Clinical Decision Making Flashcards
Define error
The failure of a planned action to be completed as intended (i.e., error of execution) or the use of a wrong plan to achieve an aim (i.e., error of planning).
How many deaths have medication errors contributed to and what would it cost the NHS
12,000 deaths per year in the NHS
0.75billion-1.5 billion
What are the causes of medical errors
Both system-related and cognitive factors
Cognitive error only
System-related error only
No-fault factors only
What are heuristics
Cognitive processes
Rules of thumb, educated guesses, or mental shortcuts
Describe the hot system of decision making
Emotional Go Simple Reflexive Fast Develops early Accentuated by stress Stimulus control
Describe the cold system of decision making
Cognitive Know Complex Reflective Slow Develops late Attenuated by stress Self control
What is confirmatory bias
The tendency to search for or seek, interpret and recall information in a way that confirms one’s pre-existing beliefs or hypotheses often leading to errors
What are sunk costs
Any costs that have been spent on a project that are irretrievable
What is the sunk cost fallacy
The more we have invested in the past the more we are prepared to invest in a problem in the future
What is anchoring
Individuals are poor at adjusting estimates from a given starting point
Adjustments are crude and imprecise and anchored by a starting point
What is representative heuristics
Subjective probability that a stimulus belongs to a particular class based on how ‘typical’ of that class it appears to be (regardless of base rate probability)
What are the effects of framing in adults
When presented with treatment descriptions described in positive, negative, or neutral terms, older adults are significantly more likely to agree to a treatment when it is positively described
Describe the availability heuristic
Probabilities are estimated on the basis of how easily and/or vividly they can be called to mind
People tend to heavily weigh their judgments toward more recent information
How can decision making be improved
Education and training Feedback Accountability Generating alternatives Consultation
What is an algorithm
A procedure which, if followed exactly, will provide the most likely answer based on the evidence
Algorithms are most useful in situations where the problem is well defined
