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Managing inconsistencies in medical decision-making: an eight-fold typology
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE). Department of Industrial Economics and Management, Blekinge Institute of Technology, Sweden.
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Business Administration. School of Engineering, Jönköping University, Sweden.ORCID iD: 0000-0002-2495-9676
2024 (English)In: European Management Journal, ISSN 0263-2373, E-ISSN 1873-5681, Vol. 42, no 1, p. 130-141Article in journal (Refereed) Published
Abstract [en]

This paper serves to deepen the understanding of how inconsistencies between feeling, thinking, and doing are managed by decision-makers in emergency settings. We use a practice approach and investigate the emergency physicians in an Emergency Department (ED), by means of 200 h of observations, 12 in-depth interviews, and organizational documentation. Data are analyzed using an abductive template-based approach. The configuration of three different decision-making modes, namely an experiential-based mode, an ostensive-based mode, and an action-based mode, provide an eight-fold typology of emergency physicians' decision-making praxis. "Weak" signals are the starting point for clinical assessment, and inconsistencies among the modes are strategically used and surprisingly often associated with positive treatment outcomes. The praxis perspective used in this article bridges literature on choice and interpretation—processes usually separated in organizational and decision-making literature. Inconsistency between the modes allow physicians to create an action space where decision-making is about more than providing the "right" answer. Making use of the eight-fold typology helps physicians identify "blind spots" improve practice in both mundane and medically rare cases, as well as aid in revision of existing routines. This awareness also provides for high-quality care, an increased acceptance of inconsistencies by the public, with a potential to reduce litigation issues.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 42, no 1, p. 130-141
National Category
Business Administration
Research subject
Business Studies
Identifiers
URN: urn:nbn:se:umu:diva-200567DOI: 10.1016/j.emj.2022.09.008ISI: 001205850300001Scopus ID: 2-s2.0-85139649299OAI: oai:DiVA.org:umu-200567DiVA, id: diva2:1707362
Funder
Ragnar Söderbergs stiftelse, E54/11Available from: 2022-10-31 Created: 2022-10-31 Last updated: 2024-06-28Bibliographically approved

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Svensson, MartinJacobsson, Mattias

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