Ramaswamy T, Sparling JL, Chang MG, Bittner EA. Ten misconceptions regarding decision-making in critical care. World J Crit Care Med 2024; 13(2): 89644 [PMID: 38855268 DOI: 10.5492/wjccm.v13.i2.89644]
Corresponding Author of This Article
Edward A Bittner, MD, PhD, Associate Professor, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States. ebittner@mgh.harvard.edu
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Jun 9, 2024; 13(2): 89644 Published online Jun 9, 2024. doi: 10.5492/wjccm.v13.i2.89644
Ten misconceptions regarding decision-making in critical care
Tara Ramaswamy, Jamie L Sparling, Marvin G Chang, Edward A Bittner
Tara Ramaswamy, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States
Jamie L Sparling, Marvin G Chang, Edward A Bittner, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
Author contributions: Bittner EA conceptualized and drafted the initial version of the manuscript; Ramaswamy T, Sparling JL, and Chang MG reviewed and substantially revised the manuscript; All authors accepted the final version of the manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Edward A Bittner, MD, PhD, Associate Professor, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States. ebittner@mgh.harvard.edu
Received: November 7, 2023 Revised: January 25, 2024 Accepted: March 1, 2024 Published online: June 9, 2024 Processing time: 208 Days and 11.1 Hours
Abstract
Diagnostic errors are prevalent in critical care practice and are associated with patient harm and costs for providers and the healthcare system. Patient complexity, illness severity, and the urgency in initiating proper treatment all contribute to decision-making errors. Clinician-related factors such as fatigue, cognitive overload, and inexperience further interfere with effective decision-making. Cognitive science has provided insight into the clinical decision-making process that can be used to reduce error. This evidence-based review discusses ten common misconceptions regarding critical care decision-making. By understanding how practitioners make clinical decisions and examining how errors occur, strategies may be developed and implemented to decrease errors in Decision-making and improve patient outcomes.
Core Tip: Diagnostic errors are prevalent in critical care practice and associated with patient harm. Cognitive science has provided insight into the clinical decision-making process. By understanding how practitioners make clinical decisions and examining how errors occur, strategies may be developed and implemented to decrease errors in decision making and improve patient outcomes.
