the burnout mentioned by the staff, and, by means of a multivariate analysis, we identified the factors which influenced it. Using logit models, we analysed whether receiving specific training in COVID-19, feeling involved in decision-making processes, and/or working within different healthcare systems had effects on the development of burnout. Results We analysed the replies of 252 employees of primary care centres in Spain with an average age of 45 (SD = 15.7) and 22 (SD = 11.4) years of experience. 68% of the participants (n = 173) indicated burnout of the frenetic subtype. 79% (n = 200) of the employees had high scores in at least one burnout subtype, and 62% (n = 156) in at least two. Women older than 45 had a lower probability of suffering burnout. Receiving specific training (OR = 0.28; CI95%: 0.11–0.73) and feeling involved in decision-making (OR = 0.32; CI95%:0.15–0.70) each reduced the probability of developing burnout. Working in a different department increased the likelihood of developing burnout of at least one clinical subtype (OR = 2.85; CI95%: 1.38–5.86). Conclusions The staff in primary care centres have developed high levels of burnout. Participation in decision-making and receiving specific training are revealed as factors that protect against the development of burnout. The measures taken to contain the adverse effects of a heavy workload appear to be insufficient. Certain factors that were not observed, but which are related to decisions taken by the healthcare management, appear to have had an effect on the development of some burnout subtypes.

Decision-Making Processes of Patients Who Use the Emergency Department for Primary Care Needs

2013 ◽  
Vol 24 (3) ◽  
pp. 1288-1305 ◽  
Author(s):  
Eric K. Shaw ◽  
Jenna Howard ◽  
Elizabeth C. Clark ◽  
Rebecca S. Etz ◽  
Rajiv Arya ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Emergency Department ◽  
Care Needs ◽  
Decision Making Processes

Errors in Surgical Neuropathology and the Influence of Cognitive Biases: The Psychology of Intelligence Analysis

2006 ◽  
Vol 130 (5) ◽  
pp. 613-616 ◽  
Author(s):  
Roger E. McLendon
Keyword(s):  
Decision Making ◽  
Cognitive Psychology ◽  
Medical Decision Making ◽  
Cognitive Biases ◽  
Correct Diagnosis ◽  
Data Sources ◽  
Medical Decision ◽  
Intelligence Analysis ◽  
First Impression ◽  
Decision Making Processes

Abstract Context.—A significant difficulty that pathologists encounter in arriving at a correct diagnosis is related to the way information from various sources is processed and assimilated in context. Objective.—These issues are addressed by the science of cognitive psychology. Although cognitive biases are the focus of a number of studies on medical decision making, few if any focus on the visual sciences. Data Sources.—A recent publication authored by Richards Heuer, Jr, The Psychology of Intelligence Analysis, directly addresses many of the cognitive biases faced by neuropathologists and anatomic pathologists in general. These biases include visual anticipation, first impression, and established mindsets and subconsciously influence our critical decision-making processes. Conclusions.—The book points out that while biases are an inherent property of cognition, the influence of such biases can be recognized and the effects blunted.

Framing Information Technology Governance in the Public Sector: Opportunities and Challenges

2015 ◽  
Vol 11 (4) ◽  
pp. 89-101 ◽  
Author(s):  
Khalifa Al-Farsi ◽  
Ramzi EL Haddadeh
Keyword(s):  
Decision Making ◽  
Information Technology ◽  
Public Sector ◽  
It Governance ◽  
Decision Makers ◽  
The Public ◽  
Technology Governance ◽  
Support Organizations ◽  
Information Technology Governance ◽  
Decision Making Processes

Information technology governance is considered one of the innovative practices that can provide support for decision-makers. Interestingly, it has become increasingly a de facto for organizations in seeking to optimise their performance. In principle, information technology governance has emerged to support organizations in the integration of information technology (IT) infrastructures and the delivery of high-quality services. On the other hand, decision-making processes in public sector organisations can be multi-faceted and complex, and decision makers play an important role in implementing technology in the public sector. The aim of this paper is to shed some light on current opportunities and challenges that IT governance is experiencing in the context of public sector services. In this respect, this paper examines the factors influencing the decision-making process to fully appreciate IT governance. Furthermore, this study focuses on combining institutional and individual perspectives to explain how individuals can take decisions in response to institutional influences.

Augmenting Medical Diagnosis Decisions? An Investigation into Physicians’ Decision-Making Process with Artificial Intelligence

2021 ◽  
Author(s):  
Ekaterina Jussupow ◽  
Kai Spohrer ◽  
Armin Heinzl ◽  
Joshua Gawlitza
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Medical Errors ◽  
Decision Makers ◽  
Medical Decision ◽  
Decision Making Process ◽  
Self Monitoring ◽  
Rule Based ◽  
Human Actors

Systems based on artificial intelligence (AI) increasingly support physicians in diagnostic decisions, but they are not without errors and biases. Failure to detect those may result in wrong diagnoses and medical errors. Compared with rule-based systems, however, these systems are less transparent and their errors less predictable. Thus, it is difficult, yet critical, for physicians to carefully evaluate AI advice. This study uncovers the cognitive challenges that medical decision makers face when they receive potentially incorrect advice from AI-based diagnosis systems and must decide whether to follow or reject it. In experiments with 68 novice and 12 experienced physicians, novice physicians with and without clinical experience as well as experienced radiologists made more inaccurate diagnosis decisions when provided with incorrect AI advice than without advice at all. We elicit five decision-making patterns and show that wrong diagnostic decisions often result from shortcomings in utilizing metacognitions related to decision makers’ own reasoning (self-monitoring) and metacognitions related to the AI-based system (system monitoring). As a result, physicians fall for decisions based on beliefs rather than actual data or engage in unsuitably superficial evaluation of the AI advice. Our study has implications for the training of physicians and spotlights the crucial role of human actors in compensating for AI errors.

Activity-Based Methodology for Development and Analysis of Integrated DoD Architectures

2007 ◽  
pp. 85-113 ◽  
Author(s):  
S. Ring
Keyword(s):  
Decision Making ◽  
Decision Makers ◽  
Process Models ◽  
Fully Integrated ◽  
The Core ◽  
Analysis Strategies ◽  
Decision Making Processes ◽  
Integrated Architecture ◽  
Architecture Development ◽  
Support Decision Making

This chapter describes the activity-based methodology (ABM), an efficient and effective approach to-ward development and analysis of DoD integrated architectures that will enable them to align with and fully support decision-making processes and mission outcomes. ABM consists of a tool-independent disciplined approach to developing fully integrated, unambiguous, and consistent DODAF Operational, System, and Technical views in supporting both “as-is” architectures (where all current elements are known) and “to-be” architectures (where not all future elements are known). ABM enables architects to concentrate on the Art and Science of architectures—that is identifying core architecture elements, their views, how they are related together, and the resulting analysis used for decision-making purposes. ABM delivers significant architecture development productivity and quality gains by generating several DoDAF products and their elements from the core architecture elements. ABM facilitates the transition from integrated “static” architectures to executable “dynamic” process models for time-dependent assessments of complex operations and resource usage. Workflow steps for creating integrated architecture are detailed. Numerous architecture analysis strategies are presented that show the value of integrated architectures to decision makers and mission outcomes.

scholarly journals The Influence of Core Self-Evaluations on Group Decision Making Processes: A Laboratory Experiment

2020 ◽  
Vol 10 (2) ◽  
pp. 29 ◽  
Author(s):  
Matteo Cristofaro ◽  
Pier Luigi Giardino ◽  
Luna Leoni
Keyword(s):  
Decision Making ◽  
Research Question ◽  
Decision Makers ◽  
Simulation Game ◽  
Manufacturing Firm ◽  
Decision Making Processes ◽  
Team Decision ◽  
High Level ◽  
Overconfidence Bias ◽  
Core Self

The personal trait called Core Self-Evaluations (CSE) has been receiving increasing attention from behavioral strategy scholars due to its ability to predict job performance and to explain some facets of decision-making processes. However, despite previous studies hypothesizing that managers with high values of CSE are intuitive thinkers, beyond any doubt of their capacities and that they significantly lead to positive results for their organization, no one has empirically investigated these assumptions. This gap can be substantiated by the following research question: “How do high Core Self-Evaluations influence team decision-making processes?”. Answering it provides insights on how the evaluations that decision makers make about situations (and the consequent actions that are implemented) highly depend on decision makers’ inner traits and their effect on cognition. To fill this gap, 120 graduate students—divided into groups of four—took part in a simulation game and were asked to make decisions acting the role of General Manager of a small-sized manufacturing firm. Tests aimed at identifying the CSE and intuitive/reflecting thinking approach of participants were administered; moreover, the performance resulting from their decision-making processes and their estimation of reached results were collected. Results show that an average level of CSE is preferable to balance intuitive and reflective thinking, as well as avoiding overconfidence bias and reaching the best performance possible. This work suggests that there is a huge misattribution in considering a high level of CSE as being beneficial for decision-making processes and consequent performance.

The views and perceptions of managers on the role of marketing research in decision making

2018 ◽  
Vol 60 (1) ◽  
pp. 67-87 ◽  
Author(s):  
Piotr Tarka
Keyword(s):  
Decision Making ◽  
Marketing Research ◽  
Decision Makers ◽  
Irrational Thinking ◽  
Analytical Thinking ◽  
Making Choices ◽  
Decision Making Processes ◽  
Specific Factors ◽  
Views And Perceptions

In this article, the author conducts an empirical diagnosis of managers’ views and perceptions in the context of use of information obtained from marketing research in decision-making processes. It is argued that decision makers who take charge of management, despite their strong declarations and beliefs about the potential and usefulness of information in decisions, in reality prefer solutions based on intuition and irrational thinking. Therefore, the objective of the conducted study is to explore mechanisms of such paradoxes. However, through empirical research, the author endeavored to find the answers associated with the specific factors that are likely to favor such an unreasonable thinking and activities undertaken by managers in decision-making processes. Based on the sample ( N = 213), which contained mainly information users, it was confirmed that managers, faced with a difficulty of information processing (e.g., due to information overloading problems and requirements of analytical thinking), or narrow cognitive capacities, limited memory, and strong reliance on personal experience, look for much simpler solutions in decision making. They preferably move toward the irrational sphere of making choices. Thus, the information, obtained from research, that is available to managers is rather neglected instead of being closely inspected (scrutinized). Moreover, the greater the surprise in information derived from marketing research (i.e., the wider is the discrepancy between the value of information provided by analysts and managers’ expectations), the greater their inclination to reject any information and much greater exposure toward irrational thinking in decision making. As a matter of fact, the problems associated with information adaptation in decisions, as well as the problems of analytical thinking, put the question mark over the entire usefulness of information and further deliberate conducting of the marketing research.

scholarly journals Orthogonal strategy based computer-mediated negotiation: Principles and example

2018 ◽  
Vol 46 (6) ◽  
pp. 1036-1060
Author(s):  
Cahyono Susetyo ◽  
Harry Timmermans ◽  
Bauke de Vries
Keyword(s):  
Decision Making ◽  
Computer System ◽  
Indifference Curve ◽  
Decision Makers ◽  
Second Phase ◽  
Face Negotiation ◽  
Computer Mediated ◽  
Decision Making Processes ◽  
Multi Stakeholder ◽  
Optimum Solution

Previous efforts to improve stakeholders’ involvement in planning and decision-making processes mostly put planners and decision makers as the ones who decide which solution is the best for the decision problems. In bottom-up planning and decision-making processes that supposedly involve stakeholders as much as possible, the most common practice is that when stakeholders have different preferences about the decision issues, supra decision makers such as planners and experts gather stakeholders’ preferences, and then, using their expertise and experience, decide what is the best choice for stakeholders. We approach the involvement of stakeholders in planning and decision-making not by relying on planners’ expertise but from a negotiation perspective. Previous works related to stakeholders’ negotiation mostly require stakeholders to engage in a face-to-face negotiation that seldom involves a computer system to improve the process. In this paper, we develop a negotiation system to support multi-issue and multi-stakeholder decision-making problems. In our approach, stakeholders do not directly interact with each other. Their proposals are submitted to a system that produces counter-proposals to reduce the differences among stakeholders’ proposals. Therefore, stakeholders do not exchange their preferences directly, but rather preference elicitations are mediated by the system. This approach is called computer-mediated negotiation. The system itself is based on the principle of an orthogonal strategy. Our computer-mediated negotiation protocol consists of two main phases. The first phase is the preference elicitation phase, which measures stakeholders’ utility functions. The second phase is the e-negotiation phase, in which stakeholders make their proposals and the computer system provides suggestions to improve them. To simulate real-world negotiations where stakeholders make proposals and counter-proposals in a series of negotiation rounds, we implemented the indifference curve approach to enable stakeholders to make incremental changes of their proposals during negotiation. The results from our experiment suggest that our method can produce an optimum solution for a multi-issue and multi-stakeholder decision problem by moving stakeholders’ proposals closer to one another.

scholarly journals P140: Emergency department decision-making for incapacitated and unrepresented patients: a comprehensive review of the literature

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S124-S125
Author(s):  
J.L. Willinsky ◽  
I. Hyun
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Medical Decision Making ◽  
Hospital Setting ◽  
Ethics Committees ◽  
Medical Decision ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Patient Cohort ◽  
Decision Making Processes

Introduction: Incapacitated patients who lack substitute decision-makers (SDM) are commonly encountered in the emergency department (ED). The number of these patients will rise dramatically as the Baby Boomers age. We can expect an influx of elderly patients who lack decisional capacity due to dementia and other illnesses, and who present without family. It is estimated that 3 to 4 percent of U.S. nursing home residents have no SDM or advance directives. Medical decision-making for this cohort poses an ethical challenge, particularly in the ED setting. Methods: A comprehensive review of the literature was conducted surrounding decision-making for incapacitated and unrepresented patients in the hospital setting. Articles were identified using MEDLINE (1946-October 2015) and Embase (1974-October 2015). The reference lists of relevant articles were hand searched. Articles describing decision-making processes that have been proposed, tested or applied in practice were chosen for full review. The aim of this review was to outline recognized medical decision-making processes for incapacitated and unrepresented patients, and to identify areas for future research. Results: The search yielded 20 articles addressing decision-making for incapacitated and unrepresented patients in the hospital setting. All of these articles focus on the intensive care unit and other hospital wards; no literature on the ED setting was found. Five types of formal consulting bodies exist to assist physicians in applying the best interest standard for this patient cohort: internal hospital ethics committees, external ethics committees, public guardians, court-appointed guardians, or judges. The majority of decisions for these patients, however, are made informally by a single physician or by a healthcare team, although it is well recognized that this approach lacks appropriate safeguards. There is no consensus surrounding the optimal approach to decision-making in these cases, and as such there is significant inconsistency in how medical decisions are made for these patients. Conclusion: There are several articles describing decision-making processes for incapacitated and unrepresented patients, none of which focus on the ED. These processes are not practical for use in the ED. Further inquiry is needed into the most ethical and respectful method of decision-making for this patient cohort in the ED.

Developing Management Systems for Statewide Transportation Planning: Early Lessons

1996 ◽  
Vol 1552 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Steven J. Kish ◽  
Michael D. Meyer
Keyword(s):  
Decision Making ◽  
Public Transportation ◽  
Implementation Strategy ◽  
Information Needs ◽  
Decision Makers ◽  
Management Systems ◽  
Department Of Transportation ◽  
Transportation Management ◽  
Organizational Planning ◽  
Decision Making Processes

The implementation of two management systems, the intermodal and public transportation management systems, in the Georgia Department of Transportation is examined. Early experience with this implementation suggests that key elements of an implementation strategy are characteristic of success in such an organizational environment. These include establishing organizational responsibilities, establishing guidance principles, assessing the organizational planning and decision-making processes, assessing the environmental context for the management system, establishing an implementation strategy that has tangible intermediate results, and identifying an agency “champion” for implementation. The challenge of implementing management systems within any organization is understanding the decision-making process and the information needs of the agency decision makers.

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