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Impossible decision? An investigation of risk trade-offs in the intensive care unit

Reader, Tom W. (2018) Impossible decision? An investigation of risk trade-offs in the intensive care unit. Ergonomics. pp. 1-12. ISSN 0014-0139

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Identification Number: 10.1080/00140139.2017.1301573


In the intensive care unit (ICU), clinicians must often make risk trade-offs on patient care. For example, on deciding whether to discharge a patient before they have fully recovered in order to create a bed for another, sicker, patient. When misjudged, these decisions can negatively influence patient outcomes: yet it can be difficult, if not impossible, for clinicians to evaluate with certainty the safest course of action. Using a vignette-based interview methodology, a naturalistic decision-making approach was utilised to study this phenomena. The decision preferences of ICU clinicians (n=24) for two common risk trade-off scenarios were investigated. Qualitative analysis revealed the sample of clinicians to reach different, and sometimes oppositional, decision preferences. These practice variations emerged from differing analyses of risk, how decisions were ‘framed’ (e.g. philosophies on care), past experiences, and perceptions of group and organisational norms. Implications for patient safety and clinical decision-making are discussed.

Item Type: Article
Official URL:
Additional Information: © 2017 Informa UK Limited
Divisions: Psychological and Behavioural Science
Subjects: H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > R Medicine (General)
Date Deposited: 28 Feb 2017 11:30
Last Modified: 16 May 2024 02:30

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